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Y E Fengli - One of the best experts on this subject based on the ideXlab platform.
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effect observation of the enhanced comfeel tranparent dressing in prevention Phlebitis caused by dopamine and amiodarone
Chinese Journal of General Practice, 2015Co-Authors: Y E FengliAbstract:Objective To explore the prevention and therapeutic effects of the enhanced comfeel tranparent dressing on Phlebitis caused by Dopamine and Amiodarone commonly used in Cardiothoracic Surgery. Methods One hundred patients who received Dopamine and Amiodarone treatment in our department were divided into the Phlebitis prevention group and Phlebitis treatment group according to the patients with or without Phlebitis. Sixty patients in the Phlebitis prevention group were divided into the experimental group 1( 30 patients) and the control group 1( 30 patients). Forty patients in the Phlebitis treatment group were divided into the experimental group 2( 20 patients) and the control group 2( 20patients). The enhanced comfeel tranparent dressing was used in the experimental group 1 of the Phlebitis prevention group and 3M transparent dressing was used in the control group 1,the incidence and the occurrence time change of the Phlebitis in two groups were compared. The enhanced comfeel tranparent dressing was used in the experimental group 2 of the patients with Phlebitis in the treatment group while 25% magnesium sulfate wet packing was performed in the control group 2. The Phlebitis pain relief and the time change of disappearance of redness and swelling were compared in two groups. Results Compared with the control group in the Phlebitis treatment group,the incidence of the Phlebitis was obviously lower in the experimental group and the occurrence time was significantly shorter( P 0. 05). In the Phlebitis treatment group,the time of Phlebitis pain relief and the time of redness and swelling disappearance were significantly shorter( P 0. 05). Conclusion The enhanced comfeel tranparent dressing shows better clinical efficacy in preventing and treating the Phlebitis caused by Dopamine and Amiodarone.
Claire M Rickard - One of the best experts on this subject based on the ideXlab platform.
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Phlebitis signs and symptoms with peripheral intravenous catheters incidence and correlation study
Journal of Infusion Nursing, 2018Co-Authors: Gabor Mihala, Gillian Raybarruel, Nicole Marsh, Joan Webster, Marianne Wallis, Matthew Richard Mcgrail, Vineet Chopra, Claire M RickardAbstract:This study was undertaken to calculate the incidence of 8 signs and symptoms used for the diagnosis of Phlebitis with peripheral intravenous catheters, or short peripheral catheters, and the level of correlation between them. A total of 22 789 daily observations of 6 signs (swelling, erythema, leakage, palpable venous cord, purulent discharge, and warmth) and 2 symptoms (pain and tenderness) were analyzed of 5907 catheter insertion sites. Most signs and symptoms of Phlebitis occurred only occasionally or rarely; the incidence of tenderness was highest (5.7%). Correlations were mostly low; warmth correlated strongly with tenderness, swelling, and erythema.
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inter rater agreement on pivc associated Phlebitis signs symptoms and scales
Journal of Evaluation in Clinical Practice, 2015Co-Authors: Gillian Raybarruel, Claire M Rickard, Nicole Marsh, Gabor Mihala, Joan Webster, Marianne WallisAbstract:Many peripheral intravenous catheter (PIVC) infusion Phlebitis scales and definitions are used internationally, although no existing scale has demonstrated comprehensive reliability and validity. We examined inter-rater agreement between registered nurses on signs, symptoms and scales commonly used in Phlebitis assessment. Seven PIVC-associated Phlebitis signs/symptoms (pain, tenderness, swelling, erythema, palpable venous cord, purulent discharge and warmth) were observed daily by two raters (a research nurse and registered nurse). These data were modelled into Phlebitis scores using 10 different tools. Proportions of agreement (e.g. positive, negative), observed and expected agreements, Cohen's kappa, the maximum achievable kappa, prevalence- and bias-adjusted kappa were calculated. Two hundred ten patients were recruited across three hospitals, with 247 sets of paired observations undertaken. The second rater was blinded to the first's findings. The Catney and Rittenberg scales were the most sensitive (Phlebitis in >20% of observations), whereas the Curran, Lanbeck and Rickard scales were the most restrictive (≤2% Phlebitis). Only tenderness and the Catney (one of pain, tenderness, erythema or palpable cord) and Rittenberg scales (one of erythema, swelling, tenderness or pain) had acceptable (more than two-thirds, 66.7%) levels of inter-rater agreement. Inter-rater agreement for Phlebitis assessment signs/symptoms and scales is low. This likely contributes to the high degree of variability in Phlebitis rates in literature. We recommend further research into assessment of infrequent signs/symptoms and the Catney or Rittenberg scales. New approaches to evaluating vein irritation that are valid, reliable and based on their ability to predict complications need exploration.
