RESUMO
The peripheral intravenous route is being used more frequently for the administration of short- to medium-term parenteral nutritional support. Dedicated fine bore cannulas have significantly reduced the incidence of thrombophlebitis. Currently available cannulas are made of polyurethane or silicone. We present our experience with a 23G silicone cannula and a 22G polyurethane alternative. Fifty-four silicone cannulas were used with a median survival of only 3 days, compared with 7 days for 90 polyurethane cannulas (P < 0.0001). Only 22% of silicone cannulas were removed electively compared with 56% of polyurethane cannulas (P < 0.00005). The most common cause for silicone cannula removal was occlusion (48%), which occurred in only 8% of polyurethane cannulas (P < 0.00001). Polyurethane cannulas develop fewer complications and are more effective in the delivery of peripheral intravenous nutritional support.
Assuntos
Cateterismo Periférico/instrumentação , Nutrição Parenteral/instrumentação , Poliuretanos , Silicones , Adulto , Idoso , Idoso de 80 Anos ou mais , Cateterismo Periférico/efeitos adversos , Falha de Equipamento , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral/efeitos adversos , Tromboflebite/etiologiaRESUMO
No one doubts that good nutrition is an important component of neonatal intensive care, nor that this can only be accomplished by the use of intravenous fat. With regard to the effects of nutrition on bronchopulmonary dysplasia, however, we are facing a dilemma. On the one hand there is the suggestion that inadequate nutrition increases the severity of bronchopulmonary dysplasia and on the other that the use of intravenous fat predisposes to it. In an attempt to narrow the area of uncertainty we randomly allocated 129 infants of less than 1750 g birth weight to receive either early or late lipid containing parenteral nutrition. The median duration of ventilation support in the 'early' group was 8.5 days and in the 'late' group eight days; this was not significantly different.
Assuntos
Doenças do Prematuro/terapia , Lipídeos/administração & dosagem , Nutrição Parenteral/métodos , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Displasia Broncopulmonar/prevenção & controle , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/prevenção & controle , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/mortalidade , Fatores de Tempo , Triglicerídeos/sangue , Aumento de Peso/fisiologiaRESUMO
Although actinomycin D is a relatively old cytotoxic agent, relatively little is known about its toxicity in man in comparison with some of the newer cytotoxic agents that have been extensively investigated. We wish to describe a case where an overdose of actinomycin D was inadvertently administered.
