Brørs Gunhild, Gjeilo Kari Hanne, Lund Tonje, Skevik Karin, Aa Elizabeth, Høvik Lise Husby, Skarsvaag Torhild, Mjølstad Ole Christian
Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030 Trondheim, Norway.
Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030 Trondheim, Norway.
Eur J Cardiovasc Nurs. 2023 Dec 14;22(8):824-831. doi: 10.1093/eurjcn/zvad003.
Intravenous amiodarone is an irritant of peripheral blood vessels with phlebitis as an adverse effect. The aims were to determine the incidence of intravenous amiodarone-induced phlebitis, to describe adherence to a clinical practice guideline, and to determine how characteristics were distributed between those with and without phlebitis.
A prospective observational study was conducted. Adult patients treated with amiodarone through a peripheral intravenous catheter (PIVC) or a central venous catheter were included. PIVC characteristics were measured using the PIVC mini questionnaire. Patients with ≥two signs of phlebitis were categorized as having phlebitis. Adherence to the clinical practice guideline was registered on a standard abstract sheet. Data were collected from the amiodarone start-up to 2 days after the amiodarone was discontinued. In total, 124 patients with amiodarone infusions were observed, of which 69% were administered via a PIVC. The phlebitis rate was 44%. Fifty-three per cent developed amiodarone-induced phlebitis during the infusion phase, while 47% presented phlebitis during the post-infusion phase. The three most observed signs or symptoms of phlebitis were redness (87%), pain (81%), and swelling (71%). The most commonly used PIVC site was the elbow, and 35% of the PIVCs were large (18 gauge), which was the last preferred site and size according to the clinical practice guideline.
A large proportion of the patients developed amiodarone-induced phlebitis. The adherence to the clinical practice guideline was not optimal according to the PIVC recommendations. Prevention of amiodarone-induced phlebitis should have high priority to reduce patient harm.
静脉注射胺碘酮是一种外周血管刺激剂，静脉炎是其不良反应。目的是确定静脉注射胺碘酮引起静脉炎的发生率，描述对临床实践指南的依从性，并确定静脉炎患者与非静脉炎患者之间特征的分布情况。
进行了一项前瞻性观察研究。纳入通过外周静脉导管（PIVC）或中心静脉导管接受胺碘酮治疗的成年患者。使用PIVC小型问卷测量PIVC的特征。有≥两种静脉炎体征的患者被归类为患有静脉炎。在标准摘要表上记录对临床实践指南的依从性。从胺碘酮开始使用至停药后2天收集数据。总共观察了124例接受胺碘酮输注的患者，其中69%通过PIVC给药。静脉炎发生率为44%。53%在输注阶段发生胺碘酮诱导的静脉炎，而47%在输注后阶段出现静脉炎。观察到的静脉炎的三个最常见体征或症状是发红（87%）、疼痛（81%）和肿胀（71%）。最常用的PIVC部位是肘部，35%的PIVC为大号（18G），根据临床实践指南，这是最不推荐的部位和尺寸。
很大一部分患者发生了胺碘酮诱导的静脉炎。根据PIVC建议，对临床实践指南的依从性并不理想。预防胺碘酮诱导的静脉炎应高度优先考虑，以减少对患者的伤害。
