• The Korean Journal of Pain
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• 제21권3호
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• pp.248-251
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• 2008

The clinical syndrome of posttraumatic syringomyelia can complicate major spinal trauma and develops many months after spinal injury. The 50-90% of patients experienced the pain and especially the component of central pain. In patients with central pain following spinal cord injury, ketamine has been shown to be an effective analgesic. We report a case of posttraumatic syringomyelia in a 30-year-old woman who complained of central pain, weakness of both legs and dysesthesia. She had not responded to pulsed radiofrequency, or lidocaine infusion therapy, but a continuous intravenous infusion of ketamine, an N-methyl-D-asparate receptor antagonist, reduced her severe central pain. In conclusion, a ketamine infusion therapy resulted in a significant reduction of central pain without decreasing of motor power and function.

• 임상간호연구
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• 제26권1호
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• pp.59-74
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• 2020

Purpose: The purpose of this study is to investigate new nurses' needs for intravenous infusion therapy training by analyzing the current training status. Methods: This study examined the needs for intravenous infusion therapy training with 159 new nurses. The measurement tool consisted of 93 items developed based on intravenous therapy-related studies, and was evaluated on a 4-point Likert scale. For data analysis, SPSS/WIN 25.0 was used, and frequency, percentage, average, standard deviation, paired t-test, were performed. Results: The demand for intravenous therapy education was analyzed using a questionnaire composed of 8 areas, 16 sub-areas, and 93 items. According to the findings, post-ward placement intravenous therapy education(83.7%) is conducted more often than in preliminary education (72.2%). The demand for intravenous infusion therapy education did not differ significantly in preliminary and post-ward placement education (t=-.89, p=.376). While therapy skills were preferred in preliminary education, there were high demands for education content related to blood transfusion, central venous catheter, and drug use in continuing education. As for preferred teaching methods, lecture (38.2%) and simulation (26.7%) were most answered for preliminary education, while a range of methods were preferred for continuing education including lecture (31.1%), clinical practice (20.6%), preceptor training (19.8%), simulation (16.8%), and self-study (11.6%). Conclusion: For efficient training, it is required to provide different education contents and methods for each stage.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2391-2395
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• 2015

Objective: The aim of this retrospective study was to evaluate the feasibility and efficacy of response to continuous-infusion ifosfamide and doxorubicin combination as second-line chemotherapy for patients with recurrent or refractory osteosarcoma. Materials and Methods: Eighteen recurrent or refractory osteosarcoma patients who were treated with continuous-infusion ifosfamide and doxorubicin combination between May 1999 and April 2011 were included in the analysis. Ifosfamide at $12g/m^2$ was administered by intravenous continuous infusion over 3 days, and doxorubicin $60mg/m^2$ was administered as an intravenous bolus injection on day 1. The combination therapy was repeated every 3 weeks. Treatment was continued until evidence of disease progression or unacceptable toxicity. Results: The patients (ages 7-53 years) received a total of 42 cycles of chemotherapy (median: 2 courses; range: 2-5 courses). The overall response rate was 0% and the disease control rate was 22.3%, with four patients having stable disease. The median time to progression and overall survival time were 2 months (range: 2-5 months) and 9 months (range: 3-29 months), respectively. Major severe toxicities were leucopenia 7 (38.9%), nausea and vomiting 3 (16.7%) and alopecia 9 (50%). There were no treatment-related deaths. Conclusions: In our experience, continuous-infusion ifosfamide and doxorubicin combination therapy at this dosage and schedule was found to be well tolerated and moderate effective, which could be considered as salvage therapy for patients with recurrent or refractory osteosarcoma. Further assessment is necessary to confirm the safety and efficacy of this treatment.

• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.197-203
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• 2015

Objective : The potassium disturbance associated with thiopental continuous infusion in neurosurgical patients is well known. However, the effect of propofol continuous infusion on serum potassium levels has not been investigated extensively. Methods : We reviewed the medical records of 60 consecutive patients who received coma therapy or deep sedation for intracranial pressure control using either thiopental or propofol between January 2010 and January 2012. Results : The overall incidence of hypokalemia (K<3.5 mmol/L) was comparable between thiopental and propofol groups (89.2% vs. 82.6%). But, the incidence of moderate to severe hypokalemia (K<3.0 mmol/L) was significantly higher in thiopental group (51.4% vs. 13.0%, p=0.003). The lowest potassium level (2.9 mmol/L vs. 3.2 mmol/L, p=0.020) was lower in thiopental group. The patients in the thiopental group required greater potassium replacement than the propofol group patients (0.08 mmol/kg/h vs. 0.02 mmol/kg/h, p<0.001). On multivariate analysis, thiopental [odds ratio, 95% confidence interval, 7.31 (1.78-27.81); p=0.005] was associated with moderate to severe hypokalemia during continuous infusion. The incidence of rebound hyperkalemia (K>5.0 mmol/L, 32.4% vs. 4.3%, p=0.010) and the peak potassium concentration (4.8 mmol/L vs. 4.2 mmol/L, p=0.037) after the cessation of therapy were higher in thiopental group. On multivariate analysis, thiopental [8.82 (1.00-77.81); p=0.049] and duration of continuous infusion [1.02 (1.00-1.04); p=0.016] were associated with rebound hyperkalemia once therapy was discontinued. Conclusion : Propofol was less frequently associated with moderate to severe hypokalemia after induction and rebound hyperkalemia following the cessation of continuous infusion than thiopental.

