• Title/Summary/Keyword: Intravenous therapy

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Meta-analysis of factors predicting resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease

  • Baek, Jin-Young;Song, Min Seob
    • Clinical and Experimental Pediatrics
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    • v.59 no.2
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    • pp.80-90
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    • 2016
  • Purpose: Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques. Methods: All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For studies in English on KD and IVIG resistance, predictive factors were included. A meta-analysis was performed that calculated the effect size of various laboratory parameters as predictive factors for IVIG-resistant KD. Results: Twelve studies comprising 2,745 patients were included. Meta-analysis demonstrated significant effect sizes for several laboratory parameters: polymorphonuclear leukocytes (PMNs) 0.698 (95% confidence interval [CI], 0.469-0.926), C-reactive protein (CRP) 0.375 (95% CI, 0.086-0.663), pro-brain natriuretic peptide (pro-BNP) 0.561 (95% CI, 0.261-0.861), total bilirubin 0.859 (95% CI, 0.582-1.136), alanine aminotransferase (AST) 0.503 (95% CI, 0.313-0.693), aspartate aminotransferase (ALT) 0.436 (95% CI, 0.275-0.597), albumin 0.427 (95% CI, -0.657 to -0.198), and sodium 0.604 (95% CI, -0.839 to -0.370). Particularly, total bilirubin, PMN, sodium, pro-BNP, and AST, in descending numerical order, demonstrated more than a medium effect size. Conclusion: Based on the results of this study, laboratory predictive factors for IVIG-resistant KD included higher total bilirubin, PMN, pro-BNP, AST, ALT, and CRP, and lower sodium and albumin. The presence of several of these predictive factors should alert clinicians to the increased likelihood that the patient may not respond adequately to initial IVIG therapy.

Analysis of the Nursing Interventions performed by neurosurgery unit using NIC (간호중재분류체계(NIC)에 근거한 간호중재 수행분석 - 신경외과 간호단위 간호사를 중심으로 -)

  • Oh, Myung-Seon;Park, Kyung-Sook
    • Korean Journal of Adult Nursing
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    • v.14 no.2
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    • pp.265-275
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    • 2002
  • Pursose: The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses. Method: The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky & Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program. Result: The results of this study are as follows. 1. The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2. Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3. Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital. Conclusion: The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.

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

  • Choi, Ja-Yun;Kim, Mi-Won
    • Journal of Korean Biological Nursing Science
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    • v.11 no.1
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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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Anticancer effect of mountain ginseng Pharmacopuncture to the nude mouse of lung carcinoma induced by NCI-H460 human non-small cell lung cancer cells

  • Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.13 no.1
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    • pp.5-14
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    • 2010
  • Objectives : This study was performed to examine the anticancer effect of mountain ginseng Pharmacopuncture(MGP) to the nude mouse of lung carcinoma induced by NCI-H460 human nonsmall lung cancer cells. Methods : Human lung cancer (NCI-H460) cells were cultured and applied to evaluate anti-tumor activity in nude mice. After confirmed tumor growth in mice, MGP was treated per 0.1ml/kg dose to intraperitoneal and intravenous injection everyday for four weeks. And checked the changes in body weights, tumor volume, mean survival time and percent, increase in life span, histo-pathological findings, organ weights, and blood chemistry levels. Results : The results of in vivo study showed that MGP may have potential as growth inhibitor of solid tumor induced NCI-H460 without marked side effects. MGP inhibited dosage-dependently the growth of NCI-H460 cell-transplanted solid tumor compared with the control group. And mean survival time of MGP treated group was prolonged comparing with control group. Generally the group of intravenous injection is more effective than intraperitoneal injection. Conclusion : These results were suggested that MGP may be a useful anticancer agent for therapy of human lung cancer. And follow study need for the certain evidence.

Improved Case of Recurred and Metastatic Ascending Colon Cancer by Combination of Oriental Medical Therapy and FOLFIRI Chemotherapy (산삼약침과 FOLFIRI 항암화학요법의 병행으로 호전된 전이성 대장암 환자 1례)

  • Ha, Tai Hyoun;Seong, Shin;Lee, Dong Hyun;Kim, Sung Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.1
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    • pp.148-151
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    • 2013
  • This study is aimed to investigate the effects of intravenous Cultivated Wild Ginseng Pharmacopuncture(CWGP) and the FOLFIRI chemotherapy combination on recurred and metastatic ascending colon cancer patient. A 42-years-old man was diagnosed as ascending colon adenocarcinoma on 9th Mar. 2011. After performing right hemicolectomy and 12 cycles of FOLFOX chemotherapy recurrence at hemicolectomy site and metastases in liver, spleen and lungs were found on 7th Feb. 2012. Intravenous CWGP were performed during total 12 cycles of FOLFIRI chemotherapy from 3rd Mar. 2012 to 27th Sep. 2012. The effects and toxicities of CWGP and FOLFIRI chemotherapy combination were evaluated with PET torso(AA) and National Cancer Institute-Common Toxicity Criteria. The tumor mass in the splenic hilum and liver S4 was disappeared and multiple pulmonic lymph nodules were decreased in size. The recurred lesion on the site of right hemicolectomy showed no changes. During the treatment the patient had no toxicity over grade 1.

