• 임상간호연구
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• 제29권1호
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• pp.42-55
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• 2023

Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

• 대한의생명과학회지
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• 제27권1호
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• pp.19-27
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• 2021

This study was undertaken to clarify the effects of omega-3 fatty acid on endotoxin-induced acute lung injury. Rabbits were randomly assigned to one of four groups. Each group received intravenous infusion of saline only, saline and Escherichia coli endotoxin, omegaven infuison (0.5 mL/kg/hr) and endotoxin, lipoven (0.5 mL/kg/hr) and endotoxin respectively. Infusion of saline was started 0.5 hr before the infusion of saline or endotoxin, and omegaven and lipoven were started 2 hours after endotoxin infusion for 4 hours. The lungs of rabbits were ventilated with 40% oxygen. Mean blood pressure, heart rate, arterial oxygen tension (PaO2), and peripheral blood leukocyte were recorded. The wet/dry (W/D) weight ratio of lung and lung injury score were measured, and analysis of bronchoalveolar lavage fluid (BALF) was done. Endotoxin decreased PaO2, and peripheral blood leukocyte and platelet count. And it increased W/D ratio of lung, lung injury score and leukocyte count, percentage of PMN cells, concentration of IL-8 in BALF. Omegaven attenuated all these changes except for peripheral blood leukocyte counts. Omegaven attenuated endotoxin-induced acute lung injury in rabbits mainly by inhibiting neutrophil and IL-8 responses, which may play a central role in endotoxin-related lung injury.

• International Journal of Oral Biology
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• 제33권3호
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• pp.97-103
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• 2008

The present study investigated the role of peripheral group I, II, and III metabotropic glutamate receptors (mGluRs) in mustard oil (MO)-induced nociceptive response in the masseter muscles of lightly anesthetized rats. Experiments were carried out on male Sprague-Dawley rats weighing 300-350 gm. After initial anesthesia with sodium pentobarbital (40 mg/kg, i.p.), one femoral vein was cannulated and connected to an infusion pump for intravenous infusion of sodium pentobarbital. The rate of infusion was adjusted to provide a constant level of anesthesia. MO (30 ${\mu}L$) was injected into the mid-region of the left masseter muscle via a 30-gauge needle over 10 seconds. After 30 mL injection of 5, 10, 15, or 20% MO into the masseter muscle, total number of hindpaw-shaking behavior was monitored. Intramuscular administration of MO significantly produced hindpawshaking behavior in a dose-dependent manner, as compared with the vehicle (mineral oil)-treated group. Intramuscular pretreatment with 10 or 100 ng DHPG, a group I mGluRs agonist, enhanced MO-induced hindpaw-shaking behavior, while APDC (20 or 200 ${\mu}g$), a group II mGluRs agonist, or L-AP4 (2 ${\mu}g$), a group III mGluRs agonist, significantly reduced MO-induced nociceptive behavior. The antinociception, produced by group II or III mGluRs agonists, was abolished by pretreatment with LY341495, a group II mGluRs antagonist, or CPPG, a group III mGluRs antagonist, res-pectively. Based on these observations, peripheral mGluRs differentially modulated MO-induced nociceptive behavior response in the craniofacial muscle pain and peripheral group II and III mGluRs agonists could be used in treatment of craniofacial muscle nociception.

• 대한간호학회지
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• 제46권4호
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• pp.534-541
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• 2016

Purpose: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. Methods: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea. The 193 patients, who were hospitalized from January to May, 2014 formed the control group and did not have OW, and the 167 patients, who were hospitalized from January to May, 2015 formed the window group and had OW. Data were analyzed using ${\chi}^2$-test, independent samples t-test and multiple logistic regression. Results: First stage IV infiltration was 39.5% for the window group and 25.9% for the control group, which was significantly different (p=.007). The likelihood of $2^{nd}$ stage and above IV infiltration decreased by 44% in the window group, which was significantly different (p=.014). Conclusion: OW at the peripheral IV catheter site was found to be an effective measure in early recognition of IV infiltration. Considering the effect of OW, we recommend that nurses should make an OW with transparent dressing during stabilization of the IV catheter site in hospitalized children in clinical settings.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2004년도 제47차 추계학술대회
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• pp.98-98
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• 2004

• 대한약리학회지
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• 제13권2호
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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.

