中国中西医结合急救杂志2025，Vol.32Issue(1)：60-66,7.DOI:10.3969/j.issn.1008-9691.2025.01.011
紧急情况下经外周静脉输注去甲肾上腺素安全注射方案的范围综述
A scoping review of safe injection protocols for peripheral norepinephrine in emergency
摘要
Abstract
Objective To review the research of safe injection protocols for peripheral norepinephrine(pNE),to make clear the main contents of safe injection protocols and the compliance of clinical implementation protocols,and to provide reference for clinical nurses to use drugs safely.Methods Systematic searches were conducted in the PubMed database,the Embase database from the Netherlands,the Web of Science,the Cochrane library,CNKI,Wanfang database,VIP,and the China biomedical literature database for studies related to safe injection protocols for pNE.The search period extended from the establishment of the databases to April 30,2024.Two researchers conducted data extraction and summary analysis of the included literature.Results A total of 10 articles were incorporated,including 2 guidelines,4 observational retrospective cohort studies,2 observational prospective cohort studies,2 ambispective cohort study.All documents provide a complete safe injection scheme of pNE,and its main contents were as follows:the drug concentration should be diluted to 8～64 mg/L;the injection dose should be small,and the maximum dose should not exceed 0.5 μg·kg-1·min-1 or 25 μg/min;a short infusion time was appropriate,among which 4 schemes require≤24 hours;intravenous catheters should be large-bore models,mainly 16,18 and 20 G;selection of infusion sites with favorable venous conditions of upper limb should be selected for injection;during infusion,regular and effective monitoring was required,and the frequency of monitoring should be once an hour,not exceeding a maximum of 2 hours;observation of the puncture site,and must assess whether there was blood return to the venous pathway,develop an emergency plan for drug extravasation.Several studies provided the compliance analysis of the protocol.The items with the highest compliance were using the drug concentration specified in the protocol,with the highest implementation rate of 100.0%.The items with low compliance were:using ultrasonic catheterization or evaluation,with minimum 26.6%;monitor according to the specified time frequency,with a minimum of 36.0%;selection of infusion sites,with a minimum of 65.0%.Conclusion The pNE is safe and feasible in emergency situations,but it comes with numerous risks and limitations.Norepinephrine(NE)should be administered at low concentrations and small doses,using large-caliber venous indwelling needles,and choosing optimal injection sites.Ultrasound assessment and localization can be used if conditions permit.Short-term infusion is preferred,and effective monitoring should be conducted at regular intervals during the infusion.Emergency plans for drug extravasation should be established.Developing safe injection protocols can reduce the incidence of adverse events such as extravasation.关键词
外周静脉/去甲肾上腺素/血管活性药物/安全注射方案/范围综述Key words
Peripheral intravenous/Norepinephrine/Vasoactive medication/Safe injection protocol/Scoping review引用本文复制引用
曾倩,张蔚青,顾艳婷,葛晓莹,顾秋莹..紧急情况下经外周静脉输注去甲肾上腺素安全注射方案的范围综述[J].中国中西医结合急救杂志,2025,32(1):60-66,7.基金项目
上海交通大学医学院护理科研重中之重项目(Jyhz2402)The Top Project of Nursing Scientific Research in Shanghai Jiaotong University School of Medicine(Jyhz2402) （Jyhz2402）