Status Epilepticus Caused by Nefopam

  • Park, Yong-Sook;Kim, Young-Baeg;Kim, Jeong-Min
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.448-450
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    • 2014
  • Nefopam, a centrally acting analgesic, has been used to control postoperative pain. Reported adverse effects are anticholinergic, cardiovascular or neuropsychiatric. Neurologic adverse reactions to nefopam are confusion, hallucinations, delirium and convulsions. There are several reports about fatal convulsive seizures, presumably related to nefopam. A 71-year-old man was admitted for surgery for a lumbar spinal stenosis. He was administered intravenous analgesics : ketorolac, tramadol, orphenadrine citrate and nefopam HCl. His back pain was so severe that he hardly slept for several days; he even needed morphine and pethidine. At 4 days of administration of intravenous analgesics, the patient suddenly started generalized tonic-clonic seizures for 15 seconds, and subsequently, status epilepticus; these were not responsive to phenytoin and midazolam. After 3 days of barbiturate coma therapy the seizures were controlled. Convulsive seizures related to nefopam appear as focal, generalized, myoclonic types, or status epilepticus, and are not dose-related manifestations. In our case, the possibility of convulsions caused by other drugs or the misuse of drugs was considered. However, we first identified the introduced drugs and excluded the possibility of an accidental misuse of other drugs. Physicians should be aware of the possible occurrence of unpredictable and serious convulsions when using nefopam.

Nitrogen Sparing Effect of Intravenous Amino Acid Solutions (종합 아미노산수액 투여에 의한 Nitrogen balance의 임상적 검토)

  • Park, C.W.;Lim, J.K.;Lee, J.K.;Lee, J.O.;Park, K.W.
    • The Korean Journal of Pharmacology
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    • v.13 no.2
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    • pp.67-73
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    • 1977
  • The nitrogen sparing effect of intravenous 3% amino acid solution was compared with 5% dextrose solution in 30 patients who were undergoing surgical operations or radiation therapy. Infusion of 3% amino acid solution or 5% dextrose solution was given before and immediately after operations or irradiation and continued for 6 days. Infusion of solutions through peripheral vein was well tolerated and not experienced any specific hematologic or blood chemistry change in all patients subjected throughout the experiment. The patients received 3% amino acid solution showed low blood glucose and insulin level, but significantly high blood urea nitrogen and ketone body. In patients receiving amino acids, as compared with those receiving dextrose, mean cumulative six day nitrogen losses were significantly lower($63.95{\pm}2.12$ Gm and $79.12{\pm}2.43Gm$ respectively). The nitrogen sparing effect of amino acids is probably due to decreased glucose and insulin levels allowing greater endogenous fat mobilization.

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Analysis of Nursing Interventions Performed by Chosunjok Nurses in Yanbian Using NIC (연변조선족 간호사가 수행하는 간호중재 분석)

  • ;;;;Li, Chun-Yu;Kim, Kyung-Yun;Huang, Zhen-Yu;Yuk, Moon-Ae
    • Journal of Korean Academy of Nursing
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    • v.31 no.5
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    • pp.793-806
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    • 2001
  • To identify nursing interventions performed by Chosunjok nurses in Yanbian using NIC. Methods: The sample consisted of 36 nurses working in 2 hospitals. The Nursing Interventions Use Questionnaire developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean using the method of back-translation. Results: Twenty-eight interventions were performed at least daily. Interventions in the Physiological: Basic domain were most frequently used at least daily. The most frequently used interventions was Positioning, followed by the interventions Pressure Ulcer Prevention, Intravenous (IV) Therapy, Hypothermia Treatment and Intravenous (IV) Insertion. The least frequently used interventions was Electronic Fetal Monitoring: Antepartum. Nurses working in special medical care units performed interventions most often, while nurses working in general surgical units performed them least. Nurses working in general medical, special medical and other care units performed interventions in the Physiological domain more often than the nurses working in general surgical units. Conclusion: Chosunjok nurses in Yanbian performed physiological interventions frequently. Further studies will be needed to compare interventions performed by nurses in two countries.

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Pharmaceutical Care for Medication Safety in Critically Ill Neonates (신생아중환자의 안전한 약물사용을 위한 약료서비스)

  • An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.143-148
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    • 2020
  • Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

The Trial of Continuous Intravenous Infusion of Ketamine in Patients with Phantom Limb Pain -A case report- (환지통 환자에서 Ketamine 지속 정주에 의한 치료 경험 -증례보고-)

  • Cheong, Yong Kwan;Lee, Cheol;Son, Yong;Song, Yoon Kang;Kim, Tai Yo;Lee, Seung Woo
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.233-236
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    • 2006
  • Phantom limb pain is a painful sensation from an absent limb. The onset of pain is generally early, with 75% of patients developing pain within the first few days after amputation. The frequency and duration of attacks tend to be reduced with time, although the prevalence and intensity remain constant. We report here a case of a 38-year-old man who exhibited the signs and symptoms of phantom limb pain due to the above-knee amputations of both legs. He was not responded to opioid therapy and a continuous intravenous infusion of ketamine, an N-methyl-D-aspatate receptor antagonist, reduced his severe pain.