Efficacy of 0.9% sodium chloride injection with and without heparin for maintaining indwelling intermittent injection sites

The efficacy of 0.9% sodium chloride injection with and without heparin in maintaining indwelling intermittent ("heparin lock") injection sites was studied. All patients in whom heparin locks were placed after admission to the medical and surgical units of a 128-bed acute-care hospital during a six-month period were included in the study. Three different solutions were used to flush heparin locks: 0.9% sodium chloride injection alone, heparin 10 units/ml in 0.9% sodium chloride injection, and heparin 100 units/ml in 0.9% sodium chloride injection. Solutions were randomly assigned to all patients on a given nursing unit for a two-month period; flush solutions were switched every two months until each of the three solutions had been used on both the medical and surgical units. Heparin locks were flushed after each medication administration and every eight hours when medications were not being given. Using a standardized evaluation form, one of five i.v. therapists evaluated each site daily for the presence of phlebitis and loss of patency. Length of catheter placement and the percentage of patient days during which patients received cephalosporin and penicillin antibiotics were examined for each group. Rates of site loss caused by phlebitis or loss of patency were compared in each group. A total of 412 patients representing 1448 patient days of heparin-lock therapy was evaluated. No significant differences were found among the three groups in the mean duration of heparin-lock placement, the percentage of patient days during which antibiotics were prescribed, or the rate of site loss caused by phlebitis or loss of patency.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of heparin and 0.9% sodium chloride injection in the maintenance of indwelling intermittent i.v. devices

Heparin sodium 10 units/mL was compared with 0.9% sodium chloride injection as a flush solution for indwelling intermittent i.v. devices, or i.v. locks (IVLs), in a prospective, randomized, double-blind study. The heparin and 0.9% sodium chloride injections were prepared in the pharmacy using aseptic technique. Most of the IVLs were inserted by an i.v. therapy team member. Each patient's IVL site was evaluated for phlebitis and patency by one of three study nurses, and when a catheter was removed, its contents were flushed so that clots or fibrin strands could be detected. Nurses also collected information regarding disease states, surgical procedures, medications administered, and how long each site lasted. A total of 173 sites were studied in 76 patients in the heparin group, and 131 sites were studied in 71 patients in the sodium chloride group. The groups were well matched, except that the sodium chloride group received more vancomycin and dextrose-containing i.v. solutions, while the heparin group received more penicillins. There was no significant difference in the incidence of phlebitis or lost patency between the groups. When locks through which vancomycin, penicillins, and dextrose-containing i.v. solutions were administered were excluded, there was still no significant difference between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)     

Infusion phlebitis associated with a programmable syringe-pump system versus gravity-feed minibottles

The occurrence of infusion phlebitis in patients receiving intravenous antibiotics via a gravity-feed minibottle system versus a new syringe-pump system was compared. Patients at least 18 years old who had indwelling intermittent injection sites inserted for medication administration were randomized to either the minibottle system or the syringe-pump system. Antibiotics in minibottles were diluted in 50-100 mL of 5% dextrose injection; in the syringe-pump group, aminoglycoside antibiotics were diluted in 0.9% sodium chloride injection and all other antibiotics were diluted in sterile water for injection. Antibiotics were not piggybacked into running primary infusions in any of the study patients, and no other medications except for 0.9% sodium chloride flushes were administered through the catheters. All catheters were inserted in peripheral veins and evaluated for phlebitis by i.v. nurse specialists using standardized criteria. Catheters were changed upon the occurrence of grade 1 phlebitis or after a period of three days without the development of phlebitis. Over an 18-week period, 85 catheter sites (53 syringe-pump group versus 32 minibottle group) were evaluated in 30 patients (14 syringe-pump group versus 16 minibottle group). The mean +/- S.D. catheter life in both groups was 50.6 +/- 20 hours. Phlebitis occurred in 62% of syringe-group sites versus 66% of minibottle-group sites; the incidence and severity of phlebitis were not significantly different between groups. The majority of catheter sites were infused with cefazolin sodium. The potential for phlebitis using the syringe-pump system in this study appears to be similar to that of the gravity-feed minibottle system when appropriate diluents, diluent volumes, and infusion rates are used.     

