Author Affiliations: Ribeirão Preto College of Nursing (Drs Garbin and Carvalho) and Hospital das Clínicas, Faculty of Medicine (Dr Simões and Ms Curcioli), University of São Paulo, Ribeirão Preto, Brazil.
Cancer Nurs. 2018 Jul/Aug;41(4):E55-E61. doi: 10.1097/NCC.0000000000000544.
There are controversies regarding the best way to collect blood samples for cyclosporine A (CsA) serum levels when this immunosuppressant is administered continuously through a silicone central venous catheter (CVC) to hematopoietic stem cell transplant recipients.
The aim of this study was to verify the effect of the time elapsed between the interruption of a continuous intravenous CsA infusion and the collection of blood samples on CsA serum levels.
This randomized 2-group clinical trial involved 32 adults. In group A, blood samples were collected immediately after interrupting the medication from peripheral vein and CVC lines. In group B, the same procedures were performed 5 minutes after interrupting the infusion.
We did not observe influence of the time elapsed between interruption of the infusion and collection of the samples, independent of the collection mode and the volume discarded (P > .05). The line used for the infusion maintained a constant high level when compared with different moments of collection (P > .05), whereas in the other lines, there was a significant increase when compared with the levels obtained at 24 hours and 7 days after CsA start (P = .00).
The CVC line free from cyclosporine can safely be used to collect blood. The procedure can be performed immediately after interrupting the infusion, and discarding 5 mL is sufficient to obtain accurate levels.
The results can help nurses choose how to collect blood samples through the CVC, thus preventing patients from having a painful and stressful procedure such as peripheral venipuncture.
当免疫抑制剂环孢素 A（CsA）通过硅胶中心静脉导管（CVC）持续给药给造血干细胞移植受者时，关于采集 CsA 血清水平血样的最佳方法存在争议。
本研究旨在验证在中断连续静脉 CsA 输注与采集血样之间的时间间隔对 CsA 血清水平的影响。
这是一项随机 2 组临床试验，涉及 32 名成年人。在 A 组中，在从外周静脉和 CVC 线中断药物后立即采集血样。在 B 组中，在中断输注后 5 分钟进行相同的操作。
我们没有观察到中断输注和采集样本之间的时间间隔的影响，与采集模式和丢弃的体积无关（P＞.05）。与不同采集时刻相比，输注线保持恒定的高水平（P＞.05），而在其他线路中，与 CsA 开始后 24 小时和 7 天获得的水平相比，有显著升高（P＝.00）。
可以安全地使用无环孢素的 CVC 线采集血样。可以在中断输注后立即进行操作，丢弃 5 mL 即可获得准确的水平。
结果可以帮助护士选择如何通过 CVC 采集血样，从而避免患者进行外周静脉穿刺等痛苦和有压力的操作。
