• 제목/요약/키워드: Infusion method

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Rituximab 주입관련 부작용발생 및 위험인자 분석 (Rituximab Infusion-related Adverse Events and Risk Factors)

  • 이은정;김영주;이정연
    • 한국임상약학회지
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    • 제23권3호
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    • pp.223-231
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    • 2013
  • Objective: This study aimed to identify the status and risk factors of rituximab infusion-related adverse events (ADE) in rituximab-na$\ddot{i}$ve patients with cancer diseases. Method: A retrospective analysis using electronic medical records review was conducted. Inclusions were patients with a diagnosis of cancer disease with the initiation of rituximab-included treatment who were na$\ddot{i}$ve to rituximab during January 2011 to March 2013 at National Cancer Center (NCC) in Korea. Result: Total 110 patients, 582 cases of rituximab administrations, were reported in the study. About 57.2% of patients were 51-70 years old and evenly distributed between two genders and 72.7% were BMI less than $25kg/m^2$. All of study patients were diagnosed with non-Hodgkin lymphoma. Fifty patients (45.4%) and 54 cases (9.3%) were experienced rituximab infusion-related AEs even with conservative administration protocol at NCC. The most frequently occurring AEs were shivering followed by rash and itching. In single variant analysis, we found that the early stage of NHL, low exposure to rituximab administrations, high white blood cell counts, high lymphocyte counts, high absolute neutrophil count and low lactate dehydrogenase were associated with infusion-related AEs (p<0.05). The early stage of disease, high lymphocyte counts, low exposure to rituximab administrations were also related significantly with AEs in multiple variants analysis (p<0.05). Conclusion: Rituximab infusion-related AEs for patients who were na$\ddot{i}$ve to rituximab were still a concern with conservative administration protocol. The adverse drug reactions were significantly associated with early stage of NHL, higher lymphocyte counts and low exposure to rituximab administrations. The factors need to be considered with close monitoring to prevent rituximab infusion-related AE.

아동의 말초정맥주사 간호프로토콜 적용 및 효과 (The Application and Effect of the Nursing Protocol of Pediatric Peripheral Intravenous Infusion)

  • 최희강;강미정;강현주;김은혜
    • Perspectives in Nursing Science
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    • 제14권2호
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    • pp.45-54
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    • 2017
  • Purpose: The aim of this study was to compare the effect of training and implementation of a pediatric peripheral intravenous infusion protocol on the nurses' performance and infusion complication rate. Methods: A quasiexperimental study using a posttest comparison of a one group pretest-time series design was utilized. This method was developed to measure nursing knowledge and performance based on a pediatric peripheral intravenous infusion protocol. To calculate the occurrence rate of complications, the number of complications were divided into the number of intravenous insertions. Results: It was shown that the training developed by the study team in 2015 contributed to nurses' increased knowledge, as well as improved job performance. Furthermore, the implementation of the protocol revealed that the number of peripheral intravenous insertions, an invasive procedure, decreased. Additionally, the nursing workload related to pediatric intravenous infusions was reduced. Conclusion: This protocol may contribute to the improved scientific quality and efficiency of nursing management of peripheral intravenous infusions.

허혈성 뇌졸중환자의 헤파린 주입량과 주입기간에 영향을 미치는 임상적 요인 (Clinical Factors which Affect the Amount and Length of Intravenous Heparin Infusion in Stroke)

  • 최자윤;김미원
    • Journal of Korean Biological Nursing Science
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    • 제11권1호
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    • pp.14-22
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    • 2009
  • Purpose: This study was conducted to examine the clinical factors which affected the amount and the duration of infusion of intravenous (IV) heparin on ischemic stroke. Method: A cross-sectional descriptive study was designed to examine the factors. A total of 101 patients with ischemic stroke from a University hospital in G-city, Korea from January to December, 2006 were participated in this study. Data were analyzed by t- and ANOVA test, correlation coefficient, and stepwise multiple linear regression analysis. Result: This study showed that the patients who have been temporarily stopped to infuse iv heparin for more than one hour, had cardioembolic stroke, and had the lower count of initial red blood cell (RBC) had significantly lower amount of iv heparin infusion per body surface. In addition, this study founded that the patients with lower count of initial RBC and the lower level of initial blood sugar were significantly less likely to have the lower length of iv heparin infusion. Conclusion: Continuous monitoring and controlling the count of RBC and the level of blood sugar are needed to increase the efficacy of iv heparin therapy on ischemic stroke. Further empirical studies should be conducted to support the results of this study.

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근위축성 측삭경화증 환자(ALS)의 치과 진료 시 목표농도 주입법을 이용한 정주 진정 마취: 증례 보고 (Intravenous Target Controlled Infusion Sedation for Patients with Amyotrophic Lateral Sclerosis: Case Report)

  • 도레미;김승오
    • 대한치과마취과학회지
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    • 제12권3호
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    • pp.177-181
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    • 2012
  • Amyotrophic lateral sclerosis (ALS) is one of the major neurodegenerative diseases that involves degeneration at all levels of the motor system- from the cortex to the anterior horn of the spinal cord. Patients with ALS often have difficulty of ambulation for dental treatment though they have poor oral hygiene state. General anesthesia may cause respiratory problem due to its high sensitivity to muscle relaxant and weakened upper airway. In this case report, 38-year-old female patient with ALS required many dental treatments. Conscious sedation with intravenous target controlled infusion method was successfully employed and patient was discharged without any complications.

