集中治療室におけるニカルジピン注射液による血管障害に対する取り組みと評価

抄録

Nicardipine hydrochloride injection often induces venous irritation despite infusion at the recommended concentrations in the intensive care unit (ICU) at Kyushu University Hospital. We retrospectively investigated the incidence and risk factors of venous irritation in ICU patients, and previously reported that administration time and infusion rate are risk factors for nicardipine injection-induced venous irritation. Based on this result, we carried out compliance with the package insert, setting of the infusion rate (45 mL/h or less) and enhancement of monitoring (if the administration time exceeds 20 h), as efforts to prevent nicardipine injection-induced venous irritation in ICU. Moreover, we arranged the replacement of the catheter within 96 h in ICU, and pharmacists were alerted about it. In this study, we evaluated the effects of these efforts. After the efforts, the incidence of venous irritation induced by nicardipine injection was significantly decreased (P = 0.0172). In addition, 3 patients experinced severe vascular damage before the efforts, while no patients experienced severe vascular damage after the efforts. These results suggest that this approach is useful in the prevention of venous irritation.