Alteraciones hemodinámicas en el paciente crítico portador de catéter venoso central al administrar drogas vasoactivas

  1. María del Mar Pastor Armendáriz 25
  2. María Jesús Vicente Galán 3
  3. Raquel Moreno Sánchez 14
  4. María Luisa Gallardo Rodríguez 5
  5. Rocío Albarrán García 5
  6. Marta López Herranz 6
  7. SALVADOR POSTIGO MOTA coord. 7
  1. 1 Universidad Camilo José Cela de Madrid.
  2. 2 Departamento de Enfermería Universidad Complutense de Madrid.
  3. 3 Unidad Crónicos Cardiológicos. HUFA. Alcorcón, Madrid.
  4. 4 SUMMA.
  5. 5 Unidad de Anestesia y Reanimación del Hospital Universitario Fundación de Alcorcón (HUFA). Alcorcón, Madrid.
  6. 6 Universidad Complutense de Madrid
    info

    Universidad Complutense de Madrid

    Madrid, España

    ROR 02p0gd045

  7. 7 Facultad de Medicina y Ciencias de la Salud. Universidad de Extremadura.
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Journal:
Revista ROL de enfermería

ISSN: 0210-5020

Year of publication: 2022

Volume: 45

Issue: 11-12

Pages: 22-34

Type: Article

DOI: 10.55298/ROL2022.4577 DIALNET GOOGLE SCHOLAR

More publications in: Revista ROL de enfermería

Abstract

CVCs (Central Venous Catheters) are frequently used in intensive care and resuscitation units for the management of patients in a critical situation. These catheters provide valuable information for the diagnosis, assessment of the patient and the treatment of the same in serious situations of hemodynamic instability, mainly. It is of vital importance, the hospital consensus of the use of these catheters, since they provide a very useful tool and with fewer and fewer potential risks associated with their use. The CVCs have as their objective, hemodynamic measurements, parenteral contributions to the patient, cover emergency needs, blood extractions, administration of vasoactive drugs, etc. Due to their characteristics, they are the most suitable for patients with ICUs and OERs. There are numerous studies that indicate that in a three/five-light central venous catheter, the extractions of samples for analysis should be carried out by extracting a minimum amount of blood from the proximal lumen, without prior or subsequent washing1, in order to avoid excessive manipulation of the catheter, and iatrogenic anemias due to the amount of blood that is discarded. However, there is no consensus, nor studies of relevance and research that indicate what is the appropriate distribution of infusions in a central venous catheter of several lights, when vasoactive drugs, noradrenaline type, dopamine, dobutamine, etc. are administered, nor what is the hemodynamic repercussion if the extraction is performed by another branch of the central venous catheter. The infusion therapy standards of practice provide evidence-based recommendations published by the Nurses Society2 Infusion every 5 years. On the contrary, there are studies that demonstrate the most appropriate form of change in infusions when they are finished, in order to avoid hemodynamic alterations in the patient3,4. These catheters vary in the amount of lumen generally, between two and five. In the HUFA, three- and five-lumen catheters are evaluated with the passage of vasoactive drugs through the medial lumen, without stopping any of the infusions that are administered by any of the other lumens. This work tries to demonstrate that the choice of one light or another of the CVC for the washing and extraction of analyzes, can have hemodynamic repercussion and therefore, this nursing care, can be subjected to measurement and analysis to determine the ideal procedure.

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