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[PMID]:29489681
[Au] Autor:Kim CO; Song J; Min JY; Park SJ; Lee HM; Byon HJ
[Ad] Endereço:Department of Clinical Pharmacology and Clinical Trials Center, Severance Hospital, Yonsei University Health System, Seodaemun-gu, Seoul.
[Ti] Título:A comparison of the pharmacokinetic and pharmacodynamic properties of nitroglycerin according to the composition of the administration set: A preliminary study.
[So] Source:Medicine (Baltimore);97(9):e9829, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is a risk of drug sorption into an intravenous administration set composed of polyvinyl chloride (PVC), polyurethane (PU), or polyolefin (PO). This has implications on the dose of the active ingredient the patient receives, and thus therapeutic success. This study aimed to determine the plasma concentration of nitroglycerin and the effect of nitroglycerin on patients based on the composition of the administration set. METHODS: Using a randomized, open-labeled, 3 × 3 crossover method, 9 volunteers were assigned to 3 groups. In period I, nitroglycerin (100 µg/mL) was infused via a PVC- (group A), PU- (group B), or PO-based (group C) administration set. In period II, PU- (group A), PO- (group B), and PVC-based (group C) administration sets were used, and in period III, PO- (group A), PVC- (group B), and PU-based (group C) administration sets were used. The rate of drug administration in all periods was 12 mL/hour for 30 minutes using an infusion pump. Blood samples were collected, and the plasma concentrations of nitroglycerin were analyzed using validated high-performance liquid chromatography coupled with tandem mass spectrometry. Blood pressure was determined using a sphygmomanometer applied to the other upper arm at an interval of 5 minutes. RESULTS: We observed that the mean plasma concentration of nitroglycerin over time when administered using a PO-based tube was higher than that when using a PU- or PVC-based tube. When the percent change of the mean arterial pressure from baseline at each time point was compared among groups, there were statistically significant differences between PU and PO or PVC at most points during nitroglycerin infusion. CONCLUSION: Our results showed higher nitroglycerin plasma concentration and lower arterial pressure when a PO-based administration set was used than when a PVC- or PU-based administration set was used. PO-based administration sets may be more appropriate for nitroglycerin administration compared to those composed of PVC or PU.
[Mh] Termos MeSH primário: Administração Intravenosa/instrumentação
Desenho de Equipamento
Bombas de Infusão
Nitroglicerina/farmacocinética
Vasodilatadores/farmacocinética
[Mh] Termos MeSH secundário: Administração Intravenosa/métodos
Adulto
Pressão Sanguínea
Cromatografia Líquida/métodos
Estudos Cross-Over
Seres Humanos
Masculino
Meia-Idade
Nitroglicerina/administração & dosagem
Nitroglicerina/sangue
Polienos
Poliuretanos
Cloreto de Polivinila
Espectrometria de Massas em Tandem
Vasodilatadores/administração & dosagem
Vasodilatadores/sangue
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Polyenes); 0 (Polyurethanes); 0 (Vasodilator Agents); 83136-87-2 (PL 732); 9002-86-2 (Polyvinyl Chloride); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009829


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[PMID]:27777173
[Au] Autor:Poole DS; Doorenweerd N; Plomp JJ; Mahfouz A; Reinders MJT; van der Weerd L
[Ad] Endereço:Department of Radiology, Leiden University Medical Centre, Leiden, Netherlands. Electronic address: D.Poole@lumc.nl.
[Ti] Título:Continuous infusion of manganese improves contrast and reduces side effects in manganese-enhanced magnetic resonance imaging studies.
[So] Source:Neuroimage;147:1-9, 2017 Feb 15.
[Is] ISSN:1095-9572
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The ability to administer systemically high doses of manganese as contrast agent while circumventing its toxicity is of particular interest for exploratory MRI studies of the brain. Administering low doses either repeatedly or continuously over time has been shown to enable the acquisition of satisfactory MRI images of the mouse brain without apparent side effects. Here we have systematically compared the obtained MRI contrast and recorded potential systemic side effects such as stress response and muscle strength impairment in relation to the achieved contrast. We show in mice that administering MnCl via osmotic infusion pumps allows for a side-effect free delivery of a high cumulative dose of manganese chloride (480mg/kg bodyweight in 8 days). High contrast in MRI was achieved while we did not observe the weight loss or distress seen in other studies where mice received manganese via fractionated intraperitoneal injections of lower doses of manganese. As the normal daily conduct of the mice was not affected, this new manganese delivery method might be of particular use to study brain activity over several days. This may facilitate the phenotyping of new transgenic mouse models, the study of chronic disease models and the monitoring of changes in brain activity in long-term behavioral studies.