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postinfusion Phlebitis incidence and risk factors
Nursing Research and Practice, 2015Co-Authors: Joan Webster, Gillian Raybarruel, Nicole Marsh, Marianne Wallis, Matthew Richard Mcgrail, Claire M RickardAbstract:Objective. To document the incidence of postinfusion Phlebitis and to investigate associated risk factors. Design. Analysis of existing data set from a large randomized controlled trial, the primary purpose of which was to compare routine peripheral intravascular catheter changes with changing catheters only on clinical indication. Participants and Setting. Patients admitted to a large, acute general hospital in Queensland, Australia, and who required a peripheral intravenous catheter. Results. 5,907 PIVCs from 3,283 patients were studied. Postinfusion Phlebitis at 48 hours was diagnosed in 59 (1.8%) patients. Fifteen (25.4%) of these patients had Phlebitis at removal and also at 48 hours after removal. When data were analyzed per catheter, the rate was lower, 62/5907 (1.1%). The only variable associated with postinfusion Phlebitis was placement of the catheter in the emergency room (P = 0.03). Conclusion. Although not a common occurrence, postinfusion Phlebitis may be problematic so it is important for health care staff to provide patients with information about what to look for after an intravascular device has been removed. This trial is registered with ACTRN12608000445370.
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infusion Phlebitis assessment measures a systematic review
Journal of Evaluation in Clinical Practice, 2014Co-Authors: Gillian Raybarruel, Denise F Polit, Jenny Murfield, Claire M RickardAbstract:Rationale, aims and objectives Phlebitis is a common and painful complication of peripheral intravenous cannulation. The aim of this review was to identify the measures used in infusion Phlebitis assessment and evaluate evidence regarding their reliability, validity, responsiveness and feasibility. Method We conducted a systematic literature review of the Cochrane library, Ovid MEDLINE and EBSCO CINAHL until September 2013. All English-language studies (randomized controlled trials, prospective cohort and cross-sectional) that used an infusion Phlebitis scale were retrieved and analysed to determine which symptoms were included in each scale and how these were measured. We evaluated studies that reported testing the psychometric properties of Phlebitis assessment scales using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Results Infusion Phlebitis was the primary outcome measure in 233 studies. Fifty-three (23%) of these provided no actual definition of Phlebitis. Of the 180 studies that reported measuring Phlebitis incidence and/or severity, 101 (56%) used a scale and 79 (44%) used a definition alone. We identified 71 different Phlebitis assessment scales. Three scales had undergone some psychometric analyses, but no scale had been rigorously tested. Conclusion Many Phlebitis scales exist, but none has been thoroughly validated for use in clinical practice. A lack of consensus on Phlebitis measures has likely contributed to disparities in reported Phlebitis incidence, precluding meaningful comparison of Phlebitis rates.
Shuji Kubo - One of the best experts on this subject based on the ideXlab platform.
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EXPERIMENTAL INFUSION Phlebitis : TOLERANCE pH OF PERIPHERAL VEIN
The Journal of toxicological sciences, 1999Co-Authors: Takashi Kuwahara, Shougo Asanami, Yoshiyuki Kawauchi, Shuji KuboAbstract:This study aims to determine the pH that peripheral veins can tolerate. Intravenous nutrient solutions with different pHs (from 4.52 to 6.71) were infused into rabbit ear veins, and the veins were examined histopathologically. After 6-hr infusion at 10 mL/kg/hr, a commercial 2.72% amino acid/7.5% glucose solution with electrolytes (AG) caused obvious phlebitic changes, such as loss of venous endothelial cells, inflammatory cell infiltration, and perivascular edema, in all 6 rabbits because of its low pH (4.52) and high titratable acidity (22 mEq/L). The Phlebitis was reduced when the solution was neutralized with NaOH to pH 5.93, and was almost eliminated when the pH was neutralized to 6.49. After 8-hr infusion at 15 mL/kg/hr, AG-adjusted pH to 6.30 caused slight phlebitic changes, but AG-adjusted pH to 6.71 scarcely caused any change. Furthermore, 24-hr infusion of the pH 6.49 solution caused no histopathological changes in 3 rabbits. These results suggest that the tolerance pH for the peripheral vein is about 6.5, and that an infusion solution does not cause Phlebitis due to acidity if the pH is not lower than the tolerance pH.
