RESUMO
La administración de norepinefrina por vía periférica es restringida, por la asociación de la extravasación con necrosis tisular. Método: Revisión de alcance con el objetivo de describir los efectos adversos relacionados con la administración de norepinefrina por acceso venoso periférico corto y las características de administración del fármaco en pacientes hospitalizados en servicios de UCI, cirugía y urgencias. Resultados: Se incluyeron 12 estudios de características heterogéneas por tamaño y tipo de población. La proporción de complicaciones asociadas a la administración de norepinefrina por vía periférica fue inferior al 12% en los estudios observacionales y menor al 2% en aquellos que utilizaron dosis menores a 0,13μg/kg/min y concentraciones inferiores a 22,3μg/ml. La principal complicación asociada fue la extravasación y no se presentó ningún caso de necrosis tisular en el sitio de venopunción. El tratamiento farmacológico utilizado para su manejo fue con terbutalina o nitroglicerina tópica; el tiempo de administración del fármaco osciló entre 1 y 528 horas, con una media ponderada de 2,78 horas. Conclusión: El principal efecto adverso fue la extravasación, no se presentaron complicaciones adicionales, la fentolamina y terbutalina parecen ser útiles en estos casos; su disponibilidad es una necesidad para una administración periférica segura. Es necesario que la enfermera realice una valoración estrecha y un cuidado integral en los pacientes que reciben norepinefrina por vía periférica.(AU)
Peripheral administration of norepinephrine is restricted due to the association of extravasation with tissue necrosis. Method: scoping review with the objective of describing the adverse effects related to the administration of norepinephrine through short peripheral venous access and the characteristics of drug administration in patients hospitalized in ICU, surgery, and emergency services. Results: 12 studies with heterogeneous characteristics by size and type of population were included. The proportion of complications associated with peripheral norepinephrine administration was less than 12% in observational studies and it was less than 2% in those that used doses less than 0.13μg/kg/min, and concentrations less than 22.3μg/ml. The main associated complication was extravasation and there were no cases of tissue necrosis at the venipuncture site, some extravasation cases were treated with phentolamine, terbutaline or topical nitroglycerin. The drug administration time ranged between 1-528hours with a weighted mean of 2.78h. Conclusion: The main adverse effect was extravasation, no additional complications occurred, phentolamine and terbutaline seem to be useful, and its availability is a necessity. It is essential for the nursing staff to carry out a close assessment and comprehensive care in patients receiving norepinephrine by peripheral route.(AU)
Assuntos
Humanos , Norepinefrina/efeitos adversos , Dispositivos de Acesso Vascular , Norepinefrina/administração & dosagem , HipotensãoRESUMO
Peripheral administration of norepinephrine is restricted due to the association of extravasation with tissue necrosis. METHOD: Scoping review with the objective of describing the adverse effects related to the administration of norepinephrine through short peripheral venous access and the characteristics of drug administration in patients hospitalized in ICU, surgery, and emergency services. RESULTS: 12 studies with heterogeneous characteristics by size and type of population were included. The proportion of complications associated with peripheral norepinephrine administration was less than 12% in observational studies and it was less than 2% in those that used doses less than 0.13µg/kg/min, and concentrations less than 22.3µg/mL. The main associated complication was extravasation and there were no cases of tissue necrosis at the venipuncture site, some extravasation cases were treated with phentolamine, terbutaline or topical nitroglycerin. The drug administration time ranged between 1 and 528hours with a weighted mean of 2.78h. CONCLUSION: The main adverse effect was extravasation, no additional complications occurred, phentolamine and terbutaline seem to be useful, and its availability is a necessity. It is essential for the nursing staff to carry out a close assessment and comprehensive care in patients receiving norepinephrine by peripheral route.