• 임상간호연구
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• 제21권2호
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• pp.188-195
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• 2015

Purpose: The purpose of this study was to evaluate the appropriateness of the replacement time intervals of 18 gauge peripheral intravenous catheters (PICs) by investigating the development of phlebitis. Methods: The subjects were 200 hospitalized patients over 18 yrs old aged who have 18 gauge PICs placed for surgery. After the insertion of PICs, the researcher monitored the insertion site daily for 96 hours for any signs of phlebitis. Results: Phlebitis developed in 25.7% of patients. Patients who developed phlebitis were significantly older and were receiving fluids with faster infusion rate. However, patients with and without phlebitis were not different by gender, insertion site, fluid osmolality, or pH of drugs administered. The incidence rate of phlebitis was higher than 10%(12.9%) starting 24~48 hours after the insertion of 18 gauge PICs. Conclusion: It is recommended to replace 18 gauge PICs within 24~48 hours after insertion. Close monitoring of the PICs insertion site for the signs of phlebitis is recommended.

• The Korean Journal of Physiology and Pharmacology
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• 제6권4호
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• pp.199-205
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• 2002

The role of peripheral vestibular receptors in acute hypotension was investigated in anesthetized rats. Acute hypotension was induced by either intravenous infusion of sodium nitroprusside (SNP) or by experimental hemorrhage, and electrical activity and expression of cFos-like immunoreactive (cFL) protein were measured in the medial vestibular nuclei (MVN). Blood pressure decreased proportionately to the does of intravenous SNP and to the volume of the hemorrhage. Blood pressure decreased 10, 30, 50% for the 5, 10, $15{\mu}g/kg$ SNP injection, respectively, and also decreased 30 and 50% after 1- and 2-ml blood loss, respectively, due to hemorrhage. In animals with intact labyrinths, acute hypotension induced by either intravenous infusion of SNP or hemorrhage produced different electrical activities with three different patterns in type I and II neurons of MVN. The responses of type I neurons showed excitatory in 2/3 of recorded neurons and inhibitory or no change in 1/3 of neurons, while the responses of type II neurons showed inhibitory in 2/3 of recorded neurons and excitatory or no change in 1/3 of neurons. In unilateral labyrinthectomized animals, 2/3 of type I neurons ipsilateral to the lesion showed an inhibitory response, and 2/3 of contralateral type I neurons showed an excitatory response after the induction of acute hypotension. The response patterns of type II neurons were opposite from those of the type I neurons. After 30% decrease in blood pressure, cFL protein expressed in the bilateral vestibular nuclei of control animals with intact labyrinths. Expression of cFL protein increased significantly proportionately to the reduction of blood pressure. The unilateral labyrinthectomized animals with acute hypotension produced expression of cFL neurons in contralateral vestibular nuclei to the lesion side, but not in ipsilateral vestibular nuclei. However, cFL protein was not expressed in bilateral vestibular nuclei after acute hypotension in bilateral labyrinthectomized animals. These results suggest that the peripheral vestibular receptors might play a significant role in controlling blood pressure following acute hypotension via activation of type I neurons and inhibition of type II neurons in the vestibular nuclei.

