Flinspach Armin Niklas, Mohr André, Wehrle Jahn, Zacharowski Kai, Neef Vanessa, Raimann Florian Jürgen
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt, Germany.
Medical Clinic 2 (Hematology, Oncology, Haemostaseology, Rheumatology, Infectiology), University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
J Clin Med. 2024 May 24;13(11):3070. doi: 10.3390/jcm13113070.
: Catecholamines are among those agents that are indispensable in modern intensive care medicine. The rapid availability of hygienically impeccable and correctly concentrated injectable solutions, e.g., for syringe pumps, is becoming more and more important. However, little research has been conducted regarding how the use of catecholamines is distributed in different wards and what options can be used to achieve optimal availability. : In a retrospective monocentric study from 2019 to 2022, all continuously applied catecholamines in intensive care units (ICU) and intermediate care units (IMC) were investigated. The focus was on potential optimization by utilizing manufactured ready-to-administer solutions in the context of the economization of patient care. Norepinephrine syringes represented 81% of all syringes administered, appearing to be the most frequently used on all wards. Production by the in-house pharmacy showed both financial advantages and an increase in patient safety compared to syringes produced at the bedside. Increasing numbers of critically ill patients coupled with growing staff shortages and an increased awareness of safety requirements are driving the move towards ready-to-use and ready-to-administer solutions in critical care medicine. In-house manufacturing by hospital pharmacies can be a promising option to optimize processes and improve the economics of patient care. Individual calculations of the required catecholamine preparations with regard to possible economic advantages should be carried out in hospitals. In particular, in-house production of ready-to-use and ready-to-administer preparations could significantly increase patient safety and seems to be economically viable.
儿茶酚胺是现代重症医学中不可或缺的药物之一。卫生条件无可挑剔且浓度正确的可注射溶液(例如用于注射泵)能够快速获取,这一点变得越来越重要。然而,关于儿茶酚胺在不同病房的使用分布情况以及可采用哪些方法来实现最佳可及性,相关研究较少。:在一项2019年至2022年的回顾性单中心研究中,对重症监护病房(ICU)和中级护理病房(IMC)中所有持续使用的儿茶酚胺进行了调查。重点在于在患者护理节约化的背景下,通过使用预制好的即用型溶液来实现潜在的优化。去甲肾上腺素注射器占所有使用注射器的81%,似乎是所有病房中使用最频繁的。与床边制作的注射器相比,医院内部药房制作的注射器在经济上具有优势,同时还提高了患者安全性。重症患者数量不断增加,加上工作人员短缺加剧以及对安全要求的认识提高,推动了重症医学向即用型和预制好的可注射溶液发展。医院药房的内部制作可能是优化流程和提高患者护理经济性的一个有前景的选择。医院应就可能的经济优势对所需儿茶酚胺制剂进行单独计算。特别是,内部生产即用型和预制好的制剂可显著提高患者安全性,而且在经济上似乎是可行的。