[Mh] Termos MeSH primário: Cloretos/administração & dosagem
Cloretos/farmacologia
Meios de Contraste/administração & dosagem
Meios de Contraste/farmacologia
Imagem por Ressonância Magnética/métodos
Compostos de Manganês/administração & dosagem
Compostos de Manganês/farmacologia
[Mh] Termos MeSH secundário: Animais
Cloretos/efeitos adversos
Meios de Contraste/efeitos adversos
Corticosterona/sangue
Aumento da Imagem
Bombas de Infusão
Infusões Intravenosas
Injeções Intraperitoneais
Masculino
Compostos de Manganês/efeitos adversos
Camundongos
Camundongos Endogâmicos C57BL
Força Muscular/efeitos dos fármacos
Estresse Psicológico/induzido quimicamente
Estresse Psicológico/psicologia
Perda de Peso/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chlorides); 0 (Contrast Media); 0 (Manganese Compounds); QQE170PANO (manganese chloride); W980KJ009P (Corticosterone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29241898
[Au] Autor:Marshall T; Pugh A; Fairchild A; Hass S
[Ad] Endereço:AbbVie, Inc., North Chicago, IL, USA. Electronic address: t.marshall@abbvie.com.
[Ti] Título:Patient Preferences for Device-Aided Treatments Indicated for Advanced Parkinson Disease.
[So] Source:Value Health;20(10):1383-1393, 2017 12.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Effective treatment for advanced Parkinson disease (PD) uncontrolled with oral medication includes device-aided therapies such as deep brain stimulation (DBS) and continuous levodopa-carbidopa infusion to the duodenum via a portable pump. OBJECTIVE: Our objective was to quantify patient preferences for attributes of these device-aided treatments. METHODS: We administered a Web-enabled survey to 401 patients in the United States. A discrete-choice experiment (DCE) was used to evaluate patients' willingness to accept tradeoffs among efficacy, tolerability, and convenience of alternative treatments. DCE data were analyzed using random-parameters logit. Best-worst scaling (BWS) was used to elicit the relative importance of device-specific attributes. Conditional logit was used to analyze the BWS data. We tested for differences in preferences among subgroups of patients. RESULTS: Improving ability to think clearly was twice as important as a 6-hour-per-day improvement in control of movement symptoms. After controlling for efficacy, treatment delivered via portable infusion pump was preferred over DBS, and both devices were preferred to oral therapy with poor symptom control. Patients were most concerned about device attributes relating to risk of stroke, difficulty thinking, and neurosurgery. Avoiding surgery to insert a wire in the brain was more important than avoiding surgery to insert a tube into the small intestine. Some differences in preferences among subgroups were statistically, but not qualitatively, significant. CONCLUSIONS: This study clarifies the patient perspective in therapeutic choices for advanced PD. These findings may help improve communication between patients and providers and also provide evidence on patient preferences to inform regulatory and access decisions.
[Mh] Termos MeSH primário: Antiparkinsonianos/administração & dosagem
Carbidopa/administração & dosagem
Estimulação Encefálica Profunda/métodos
Levodopa/administração & dosagem
Doença de Parkinson/terapia
Preferência do Paciente
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Comportamento de Escolha
Combinação de Medicamentos
Sistemas de Liberação de Medicamentos
Duodeno
Desenho de Equipamento
Feminino
Seres Humanos
Bombas de Infusão
Internet
Masculino
Meia-Idade
Doença de Parkinson/fisiopatologia
Doença de Parkinson/psicologia
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Drug Combinations); 0 (carbidopa, levodopa drug combination); 46627O600J (Levodopa); MNX7R8C5VO (Carbidopa)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:28834856
[Au] Autor:Smetana KS; Roe NA; Doepker BA; Jones GM
[Ad] Endereço:Department of Clinical Pharmacy, The Ohio State University Wexner Medical Center, Columbus (Drs Smetana and Doepker); Department of Pharmacy, Baptist Health Medical Center, Little Rock, Arkansas (Dr Roe); Department of Pharmacy, Methodist University Hospital, Memphis, Tennessee (Dr Jones); and Department of Clinical Pharmacy, Neurology, and Neurosurgery, The University of Tennessee Health Science Center, Memphis (Dr Jones).