Postinfusion phlebitis associated with a syringe system versus minibags

The incidence of postinfusion phlebitis was compared in patients receiving i.v. drugs in 50- and 100-mL minibags of 5% dextrose injection or 0.9% sodium chloride injection versus 20- and 50-mL quantities of sterile water for injection or 0.45% sodium chloride injection in plastic syringes used with a venting administration set. Patients 16-75 years of age receiving one or more i.v. drugs and a concurrent maintenance i.v. fluid through a Teflon catheter in a peripheral vein were included. Patients receiving antineoplastic drugs, drugs that require a minimum diluent volume greater than 50 mL, or i.v. heparin sodium in doses of greater than or equal to 500 units/hr were excluded. For the syringe system, the type and amount of diluent were selected to achieve a solution osmolarity of approximately 300 mOsm/L. Patients' i.v. sites were examined every eight hours for 72 hours, and phlebitis was assessed according to predetermined criteria. There were 47 patients in the minibag group and 46 in the syringe group. There were no significant differences between the groups in demographic characteristics, catheter size, duration of infusion, number of doses, number or type of i.v. drugs, or incidence or severity of phlebitis. Administration of i.v. drugs with controlled solution osmolarity via this syringe infusion system was not associated with an incidence of postinfusion phlebitis different from that for i.v. drugs diluted in minibags.     

Clinical use of intravenous phenytoin sodium infusions

The safety of administering phenytoin sodium by intermittent intravenous infusion was evaluated. Twenty-eight adult patients in a neurosurgical intensive-care unit were studied; most patients had head trauma. Ninety-three doses of phenytoin sodium 300 mg in 0.9% sodium chloride injection 50 ml were administered according to hospital-approved guidelines, which included administration over 30-60 minutes, initiation of infusion within one hour of solution preparation, and use of a 5-microns inline filter. All patients were monitored for adverse reactions and were on continuous ECG monitoring. Analysis of clinical data before and immediately after phenytoin infusions showed no statistically significant change in blood pressure and a small but significant drop in mean heart rate. There were no cases of hypotension, arrhythmias, bradycardia, or phlebitis. Single occurrences of hypertension, nystagmus, and pain at the i.v. site were noted. It is concluded that careful infusion of phenytoin sodium in 0.9% sodium chloride injection is safe. The use of approved written guidelines to govern important factors of preparation and administration are recommended.     

0.9%氯化钠注射液预充式导管冲洗器用于婴幼儿头皮静脉留置针封管150例效果观察

目的观察0．9％氯化钠注射液预充式导管冲洗器在婴幼儿头皮静脉留置针封管中的应用效果。方法将2012年1月至6月儿科住院的30d至2岁使用头皮静脉留置针患儿300例随机分为试验组和对照组,各150例。试验组采用0．9％氯化钠注射液预充式导管冲洗器封管,对照组使用注射器抽取5mL稀释肝素钠正压封管,比较两组单次留置时间内堵管、静脉炎、外渗的发生情况。结果试验组单次留置时间内堵管、静脉炎、外渗发生率均明显低于对照组（P〈0．01）。结论采用0．9％氯化钠注射液预充式导管冲洗器封管效果较好,值得临床推广。     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的探讨静脉留置针封管方法与留置时间的关系。方法采用静脉留置针常用的输液器直接快速输入封管法、0．9％氯化钠注射液封管法和肝素液封管法，观察静脉留置针的留置时间及静脉炎的发生率。结果快速输入封管组和0．9％氯化钠注射液封管组比肝素液封管组的留置时间分别延长25．7％和19．3％，差异有统计学意义（P〈0．01或P〈0．05）；但快速输入封管组与0．9％氯化钠注射液封管组间的留置时间差异无统计学意义（P〉0．05）。快速输入封管组、0．9％氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组，三者问静脉炎的发生率差异有统计学意义（P〈0．05）；但快速输入封管组、0．9％氯化钠注射液封管组静脉炎的发生率差异无统计学意义（P〉0．05）。结论快速输入封管和0．9％氯化钠注射液封管可显著延长静脉留置针的留置时间，并可降低静脉炎的发生率。     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

静脉留置针封管方法与留置时间关系的探讨

目的 探讨静脉留置针封管方法与留置时间的关系.方法 采用静脉留置针常用的输液器直接快速输入封管法、0.9%氯化钠注射液封管法和肝素液封管法,观察静脉留置针的留置时间及静脉炎的发生率.结果 快速输入封管组和0.9%氯化钠注射液封管组比肝素液封管组的留置时间分别延长25.7%和19.3%,差异有统计学意义(P<0.01或P<0.05);但快速输入封管组与0.9%氯化钠注射液封管组间的留置时间差异无统计学意义(P0.05).快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率均低于肝素液封管组,三者间静脉炎的发生率差异有统计学意义(P<0.05);但快速输入封管组、0.9%氯化钠注射液封管组静脉炎的发生率差异无统计学意义(P0.05).结论 快速输入封管和0.9%氯化钠注射液封管可显著延长静脉留置针的留置时间,并可降低静脉炎的发生率.     