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experimental infusion Phlebitis tolerance osmolality of peripheral venous endothelial cells
Nutrition, 1998Co-Authors: Takashi Kuwahara, Shougo Asanami, Shuji KuboAbstract:This study aimed to determine the osmolality that peripheral venous endothelial cells can tolerate and to clarify the relationship between tolerance osmolality and duration of infusion. Nutrient solutions of 539-917 mOsm/kg, prepared to have no acidic effect, were infused into rabbit ear veins, and the veins were examined histopathologically. In each experiment of 8-, 12-, or 24-h infusion, the higher osmolality solutions caused some phlebitic changes, such as loss of venous endothelial cells, inflammatory cell infiltration, and edema; however, the lowest osmolality solution caused few changes. Infusion of 120 mL/kg of 814 mOsm/kg solution caused Phlebitis at 5 or 10 mL.kg-1.h-1, however, the same volume of the same solution scarcely caused Phlebitis at 15 mL.kg-1.h-1 because of the shortened infusion duration. These results suggest that the tolerance osmolality of peripheral venous endothelial cells with poor blood flow is about 820 mOsm/kg for 8 h, 690 mOsm/kg for 12 h, and 550 mOsm/kg for 24 h, and that the tolerance osmolality falls as the duration of infusion increases. In conclusion, hypertonic solutions should be infused at as high a rate as is clinically acceptable and compatible with nutrient bioavailability because increasing the infusion rate reduces the duration of infusion and Phlebitis.
Kelly Matsuda - One of the best experts on this subject based on the ideXlab platform.
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Phlebitis in amiodarone administration incidence contributing factors and clinical implications
American Journal of Critical Care, 2013Co-Authors: Linda C Norton, Linda K Ottoboni, Ann Varady, Chiayu Yanglu, Nancy Becker, Theresa Cotter, Eileen Pummer, Annette Haynes, Lynn Forsey, Kelly MatsudaAbstract:Background Intravenous amiodarone is an important treatment for arrhythmias, but peripheral infusion is associated with direct irritation of vessel walls and Phlebitis rates of 8% to 55%. Objectives To determine the incidence and factors contributing to the development of amiodarone-induced Phlebitis in the coronary care unit in an academic medical center and to refine the current practice protocol. Methods Medical records from all adult patients during an 18-month period who received intravenous amiodarone while in the critical care unit were reviewed retrospectively. Route of administration, location, concentration, and duration of amiodarone therapy and factors associated with occurrence of Phlebitis were examined. Descriptive statistics and regression methods were used to identify incidence and Phlebitis factors. Results In the final sample of 105 patients, incidence of Phlebitis was 40%, with a 50% recurrence rate. All cases of Phlebitis occurred in patients given a total dose of 3 g via a peripheral catheter, and one-quarter of these cases (n = 10) developed at dosages less than 1 g. Pain, redness, and warmth were the most common indications of Phlebitis. Total dosage given via a peripheral catheter, duration of infusion, and number of catheters were significantly associated with Phlebitis. Conclusions Amiodarone-induced Phlebitis occurred in 40% of this sample at higher drug dosages. A new practice protocol resulted from this study. An outcome study is in progress.
Takashi Kuwahara - One of the best experts on this subject based on the ideXlab platform.