[Ti] Título:Review of Continuous Infusion Neuromuscular Blocking Agents in the Adult Intensive Care Unit.
[So] Source:Crit Care Nurs Q;40(4):323-343, 2017 Oct/Dec.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The use of continuous infusion neuromuscular blocking agents remains controversial. The clinical benefit of these medications may be overshadowed by concerns of propagating intensive care unit-acquired weakness, which may prolong mechanical ventilation and impair the inability to assess neurologic function or pain. Despite these risks, the use of neuromuscular blocking agents in the intensive care unit is indicated in numerous clinical situations. Understanding pharmacologic nuances and clinical roles of these agents will aid in facilitating safe use in a variety of acute disease processes. This article provides clinicians with information regarding pharmacologic differences, indication for use, adverse effects, recommended doses, ancillary care, and monitoring among agents used for continuous neuromuscular blockade.
[Mh] Termos MeSH primário: Bombas de Infusão
Unidades de Terapia Intensiva
Bloqueio Neuromuscular
Bloqueadores Neuromusculares/uso terapêutico
[Mh] Termos MeSH secundário: Cuidados Críticos
Seres Humanos
Bloqueadores Neuromusculares/farmacologia
Dor/tratamento farmacológico
Respiração Artificial
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Neuromuscular Blocking Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000171


  5 / 5023 MEDLINE  
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[PMID]:28828469
[Au] Autor:Okun MS
[Ad] Endereço:Departments of Neurology and Neurosurgery, University of Florida Center for Movement Disorders and Neurorestoration, Gainesville.
[Ti] Título:Management of Parkinson Disease in 2017: Personalized Approaches for Patient-Specific Needs.
[So] Source:JAMA;318(9):791-792, 2017 Sep 05.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Antiparkinsonianos/uso terapêutico
Estimulação Encefálica Profunda
Levodopa/uso terapêutico
Doença de Parkinson/terapia
Medicina de Precisão
[Mh] Termos MeSH secundário: Seres Humanos
Bombas de Infusão
Inibidores da Monoaminoxidase/uso terapêutico
Doença de Parkinson/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Monoamine Oxidase Inhibitors); 46627O600J (Levodopa)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.7914


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[PMID]:28816893
[Au] Autor:Smith EB; Kazarian GS; Maltenfort MG; Lonner JH; Sharkey PF; Good RP
[Ad] Endereço:1The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
[Ti] Título:Periarticular Liposomal Bupivacaine Injection Versus Intra-Articular Bupivacaine Infusion Catheter for Analgesia After Total Knee Arthroplasty: A Double-Blinded, Randomized Controlled Trial.
[So] Source:J Bone Joint Surg Am;99(16):1337-1344, 2017 Aug 16.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. METHODS: This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104). The primary outcome of this study was cumulative narcotic consumption on postoperative days 0 through 3. Narcotic consumption data were collected retrospectively from in-hospital records while patients were in the hospital. Following discharge, narcotic consumption data were gathered from patient surveys, as were secondary outcomes measures. RESULTS: We did not identify greater narcotic use in the ON-Q* group compared with the Exparel group (p = 0.641). The mean difference between the groups was 0.5 morphine equivalent (95% confidence interval [CI] = -1.7 to +2.8), with the ON-Q* group consuming an average 10.4 morphine equivalents (95% CI = 8.7 to 12.0) compared with 10.9 (95% CI = 9.3 to 12.5) in the Exparel group. There were no significant differences between groups with regard to any of the secondary measures of pain with the exception of pain while walking and pain with physical therapy (p = 0.019 and p = 0.010, respectively), both of which showed an approximately 1-point difference in favor of the ON-Q* group on a visual analog scale (VAS). There were also no differences in the postoperative side effects, including nausea, constipation, or vomiting, or in the rates of study-related complications, patient satisfaction, or length of hospital stay. CONCLUSIONS: Exparel did not have superior efficacy compared with the ON-Q* Pain Relief System as reflected by narcotic consumption, our primary outcome. There were small significant differences, in favor of the ON-Q* group, in 2 secondary measures of pain during activity, but these approximately 1-point VAS differences are unlikely to be clinically relevant. The choice of a local anesthetic modality should be based on a combination of safety, convenience, and cost considerations. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Anestesia Local/métodos
