Objective To summarize the best evidence for safe infusion of vasoactive drugs in adult patients,and to provide evidence support for clinical nursing work. Methods We searched UpToDate,BMJ Best Practice,Joanna Briggs Institute library,Cochrane Library,National Guideline Clearinghouse,Centers for Disease Control and Prevention,National Institute for Health and Care Excellence,Guideline International Network,CINAHL,Embase,Registered Nurses' Association of Ontario,UK Intensive Care Society,American Intravenous Nurses Society,PubMed,Web of Science,CNKI,Wanfang Database,VIP,Chinese Nursing Association,SinoMed,Yimaitong to collect guidelines,expert consensuses,group standards,systematic reviews,evidence summaries and original study on vasoactive drug infusion in adult patients. The retrial limit was from January 1,2013 to March 10,2023.Literature quality evaluation and evidence screening were conducted independently by two researchers with evidence-based nursing research background,and the evidence was classified and integrated by the team after summary. Results A total of 12 literatures were included,and 29 pieces of evidence were summarized from five dimensions：training and education,evaluation,vascular access selection,infusion scheme and complications management. Conclusion This study summarizes the best evidence of vasoactive drug infusion in adult patients,which can provide medical staff with scientific infusion regimen,ensure patient safety and improve the quality of care.
[1] 龚玲,陈璐,朱爱娟. 品管圈在降低外周静脉输注血管活性药物安全隐患率中的应用[J].当代护士(上旬刊),2020,27(1):167-170.
Gong L,Chen L,Zhu AJ.Application of quality control circle in reducing the hidden danger rate of peripheral intravenous infusion of vasoactive drugs[J]. Today Nurse,2020,27(1):167-170.
[2] Pancaro C,Shah N,Pasma W,et al.Risk of major complica-tions after perioperative norepinephrine infusion through peri-pheral intravenous lines in a multicenter study[J]. Anesth Analg,2020,131(4):1060-1065.
[3] 钟竹青,秦宁,高学琴,等. 临床护士输注血管活性药物的现状调查[J]. 中华护理杂志,2021,56(8):1208-1215.
Zhong ZQ,Qin N,Gao XQ,et al.Current status of infusion of vasoactive agents of nurses:a nationwide survey[J]. Chin J Nurs, 2021,56(8):1208-1215.
[4] 中华护理学会. 血管活性药物静脉输注护理[Z]. 中华护理学会,T/CNAS 22-2021,2021.
Chinese Nursing Association.Intravenous infusion nursing of vasoactive drugs[Z]. Chinese Nursing Association,T/CNAS 22-2021,2021.
[5] 朱政,胡雁,邢唯杰,等. 不同类型循证问题的构成[J]. 护士进修杂志,2017,32(21):1991-1994.
Zhu Z,Hu Y,Xing WJ,et al.The composition of different types of evidence based problems[J]. J Nurses Train,2017,32(21):1991-1994.
[6] Alper BS,Haynes RB.EBHC pyramid 5.0 for accessing preap-praised evidence and guidance[J]. Evid Based Med,2016,21(4):123-125.
[7] AGREE Project Office. The AGREE Ⅱ Instrument[EB/OL].(2009-05-01)[2023-03-01]. http://www.agreetrust.org.
[8] 胡雁,郝玉芳. 循证护理学[M]. 2版. 北京:人民卫生出版社,2018.
Hu Y,Hao YF.Evidence-based nursing[M]. 2nd ed. Beijing:People's Medical Publishing House,2018.
[9] The Cochrane Collaboration.Cochrane handbook for systematic reviews of interventions[EB/OL].[2023-02-18].http://handbook-5-1.cochrane.org/.
[10] 顾莺,张慧文,周英凤,等. JBI循证卫生保健中心关于不同类型研究的质量评价工具:系统评价的方法学质量评价[J]. 护士进修杂志,2018,33(8):701-703.
Gu Y,Zhang HW,Zhou YF,et al.JBI evidence-based health center's quality assessment tool for different types of research:the quality evaluation of diagnostic and economic evaluation[J]. J Nurses Train,2018,33(8):701-703.
[11] 顾莺,张慧文,周英凤,等. JBI循证卫生保健中心关于不同类型研究的质量评价工具:分析性研究的质量评价[J]. 护士进修杂志,2018,33(5):400-403.
Gu Y,Zhang HW,Zhou YF,et al.The joanna briggs institute critical appraisal tools use in systematicreviews:analytic study[J]. J Nurses Train,2018,33(5):400-403.