• Journal of Chest Surgery
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• 제6권2호
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• pp.131-142
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• 1973

Studies of cardiopulmonary function and acid-base balance were performed on 29 dogs during control period, during oligemic hypotension and following return of blood to the animals. Intravenous morphine and local anesthesia were used. Fifteen of the 29 animals survived the complete experiment. The 14 animals that failed to survive the experimental period died between 15 to 90 minutes after the onset of bleeding. The results were as follows. 1. The heart rate increased after the onset of bleeding and failed to return to control level following reinfusion. Stroke volume decreased markedly after bleeding and failed to recover after return of blood from the reservoir. Cardiac output also decreased during oligemic hypotension and was maintained at this level after re-infusion. Total peripheral resistance decreased significantly immediately after bleeding, however it increased soon over the pre-bleeding level. Central venous pressure decreased after the onset of bleeding and remained at lower level for the rest of the experimental period. Arterial blood pressure, clown to 40-45 mmHg by acute hemorrhage, was elevated near to control level. Left ventricular work decreased tremendously during oligemic hypotension and failed to return to control level with the re-infusion of blood. Hematocrit value showed no significant decrease after bleeding and increased after re-infusion. Hemoglobin decreased after the onset of bleeding and recovered to control value after re-infusion. 2. The respiratory rate fell rapidly after bleeding from 124 to 29 and remained at this lower level for the remainder of the experiment. The tidal volume increased after bleeding and was maintained at this level for the remainder of the experiment. The respiratory minute volume showed no significant changes throughout the experimental period. Oxygen consumption fell lightly in all animals during oligemic hypotension and returned to normal levels following re-infusion. Arterial oxygen content and arterial oxygen saturation decreased following bleeding and the values returned to normal levels after the return of blood from the reservoir The arterio-venous oxygen difference increased after the onset of bleeding. It failed to return to normal values following re-infusion. Arterial $Pco_2$ decreased in all animals after the beginning of the bleeding. Partial pressure of $Co_2$ continued to fall until re-infusion, after which the values returned toward normal. Animals became acidotic. The pH fell to lower level following bleeding. Lactic acid and lactate: pyruvate ratio also increased during same period. Arterial pH and lactic acid failed to return to control value and lactate: pyruvate ratio increased more after re-infusion. Sodium bicarbonate decreased after bleeding and returned to control value following re-infusion.

• 대한치과마취과학회지
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• 제13권1호
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• pp.1-7
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• 2013

Background: Intravenous sedation is effective for dental patients who are anxious. Recently, target-controlled infusion (TCI) has begun to be used widely to administer and titrate propofol and remifentanil during sedation. To investigate the effect and safety of the pharmacologic agents used in anesthetic department, we performed a retrospective study. Methods: Retrospective study of a series of dental procedure under intravenous sedation performed in department of anesthesiology in Dental Hospital of Dankook University was carried out with propofol or propofol/remifentanil between January and August 2011 and January and April 2012. All patients received oxygen by nasal cannula. The average propofol and remifentanil target was 0.5 ${\mu}g/ml$ and 1.0 ng/ml, respectively using a TCI pump. The average peripheral oxygen saturation ($SpO_2$), heart rate, blood pressure, respiratory rate, nasal end-tidal $CO_2$ were recorded at 5-10 minute intervals. The age, gender, weight, procedure and sedation time, type of procedure were also recorded. Results: We included 22 cases of 19 adults (group A) and 6 cases of children (group B). In group A, 4 patients received propofol (group A-P), and 15 patients received propofol with remifentanil (group A-PR). In group B, 6 patients received propofol only. The mean age of group A was 41.1 years old and that of group B was 9.5 years old. No clinically significant complications were noted. There were no case of de-saturation <90%. The median respiratory rate was 13.1 (range 6 to 36) in group A and 19 (range 13 to 25) in group B. The median end tidal $CO_2$ was 36.7 mmHg(range 8 mmHg to 56 mmHg) in group A and 41.7 mmHg (range 30 mmHg to 53 mmHg) in group B. Conclusions: Based on our results, dental sedation using propofol/remifentanil in adult and propofol in children with TCI pump seems to appear as a safe and effective procedure while performing dental procedure.