Anestésicos Locais/administração & dosagem
Artroplastia do Joelho
Bupivacaína/administração & dosagem
Sistemas de Liberação de Medicamentos/métodos
Bombas de Infusão
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Cateterismo/métodos
Método Duplo-Cego
Feminino
Seres Humanos
Injeções Intra-Articulares
Tempo de Internação
Modelos Lineares
Lipossomos
Masculino
Meia-Idade
Manejo da Dor
Medição da Dor
Satisfação do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Liposomes); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00571


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[PMID]:28816851
[Au] Autor:Kane-Gill SL; Dasta JF; Buckley MS; Devabhakthuni S; Liu M; Cohen H; George EL; Pohlman AS; Agarwal S; Henneman EA; Bejian SM; Berenholtz SM; Pepin JL; Scanlon MC; Smith BS
[Ad] Endereço:1Department of Pharmacy and Therapeutics, Critical Care Medicine, Biomedical Informatics and Clinical Translational Science Institute, University of Pittsburgh, Pittsburgh, PA. 2Department of Pharmacy, UPMC, Pittsburgh, PA. 3Department of Pharmacy Practice and Science, The Ohio State University, College of Pharmacy, Columbus, OH. 4Department of Pharmacy, Banner University Medical Center Phoenix, Phoenix, AZ. 5Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD. 6Department of Pharmacy, Yale-New Haven Hospital, New Haven, CT. 7Department of Pharmacy Services, Touro College of Pharmacy, New York, NY. 8Kingsbrook Jewish Medical Center, Brooklyn, NY. 9UPMC-Presbyterian, Pittsburgh, PA. 10Department of Medicine, University of Chicago, Chicago, IL. 11Pediatric Critical Care, Department of Pediatrics, Inova Children's Hospital, Falls Church, VA. 12College of Nursing, University of Massachusetts Amherst, Amherst, MA. 13Inova Fairfax Hospital, Falls Church, VA. 14Departments of Anesthesia/CCM and Surgery, and Health Policy & Management, Johns Hopkins Schools of Medicine and Bloomberg School of Public Health, Baltimore, MD. 15Department of Pharmacy, Seton Medical Center Williamson, Round Rock, TX. 16Department of Pediatrics and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI. 17Children's Hospital of Wisconsin, Milwaukee, WI. 18Department of Pharmacy, UMass Memorial Medical Center, Worcester, MA.
[Ti] Título:Clinical Practice Guideline: Safe Medication Use in the ICU.
[So] Source:Crit Care Med;45(9):e877-e915, 2017 Sep.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To provide ICU clinicians with evidence-based guidance on safe medication use practices for the critically ill. DATA SOURCES: PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and ISI Web of Science for relevant material to December 2015. STUDY SELECTION: Based on three key components: 1) environment and patients, 2) the medication use process, and 3) the patient safety surveillance system. The committee collectively developed Population, Intervention, Comparator, Outcome questions and quality of evidence statements pertaining to medication errors and adverse drug events addressing the key components. A total of 34 Population, Intervention, Comparator, Outcome questions, five quality of evidence statements, and one commentary on disclosure was developed. DATA EXTRACTION: Subcommittee members were assigned selected Population, Intervention, Comparator, Outcome questions or quality of evidence statements. Subcommittee members completed their Grading of Recommendations Assessment, Development, and Evaluation of the question with his/her quality of evidence assessment and proposed strength of recommendation, then the draft was reviewed by the relevant subcommittee. The subcommittee collectively reviewed the evidence profiles for each question they developed. After the draft was discussed and approved by the entire committee, then the document was circulated among all members for voting on the quality of evidence and strength of recommendation. DATA SYNTHESIS: The committee followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation system to determine quality of evidence and strength of recommendations. CONCLUSIONS: This guideline evaluates the ICU environment as a risk for medication-related events and the environmental changes that are possible to improve safe medication use. Prevention strategies for medication-related events are reviewed by medication use process node (prescribing, distribution, administration, monitoring). Detailed considerations to an active surveillance system that includes reporting, identification, and evaluation are discussed. Also, highlighted is the need for future research for safe medication practices that is specific to critically ill patients.
