Docherty Toni, Montalto Michael, Leslie Joni, King Katrina, Niblett Suzanne, Garrett Tim
Department of Pharmacy, Central Coast Local Health District, Gosford Hospital, New South Wales, Australia.
Hospital in the Home, Royal Melbourne Hospital, Victoria, Australia.
Am J Health Syst Pharm. 2017 Jul 1;74(13):992-1001. doi: 10.2146/ajhp151071.
The temperature profiles of antibiotic-containing elastomeric infusion devices used by ambulatory care patients under various environmental conditions were evaluated.
A prospective, descriptive survey of temperature exposure was conducted in 4 publically funded hospitals. Over a 12-month period, electronic temperature-recording devices were attached to the antibiotic infusion devices (infusers) of prospectively randomized hospital-in-the-home (HITH) participants. Temperatures were recorded immediately after infuser connection and every 5 minutes thereafter for 24 hours. A structured data collection form was used to collect information on basic clinical and demographic characteristics and aspects of daily living (i.e., how and where the infuser was carried during the day, times the participant went to and arose from bed, location of the infuser while sleeping, and dates and times the infuser was connected and disconnected).
A total of 115 patients successfully completed the study (17-91 years old, 55% males). A total of 31,298 temperature readings were collected. The storage location of the infuser did not influence daytime readings. However, the overnight storage location did have a significant impact on the temperatures recorded overnight. The mean temperatures of infusers stored on the bed or on the body overnight were significantly higher than those for infusers stored away from the bed. Diurnal and seasonal influences were also detected. Significantly warmer temperatures were recorded in afternoons and evenings and during the summer months.
Antibiotics administered to HITH patients via continuous infusion were frequently exposed to temperatures in excess of 25 °C. Specific patient behaviors and seasonal and chronological factors influenced temperatures. The findings challenge the validity of current fixed-temperature models for testing stability, which do not reflect conditions found in clinical practice.
评估门诊患者在各种环境条件下使用的含抗生素弹性输液装置的温度分布情况。
在4家公立医院进行了一项关于温度暴露的前瞻性描述性调查。在12个月的时间里,将电子温度记录装置连接到前瞻性随机分组的居家医院(HITH)参与者的抗生素输液装置(输液器)上。在连接输液器后立即记录温度,此后每5分钟记录一次,持续24小时。使用结构化数据收集表收集有关基本临床和人口统计学特征以及日常生活方面的信息(即白天输液器的携带方式和地点、参与者上床睡觉和起床的时间、睡觉时输液器的位置以及输液器连接和断开的日期和时间)。
共有115名患者成功完成研究(年龄17 - 91岁,55%为男性)。共收集到31298个温度读数。输液器的存放位置不影响白天的读数。然而,过夜存放位置对夜间记录的温度有显著影响。夜间存放在床上或身体上的输液器的平均温度显著高于存放在离床较远位置的输液器。还检测到了昼夜和季节影响。下午、晚上以及夏季月份记录的温度明显更高。
通过持续输液给予HITH患者的抗生素经常暴露于超过25°C的温度下。特定的患者行为以及季节和时间因素会影响温度。这些发现对当前用于测试稳定性的固定温度模型的有效性提出了挑战,因为这些模型没有反映临床实践中发现的情况。