• Journal of Pharmaceutical Investigation
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• 제40권4호
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• pp.225-230
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• 2010

The particulate contamination of intravenously administered fluid has been of major concern. One of the most common complications associated with long term i.v. therapy is post-infusion phlebitis (PIP). We undertook a systematic review and meta-analysis of the effect of inline filters on PIP. An electronic search of Medline, KoreaMed, and KRIST was conducted to identify randomized controlled trials evaluating the effect of inline filters. Meta-analysis was undertaken using STATA 10. A total of 62 literatures were retrieved, of which 7 were included in meta-analysis. Inline filtration for intravenous infusion significantly reduced by 39% of the incidence of phlebitis, with a relative risk of 0.61 (95% CI 0.41-0.90, p=0.012). Therefore, inline filtration is a highly effective means of decreasing the incidence of infusion phlebitis and should be considered as a part of intravenous therapy.

• 센서학회지
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• 제26권2호
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• pp.101-106
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• 2017

A novel intravenous (IV) infusion monitoring sensor is presented to measure the drop rate in the drip chamber of an IV infusion set. It is based on a capacitive proximity sensor and detects the variation of the longitudinal electric field induced by the drop falling into the drip chamber. Unlike the conventional capacitor sensor with two semi-cylindrical conductor plates, the proximity sensor for IV monitoring is composed of a pair of conductor rings which are mounted on the outer surface of the drip chamber with a specific gap between them. The characteristics of the proximity sensor for IV monitoring were investigated through three dimensional electrostatic simulations. It showed quite superior performances in comparison with the conventional capacitor sensor. Especially, the proposed proximity sensor exhibits consistent sensitivity regardless of its mounting position on the drip chamber, operates normally though the drip chamber is tilted and shows robustness to the changes of the drop size and the drip factor of the IV infusion set. Thus, the proximity sensor for IV monitoring is more suitable for use in actual environment of IV therapy compared with the conventional capacitor sensor.

• 한국임상수의학회지
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• 제20권3호
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• pp.406-409
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• 2003

We found seventeen dairy cattle with the abnormal signs in cardiovascular and gastrointestinal systems after feeding of the yew foilage. Among them three cattle were dead due to yew poisoning. Among the remaining fourteen dairy cattle, four cattle showed similar symptoms as did dead cattle. Although the remaining ten dairy cattle did not show any abnormal signs, we conducted a therapy of forced magnesium sulfate infusion because the yew consumption might have been occurred in all cattle. As a result of the therapy, we could not found further signs of yew poisoning. The performance of the therapy and the treatment procedures adapted by the therapy could be concluded as follows: The cardioselective toxicity and inhibition of peristaltic activity by the taxine in yew foilage might be involved in the symptoms of acute poisoning as anorexia, dullness, muscle tremor, dyspnea, and sudden death. We also performed the dose response relationship of taxine to the range of clinical symptoms and examined recovery performances. Through the autopsy of the cattle, we could confirm the presence of yew foilages that might have caused the poisoning in the gastrointestinal tract. However, we could not identify further abnormalities in other organs. In this case report, we demonstrated that practice of the forced magnesium sulfate infusion in yew poisoning was helpful for the attenuating the taxine poisoning by blocking the further proceeding of the toxic effect.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.325-333
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• 2001

Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4843-4846
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• 2013

Background: The infusion rate is considered to affect incidence and severity of infusion reactions (IRs) caused by protein formulations. Trastuzumab (TRS) is approved for 90-minute infusion as the initial dose followed by 30-minute infusion with 250 ml saline. In the study, we evaluated the safety of TRS intravenously administered over 30 minutes with 100 ml saline to reduce burden of patients, safety of infusion with 250 ml saline already being established. Materials and Methods: Women with HER2 positive breast cancer, ${\geq}18$ years and ${\geq}55%$ left ventricular ejection fraction (LVEF), were registered in the study. Patients received 8mg/kg of TRS 250 ml over 90 minutes followed by 6mg/kg of TRS 100ml over 30 minutes in a three-week cycle. Results: A total of 31 patients were recruited, 24 for adjuvant therapy and seven with metastases. The median age was 59 years (range 39 to 82). The total number of TRS doses ranged from 5 to 17 with the median of 15. Mild IR occurred in two patients at the first dose. However, no IR was observed after reducing to 100 ml saline. No decrease of LVEF, increase of serum brain natriuretic peptide or any other adverse events were reported. Conclusions: Intravenous infusion of TRS with 100 ml saline over 30 minutes in breast cancer patients can be considered safe based on results from the study. It can be given on an outpatient basis as with the currently recommended dilution in 250 ml saline.