[Mh] Termos MeSH primário: Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
Unidades de Terapia Intensiva/organização & administração
Erros de Medicação/prevenção & controle
Sistemas de Medicação no Hospital/organização & administração
[Mh] Termos MeSH secundário: Processamento Automatizado de Dados
Pesos e Medidas Corporais
Lista de Checagem/normas
Protocolos Clínicos/normas
Sistemas de Apoio a Decisões Clínicas/organização & administração
Revelação
Documentação/normas
Relação Dose-Resposta a Droga
Rotulagem de Medicamentos/métodos
Meio Ambiente
Prática Clínica Baseada em Evidências
Seres Humanos
Bombas de Infusão
Capacitação em Serviço
Unidades de Terapia Intensiva/normas
Unidades de Terapia Intensiva Pediátrica/organização & administração
Sistemas de Registro de Ordens Médicas/organização & administração
Reconciliação de Medicamentos/organização & administração
Sistemas de Medicação no Hospital/normas
Cultura Organizacional
Pacotes de Assistência ao Paciente/normas
Transferência da Responsabilidade pelo Paciente/normas
Participação do Paciente
Fatores de Risco
Desenho de Programas de Computador
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002533


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[PMID]:28800617
[Au] Autor:Doesburg F; Cnossen F; Dieperink W; Bult W; de Smet AM; Touw DJ; Nijsten MW
[Ad] Endereço:University of Groningen, University Medical Center Groningen, Department of Critical Care, Groningen, The Netherlands.
[Ti] Título:Improved usability of a multi-infusion setup using a centralized control interface: A task-based usability test.
[So] Source:PLoS One;12(8):e0183104, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of this study was to assess the usability benefits of adding a bedside central control interface that controls all intravenous (IV) infusion pumps compared to the conventional individual control of multiple infusion pumps. Eighteen dedicated ICU nurses volunteered in a between-subjects task-based usability test. A newly developed central control interface was compared to conventional control of multiple infusion pumps in a simulated ICU setting. Task execution time, clicks, errors and questionnaire responses were evaluated. Overall the central control interface outperformed the conventional control in terms of fewer user actions (40±3 vs. 73±20 clicks, p<0.001) and fewer user errors (1±1 vs. 3±2 errors, p<0.05), with no difference in task execution times (421±108 vs. 406±119 seconds, not significant). Questionnaires indicated a significant preference for the central control interface. Despite being novice users of the central control interface, ICU nurses displayed improved performance with the central control interface compared to the conventional interface they were familiar with. We conclude that the new user interface has an overall better usability than the conventional interface.
[Mh] Termos MeSH primário: Serviços Centralizados no Hospital/métodos
Bombas de Infusão
Monitorização Fisiológica/instrumentação
Postos de Enfermagem/organização & administração
Interface Usuário-Computador
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Meia-Idade
Monitorização Fisiológica/métodos
Inquéritos e Questionários
Análise e Desempenho de Tarefas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170812
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183104


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[PMID]:28759483
[Au] Autor:Berman MF; Iyer N; Freudzon L; Wang S; Freundlich RE; Housey M; Kheterpal S; Multicenter Perioperative Outcomes Group (MPOG) Perioperative Clinical Research Committee
[Ad] Endereço:From the *Department of Anesthesiology, Columbia University Medical Center, New York, New York; †Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan; ‡Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut; §Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; and ‖Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
[Ti] Título:Alarm Limits for Intraoperative Drug Infusions: A Report From the Multicenter Perioperative Outcomes Group.
