Facultad de Ciencias de la Salud, Corporación Universitaria Remington, Medellín, Colombia.
Grupo de Investigación Salud Familiar y Comunitaria, Facultad de Ciencias de la Salud, Corporación Universitaria Remington, Medellín, Colombia.
Enferm Intensiva (Engl Ed). 2023 Oct-Dec;34(4):218-226. doi: 10.1016/j.enfie.2022.09.001. Epub 2023 Mar 17.
Peripheral administration of norepinephrine is restricted due to the association of extravasation with tissue necrosis.
Scoping review with the objective of describing the adverse effects related to the administration of norepinephrine through short peripheral venous access and the characteristics of drug administration in patients hospitalized in ICU, surgery, and emergency services.
12 studies with heterogeneous characteristics by size and type of population were included. The proportion of complications associated with peripheral norepinephrine administration was less than 12% in observational studies and it was less than 2% in those that used doses less than 0.13μg/kg/min, and concentrations less than 22.3μg/mL. The main associated complication was extravasation and there were no cases of tissue necrosis at the venipuncture site, some extravasation cases were treated with phentolamine, terbutaline or topical nitroglycerin. The drug administration time ranged between 1 and 528hours with a weighted mean of 2.78h.
The main adverse effect was extravasation, no additional complications occurred, phentolamine and terbutaline seem to be useful, and its availability is a necessity. It is essential for the nursing staff to carry out a close assessment and comprehensive care in patients receiving norepinephrine by peripheral route.
由于去甲肾上腺素外渗与组织坏死有关,外周给药受到限制。
通过描述通过短外周静脉通路给予去甲肾上腺素的不良反应以及 ICU、手术和急诊患者中药物给药的特点,进行范围综述。
共纳入 12 项研究,这些研究在规模和人群类型方面具有异质性。在观察性研究中,与外周去甲肾上腺素给药相关的并发症比例小于 12%,在使用剂量小于 0.13μg/kg/min 和浓度小于 22.3μg/mL 的研究中,并发症比例小于 2%。主要相关并发症为外渗,静脉穿刺部位无坏死病例,一些外渗病例用酚妥拉明、特布他林或局部硝酸甘油治疗。药物给药时间为 1 至 528 小时,加权平均值为 2.78 小时。
主要不良事件为外渗,无其他并发症发生,酚妥拉明和特布他林似乎有用,且其可用性是必需的。外周给予去甲肾上腺素时,护理人员必须密切评估并进行全面护理。