20.500.12556/DKUM-43774 PREPREČEVANJE NEVARNIH NEŽELENIH BOLUSOV ZDRAVIL PRI UPORABI PARALELNE INFUZIJE Prevention of perilous unwanted medication boluses at the administration of parallel infusion Paralelna infuzija je opredeljena kot dotok dveh ali več različnih infuzij tekočin oziroma zdravil v skupni kateter, ki vodi do bolnikovih obtočil. Pri takih pogojih lahko pride do medsebojnega vpliva različnih sistemov za infuzije, kar vodi bolnika v nevarnost ali celo v smrt. Bolnik lahko nepričakovano dobi velik odmerek zdravila, ki bi ga v običajnih pogojih črpalka pravilno aplicirala več časa. Raziskovalna metodologija: V raziskovalnem delu smo izvedli eksperimentalno »in vitro« raziskavo. Uporabili smo infuzijsko črpalko IVAC, kjer smo v paralelni infuziji kombinirali različne pretoke (1, 5, 10 in 20 ml/h) ter tlake (50, 100, 200 in 300 mmHg). Raziskava je bila razdeljena v štiri dele, v prvih dveh delih smo opazovali dogajanje, ki nastane ob uporabi paralelne infuzije pri polni in prazni infuzijski steklenici ob zapori venske poti ali infuzijske linije. V tretjem delu smo merili čas, ki je potreben, da se sproži alarm zapore ob zapori venske poti ali infuzijske linije. Četrti del raziskave je bil namenjen merjenju odmerka tekočine, ki nastane ob sprostitvi zapore infuzijske linije. Rezultati: Ob zapori infuzijske linije pri uporabi paralelne infuzije ni bilo razlike med prazno in polno infuzijsko steklenico, v obeh primerih je prišlo do povratnega toka. V tretjem delu raziskave je bilo ugotovljeno, da tlak nastavljen v infuzijski črpalki in pretok pomembno vplivata (p<0,001) na sprožitev alarma ob zapori infuzijske linije. Bolus tekočine, ki nastane ob sprostitvi zapore pri tlaku 300 mmHg, znaša 0,5 ml. Sklep: Ugotovili smo, da je potrebno prilagoditi tlak v infuzijski črpalki glede na pretok. Nižji je pretok, manjši naj bo tlak v infuzijski črpalki. Pri uporabi paralelne infuzije, posebej ob uporabi infuzijske črpalke skupaj z gravitacijskim infuzijskim sistemom, je potrebno opazovati, da ne pride do povratnega toka, saj se alarm zapore ob tej kombinacije ne sproži. Bolus vazoaktivnega/inotropnega zdravila, ki nastane ob sprostitvi zapore, lahko predstavlja nevarnost za bolnika, ki lahko privede tudi do smrti. Parallel infusion is defined as the inflow of two or more different infusions of fluids or medicine agents into a joint catheter, leading to the patient’s cardiovascular system. These circumstances can induce a mutual effect of various infusion systems, which endangers the patient and can even result in death. The patient can unexpectedly be administered a high dosage of medicine, which under normal circumstances would be applied over a longer time period. Research method: The research was carried out as an experimental “in vitro” study. We used the IVAC infusion pump and by parallel infusion combined different flows (1, 5, 10 and 20 ml/h) and pressures (50, 100, 200 and 300 mmHg). The research was divided in four segments. During the first two segments we observed the reactions following the application of parallel infusion with a full and empty infusion bottle at the blockage of a vessel or infusion line. In the third segment we measured the time required for the activation of the alarm for vessel or infusion line blockage. In the fourth segment we measured the dosage of fluids, administered at the unblocking of the infusion. Results: Following a blockage of the infusion line at the use of parallel infusion there was no difference between the empty and the full infusion bottle, in both cases the result was a reverse flow. In the third segment of the research it was determined, that the pressure of the infusion pump and the flow rate significantly influence (p<0,001) the activation of the blockage alarm. The fluid bolus, which occurs at the release of the blockage at a pressure of 300 mmHg, amounts to 0,5 ml. Conclusion: We established that the pressure in the infusion pump must be adjusted to the flow rate. The lower the flow rate, the lower the pressure in the infusion pump should be. At the use of parallel infusion, especially the use of the infusion pump together with the gravitational infusion system, it is necessary to prevent the reverse flow, because the blockage alarm will not be activated at this combination. The bolus of a vasoactive/inotropic agent, which occurs at the unblocking of the infusion, can put the patient at risk or event result in death. paralelna infuzija infuzijska črpalka bolus zdravila infuzijski sistemi parallel infusion infusion pump medicine bolus infusion systems true true false [N. Matjašič] Slovenski jezik Angleški jezik Magistrsko delo/naloga 2014-03-05 11:35:06 2014-04-02 10:23:49 2022-05-11 03:09:06 2021-04-28 03:35:23 2014 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.151.1(043.2) 2001828 URN:SI:UM:DK:RURN4HPK MAG_Matjasic_Natalija_2014.pdf MAG_Matjasic_Natalija_2014.pdf 1 C5B809D4018162B7B249F0978FE30C69 bbc703724c38e42a57663b2664cd8bc2814f2bf34cd1e1e8254ff9e168adbd1d b64059d5-7c0a-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=62484 Fakulteta za zdravstvene vede 0 0 0