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methods of preventing vinorelbine induced Phlebitis an experimental study in rabbits
International Journal of Medical Sciences, 2008Co-Authors: Emiko Kohno, Takashi Kuwahara, Saori Murase, Noboru Okamura, Mayumi Nishikata, Sumio Matzno, Kenji MatsuyamaAbstract:Purpose: In order to identify methods for preventing Phlebitis caused by intravenous administration of vinorelbine (VNR), we established a procedure for estimating the severity of Phlebitis in an animal model. Methods: Four different factors (administration rate, dilution, flushing, and infusion of fat emulsion) were evaluated for alleviation of Phlebitis caused by VNR infusion. VNR was diluted with normal saline to prepare test solutions with concentrations of 0.6 mg/mL or 0.3 mg/mL for infusion into the auricular veins of rabbits. Two days after VNR infusion, the veins were subjected to histopathological examination. Results: VNR did not cause obvious loss of venous endothelial cells, the most sensitive and common feature of Phlebitis, but VNR infusion led to inflammatory cell infiltration, edema, and epidermal degeneration. Tissue damage was significantly decreased by shortening the administration time and by diluting the VNR solution for infusion from 0.6 mg/mL to 0.3 mg/mL. However, there was no effect of flushing with normal saline after VNR infusion, while treatment with fat emulsion before and after VNR infusion only had a minimal effect. Conclusion: Rapid infusion and dilution are effective methods of reducing Phlebitis caused by the infusion of VNR, but the efficacy of flushing with normal saline or infusion of fat emulsion was not confirmed.
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EXPERIMENTAL INFUSION Phlebitis : TOLERANCE pH OF PERIPHERAL VEIN
The Journal of toxicological sciences, 1999Co-Authors: Takashi Kuwahara, Shougo Asanami, Yoshiyuki Kawauchi, Shuji KuboAbstract:This study aims to determine the pH that peripheral veins can tolerate. Intravenous nutrient solutions with different pHs (from 4.52 to 6.71) were infused into rabbit ear veins, and the veins were examined histopathologically. After 6-hr infusion at 10 mL/kg/hr, a commercial 2.72% amino acid/7.5% glucose solution with electrolytes (AG) caused obvious phlebitic changes, such as loss of venous endothelial cells, inflammatory cell infiltration, and perivascular edema, in all 6 rabbits because of its low pH (4.52) and high titratable acidity (22 mEq/L). The Phlebitis was reduced when the solution was neutralized with NaOH to pH 5.93, and was almost eliminated when the pH was neutralized to 6.49. After 8-hr infusion at 15 mL/kg/hr, AG-adjusted pH to 6.30 caused slight phlebitic changes, but AG-adjusted pH to 6.71 scarcely caused any change. Furthermore, 24-hr infusion of the pH 6.49 solution caused no histopathological changes in 3 rabbits. These results suggest that the tolerance pH for the peripheral vein is about 6.5, and that an infusion solution does not cause Phlebitis due to acidity if the pH is not lower than the tolerance pH.
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experimental infusion Phlebitis tolerance osmolality of peripheral venous endothelial cells
Nutrition, 1998Co-Authors: Takashi Kuwahara, Shougo Asanami, Shuji KuboAbstract:This study aimed to determine the osmolality that peripheral venous endothelial cells can tolerate and to clarify the relationship between tolerance osmolality and duration of infusion. Nutrient solutions of 539-917 mOsm/kg, prepared to have no acidic effect, were infused into rabbit ear veins, and the veins were examined histopathologically. In each experiment of 8-, 12-, or 24-h infusion, the higher osmolality solutions caused some phlebitic changes, such as loss of venous endothelial cells, inflammatory cell infiltration, and edema; however, the lowest osmolality solution caused few changes. Infusion of 120 mL/kg of 814 mOsm/kg solution caused Phlebitis at 5 or 10 mL.kg-1.h-1, however, the same volume of the same solution scarcely caused Phlebitis at 15 mL.kg-1.h-1 because of the shortened infusion duration. These results suggest that the tolerance osmolality of peripheral venous endothelial cells with poor blood flow is about 820 mOsm/kg for 8 h, 690 mOsm/kg for 12 h, and 550 mOsm/kg for 24 h, and that the tolerance osmolality falls as the duration of infusion increases. In conclusion, hypertonic solutions should be infused at as high a rate as is clinically acceptable and compatible with nutrient bioavailability because increasing the infusion rate reduces the duration of infusion and Phlebitis.