[So] Source:Anesth Analg;125(4):1203-1211, 2017 Oct.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Continuous medication infusions are commonly used during surgical procedures. Alarm settings for infusion pumps are considered important for patient safety, but limits are not created in a standardized manner from actual usage data. We estimated 90th and 95th percentile infusion rates from a national database for potential use as upper limit alarm settings. METHODS: We extracted infusion rate data from 17 major hospitals using intraoperative records provided by Multicenter Perioperative Outcomes Group for adult surgery between 2008 and 2014. Seven infusions were selected for study: propofol, remifentanil, dexmedetomidine, norepinephrine, phenylephrine, nitroglycerin, and esmolol. Each dosage entry for an infusion during a procedure was included. We estimated the 50th, 90th, and 95th percentile levels for each infusion across institutions, and performed quantile regression to examine factors that might affect the percentiles rates, such as use in general anesthesia versus sedation. RESULTS: The median 90th and 95th percentile infusion rates (with interquartile range) for propofol were 150 (140-150) and 170 (150-200) µg/kg/min. Quantile regression demonstrated higher 90th and 95th percentile rates during sedation for gastrointestinal endoscopy than for all surgical procedures performed under general anesthesia. For selected vasoactive medications, the corresponding median 90th and 95th percentile rates (with interquartile range) were norepinephrine 14.0 (9.8-18.1) and 18.3 (12.6-23.9) µg/min, and phenylephrine 60 (55-80) and 80 (75-100) µg/min. CONCLUSIONS: Alarm settings based on infusion rate percentile limits would be triggered at predictable rates; ie, the 95th percentile would be exceeded and an alarm sounded during 1 in 20 infusion rate entries. As a result, institutions could establish pump alarm settings consistent with desired alarm frequency using their own or externally validated usage data. Further study will be needed to determine the optimal percentile for infusion alarm settings.
[Mh] Termos MeSH primário: Anestésicos Intravenosos/administração & dosagem
Alarmes Clínicos/normas
Falha de Equipamento
Bombas de Infusão/normas
Relatório de Pesquisa
[Mh] Termos MeSH secundário: Idoso
Anestésicos Intravenosos/efeitos adversos
Feminino
Seres Humanos
Bombas de Infusão/efeitos adversos
Infusões Intravenosas
Complicações Intraoperatórias/prevenção & controle
Masculino
Meia-Idade
Propofol/administração & dosagem
Propofol/efeitos adversos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anesthetics, Intravenous); YI7VU623SF (Propofol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002305


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[PMID]:28683003
[Au] Autor:Perrigino MB; Dunford BB; Vermace BJ; Tucker SJ; Rempher KJ
[Ad] Endereço:Krannert School of Management, Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, Indiana (Mr Perrigino and Dr Dunford); University of Iowa Hospitals and Clinics, Iowa City, Iowa (Ms Vermace); Ohio State University College of Nursing, Columbus, Ohio (Dr Tucker); and Cone Health System, Greensboro, North Carolina (Dr Rempher). Matthew B. Perrigino, BBA, is a doctoral candidate in the organizational behavior and human resources program at Purdue University's Krannert School of Management in West Lafayette, Indiana. He is also a research fellow at Purdue's Regenstrief Center for Healthcare Engineering. Benjamin B. Dunford, PhD, is an associate professor at the Krannert School of Management and a Regenstrief Center for Healthcare Engineering Scholar at Purdue University in West Lafayette, Indiana. Beverly J. Vermace, MSN, RN, is a parenteral infusion device coordinator and clinical coordinator for the office of the chief medical information officer at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Sharon J. Tucker, PhD, RN, PMHCNS-BC, FAAN, is a Grayce M. Sills Endowed Professor of Psychiatric Mental Health Nursing and director of the Translational Research Core of the Helene Fuld Health Trust National Institute for Evidence-based Practice at the Ohio State University College of Nursing in Columbus, Ohio. Kenneth J. Rempher, PhD, MBA, RN, CENP, is executive vice president and health system chief nurse executive for the Cone Health System, based in Greensboro, North Carolina.
[Ti] Título:Age Differences and the Acceptance of Infusion Pump Technology.
[So] Source:J Infus Nurs;40(4):238-244, 2017 Jul/Aug.
[Is] ISSN:1539-0667
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Previous studies demonstrate that age and receptiveness to new technologies tend to be negatively correlated. Using data from a sample of 311 nurses in a large teaching hospital in the midwestern United States, this study sought to determine whether age predicted satisfaction perceptions of infusion pump technology. Hierarchical regression indicated that the relationship between age and infusion pump satisfaction was not statistically significant, but it also revealed interesting moderation effects. When perceived support for infusion pump use was low, age was negatively related to infusion pump satisfaction. However, when perceived support was high, age was positively related to infusion pump satisfaction.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Bombas de Infusão/utilização
Invenções/utilização
Recursos Humanos de Enfermagem no Hospital/psicologia
[Mh] Termos MeSH secundário: Fatores Etários
Seres Humanos
Satisfação no Emprego
Meio-Oeste dos Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1097/NAN.0000000000000226



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