Compatibility of heparin sodium and morphine sulfate

The compatibility of morphine sulfate and heparin sodium was studied in solutions of deionized water and 0.9% sodium chloride. Crystalline morphine sulfate was reconstituted and heparin sodium 100 or 200 units/mL was added. Duplicate samples with a final volume of 5 mL were prepared and stored at room temperature. Morphine sulfate concentrations were 1, 2, 5, and 10 mg/mL in each diluent with each heparin concentration. Samples were visually inspected immediately after preparation and at 0.5 and 24 hours; pH was tested before adding heparin and at 0.5 and 24 hours. Similar procedures were followed adding morphine to the heparin. Samples containing morphine sulfate 2 and 10 mg/mL were analyzed by high-performance liquid chromatography for morphine concentrations immediately before adding heparin and at 0.5 and 24 hours. Precipitate appeared immediately after the second drug was added in samples containing morphine sulfate 10 mg/mL at both heparin concentrations in the water admixtures. No precipitate formed in any solutions containing morphine concentrations of 5 mg/mL or less nor in any samples containing 0.9% sodium chloride. In both diluents, pH values decreased as morphine sulfate concentrations increased. Morphine sulfate concentrations decreased significantly in water admixtures but not in admixtures prepared with 0.9% sodium chloride solution. Morphine sulfate and heparin sodium are incompatible only at morphine concentrations greater than 5 mg/mL. The incompatibility can be prevented by using 0.9% sodium chloride as the admixture diluent.     

疏血通联合低分子肝素钠治疗急性心肌梗死的临床观察

目的 观察疏血通与低分子肝素钠联合治疗急性心肌梗死的效果。方法回顾性分析本院2007年8月～2012年8月收治住院的急性心肌梗死患者92例的资料,分为治疗组51例,对照组41例。治疗组采用0．9％氯化钠250mL＋疏血通6mL静滴1天1次,低分子肝素钠5000Uq12h治疗,对照组采用0．9％氯化钠250mL＋丹参20mL静滴1d1次治疗,两组疗程均为14d,治疗后进行疗效比较。结果治疗组总有效率及显效率均高于对照组,差异有统计学意义（P〈0．05）。结论用疏血通联合低分子肝素钠治疗急性心肌梗死有较好的疗效。     

Compatibility and stability of telavancin and vancomycin in heparin or sodium citrate lock solutions

Purpose The compatibility and stability of telavancin and vancomycin in heparin or sodium citrate lock solutions were evaluated. Methods Telavancin and vancomycin hydrochloride injection powder lyophilized for solution were reconstituted with 0.9% sodium chloride injection at room temperature according to the manufacturer's instructions and then further diluted with (1) commercially available heparin sodium to reach a final heparin concentration of 2500 units/mL or (2) sodium citrate solution 2.2% or 4% to achieve final telavancin and vancomycin concentrations of 2 and 5 mg/mL. Physical stability, chemical compatibility, and biological anticoagulant stability were analyzed for each antibiotic-anticoagulant combination immediately after preparation and at 24, 48, and 72 hours. Changes in coagulation were measured at each time point and compared using two-way analysis of variance. Results Both telavancin and vancomycin retained at least 90% of the initial concentration after incubation at 37 °C over 72 hours. The biological stability of vancomycin 2 mg/mL and telavancin 2 mg/mL did not significantly alter prothrombin time when compared with that of 0.9% sodium chloride injection. However, telavancin 5 mg/mL and vancomycin 5 mg/mL significantly increased the activated partial thromboplastin time at 72 hours compared with the control solution. Visual precipitation only occurred with vancomycin-containing solutions; however, this dissipated after 10 minutes. Conclusion Telavancin 2 and 5 mg/mL was physically compatible in combination with heparin 2500 units/mL and with sodium citrate 2.2% and 4% over 72 hours. Vancomycin 2 and 5 mg/mL initially precipitated in the sodium citrate 2.2% formulation, but no precipitation was noted after 10 minutes of incubation at 37 °C. Telavancin and vancomycin 2 and 5 mg/mL retained over 90% of the initial concentration after incubation at 37 °C over 72 hours.     

舒血宁注射液加重头孢曲松钠致凝血障碍1例

1例31a男性患者,因治疗病毒性脑炎继发的细菌感染,静脉输入注射用头孢曲松钠2g＋0.9%氯化钠注射液100mL。7d后,患者双前臂静脉输液处瘀斑扩大,查凝血象：PT15.2s,INR1.31,APTT16.9s,Fbg1.00g·L-1,TT22.8s。怀疑药源性凝血障碍,停用头孢曲松钠,肌内注射维生素K1每天10mg。为改善微循环,第2天静脉滴注舒血宁注射液20mL＋0.9%氯化钠注射液500mL,7d后患者凝血象PT34.1s,INR2.87,APTT超出检测范围,Fbg0.70g·L-1,TT22.9s,遂停用舒血宁注射液,4d后凝血象基本恢复正常。