경추 경막외강 확인법의 비교 연구 (Comparison of Methods to Confirm the Cervical Epidural Space)

  • 옥시영;전혜림;백영희;김상호;김순임;김선종;박욱;송단
    • The Korean Journal of Pain
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    • 제22권2호
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    • pp.158-162
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    • 2009
  • Background: The loss of resistance (LOR) method is most commonly used to identify the epidural space. This method is thought to rely on the penetration of the ligamentum flavum. Unfortunately the exact morphology of the ligamentum flavum is variable at different vertebral levels. Especially, it has been pointed out that the lower cervical ligamentum flavum may be discontinuous in the midline in up to 50% of patients. Thus, the LOR method may be inaccurate to confirm the cervical epidural space. The aim of this study is to determine which method is the safest and most exact for confirming the cervical epidural space. Methods: 100 adult, chronic renal failure patients who were undergoing an arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. During the cervical epidural puncture, we identified the cervical epidural space by subjectively feeling the resistance with using a finger just through the ligamentum flavum, and we also used the drip infusion method, the loss of resistance method using air, and the hanging drop method. By using 5 grades, we classified the extent of whether or not the techniques were effective. Results: Using the drip infusion method, we identify the epidural space in all the patients as +/++ grade. The catheter insertion method was also successful in identifying those epidural spaces over a ${\pm}$ grade. The pseudo LOR was over ${\pm}$ grade in 47 patients. Conclusions: The combined LOR/hanging drop with drip infusion method is useful for confirming the cervical epidural space.

The evaluation of implementing smart patient controlled analgesic pump with a different infusion rate for different time duration on postoperative pain management

  • Kim, Saeyoung;Jeon, Younghoon;Lee, Hyeonjun;Lim, Jung A;Park, Sungsik;Kim, Si Oh
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권4호
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    • pp.289-294
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    • 2016
  • Background: Control of postoperative pain is an important aspect of postoperative patient management. Among the methods of postoperative pain control, patient-controlled analgesia (PCA) has been the most commonly used. This study tested the convenience and safety of a PCA method in which the dose adjusted according to time. Methods: This study included 100 patients who had previously undergone orthognathic surgery, discectomy, or total hip arthroplasty, and wished to control their postoperative pain through PCA. In the test group (n = 50), the rate of infusion was changed over time, while in the control group (n = 50), drugs were administered at a fixed rate. Patients' pain scores on the visual analogue scale, number of rescue analgesic infusions, side effects, and patients' satisfaction with analgesia were compared between the two groups. Results: The patients and controls were matched for age, gender, height, weight, and body mass index. No significant difference in the mount of drug administered was found between the test and control groups at 0-24 h after the operation; however, a significant difference was observed at 24-48 h after the operation between the two groups. No difference was found in the postoperative pain score, number of side effects, and patient satisfaction between the two groups. Conclusions: Patient-controlled anesthesia administered at changing rates of infusion has similar numbers of side effects as infusion performed at a fixed rate; however, the former allows for efficient and safe management of postoperative pain even in small doses.

Efficacy and Safety of Combined Subacromial and Intravenous Patient-controlled Analgesia after Arthroscopic Rotator Cuff Repair

  • Seo, Joong-Bae;Yoo, Jae-Sung;Ryu, Jee-Won;Shin, Yong-Eun
    • Clinics in Shoulder and Elbow
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    • 제19권4호
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    • pp.192-196
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    • 2016
  • Background: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. Methods: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. Results: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). Conclusions: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.

근거기반 정맥주입요법 간호실무지침 실무적용 프로그램 개발 및 평가 - 중소병원을 대상으로 (Development and Effectiveness of Practice Application Program of Intravenous Infusion Evidence-Based Nursing Practice Guideline - for Small and Medium Sized Hospitals)

  • 홍인화;은영
    • 대한간호학회지
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    • 제50권6호
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    • pp.863-875
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    • 2020
  • Purpose: This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals. Methods: A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital's medical records. Data were analyzed using t-test, χ2-test, and Shapiro-Wilk test, with qualitative content analysis used for interview data. Results: Following the intervention, nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group. Conclusion: This program is effective to improve nurse's perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.

공기 주입과 동시에 시행한 견봉하 관절경 술식을 이용한 회전근개 파열의 정도 평가 (Bursoscopic Evaluation for Degree of the Rotator Cuff Tear with Air Infusion Method)

  • 문영래;손홍문;김남형
    • 대한관절경학회지
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    • 제6권2호
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    • pp.126-130
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    • 2002
  • 목적 : 견봉하 점액낭에 가려져 부분층 파열로 여겼던 회전근개 전층 파열을 견관절 내 공기 주입 방식을 사용한 견봉하 점액낭 관절경적 관찰로 효과적인 진단의 가능 여부를 알아 보고자 하였다. 대상 및 방법 : 65예 중 견관절 관절경상 회전근 개 부분층 파열인 18예를 제 1군으로, 전층 파열로서 봉합을 시행 한 37예를 제 2군으로 나누어 견관절에 $50\~100ml$의 공기주입으로 확장을 시킴과 동시에 견봉하 관절내로 누출 되는 공기 방울을 관찰하였다. 결과 : 제 1군 중 3예에서 공기 누출을 보고 전층 파열임을 확인할 수 있었으며, 제 2군 중 2예에서는 다량의 공기 누출 부위가 발견되어 불완전한 봉합임을 확인하고 추가 봉합을 시행 할 수 있었다. 결론 : 공기 주입 방식은 회전근 개 부분층 파열과 전층 파열을 감별하고, 비후되고 유착된 점액낭에 가려져 있는 전층 파열을 발견할 수 있으며, 술 후 봉합 부위의 평가에 유용한 방법으로 사료된다.

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