[12] The Joanna Briggs Institute(JBI)[EB/OL].(2017-07-15)[2023-02-18]. http://joannabriggs.org/research/critical-appraisal-tools.
[13] 王春青,胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志,2015,30(11):964-967.
Wang CQ,Hu Y.JBI evidence pre-classification and evidence rank system(2014 Edition)[J]. J Nurses Train,2015,30(11):964-967.
[14] Intensive Care Society. Guidance for:the use of vasopressor agents by peripheral intravenous infusion in adult critical care patients[EB/OL].(2020)[2023-02-22]. https://ics.ac.uk/resour-ce/peripheral-vasopressor-guide.html.
[15] Gorski LA,Hadaway L,Hagle ME,et al.Infusion therapy stan-dards of practice,8th edition[J]. J Infus Nurs,2021,44(1S Suppl 1):S1-S224.
[16] Djogovic D,MacDonald S,Wensel A,et al. Vasopressor and inotrope use in Canadian emergency departments:evidence based consensus guidelines[J]. CJEM,2015,17(Suppl 1):1-16.
[17] 中国医师协会急诊医师分会,中华医学会急诊医学分会,中国医疗保健国际交流促进会急诊分会. 血管加压药物在急诊休克中的应用专家共识[J]. 中华急诊医学杂志,2021,30(8):929-936.
Emergency Physicians Branch of Chinese Medical Doctor Association, Emergency Medicine Branch of Chinese Medical Association, Emergency Medicine Branch of China Healthcare International Exchange Promotion Association. Expert consen-sus on the application of vasopressors in emergency shock[J]. Chin J Emerg Med,2021,30(8):929-936.
[18] 中国医师协会心血管内科医师分会心力衰竭学组,中国医师协会急诊医师分会循环与血流动力学学组,中国老年医学会心电与心功能分会. 多巴胺药物临床应用中国专家共识[J]. 中华医学杂志,2021,101(20):1503-1512.
Heart Failure Group of Cardiovascular Physicians Branch of Chinese Medical Doctor Association,Circulation and Hemody-namics group of Emergency Physicians Branch of Chinese Medical Doctor Association,Electrocardiography and Cardiac Function Branch of Chinese Geriatrics Society. China expert consensus on clinical application of dopamine drugs[J]. Natl Med J China,2021,101(20):1503-1512.
[19] 卢姣娣,石双姣,钟竹青. 微量泵在血管活性药物使用中的最佳证据总结[J]. 中华现代护理杂志,2023,29(5):581-589.
Lu JD,Shi SJ,Zhong ZQ.Summary of best evidence for mi-cropump use in vasoactive drugs[J]. Chin J Mod Nurs,2023, 29(5):581-589.
[20] Tian DH,Smyth C,Keijzers G,et al.Safety of peripheral admi-nistration of vasopressor medications:a systematic review[J]. Emerg Med Australas,2020,32(2):220-227.
[21] 张晓梅,朱亚芳,周春兰,等. 不同冲封管方法对泵入去甲肾上腺素患者血压波动影响的研究[J]. 中华护理杂志,2017,52(5):554-557.
Zhang XM,Zhu YF,Zhou CL,et al.Effect of different flu-shing and sealing methods on blood pressure fluctuation in patients with norepinephrine pumping[J]. Chin J Nurs,2017, 52(5):554-557.
[22] Padmanaban A,Venkataraman R,Rajagopal S,et al.Feasibility and safety of peripheral intravenous administration of vaso-pressor agents in resource-limited settings[J]. J Crit Care Med(Targu Mures),2020,6(4):210-216.
[23] Prasanna N,Yamane D,Haridasa N,et al.Safety and efficacy of vasopressor administration through midline catheters[J]. J Crit Care,2021,61:1-4.
[24] Rooke GA,Bowdle TA.Syringe pumps for infusion of vasoac-tive drugs:mechanical idiosyncrasies and recommended opera-ting procedures[J]. Anesth Analg,1994,78(1):150-156.
[25] Kern H,Kuring A,Redlich U,et al.Downward movement of syringe pumps reduces syringe output[J]. Br J Anaesth,2001, 86(6):828-831.
[26] Weiss M,Fischer J,Neff T,et al.The effects of syringe plun-ger design on drug delivery during vertical displacement of syringe pumps[J]. Anaesthesia,2000,55(11):1094-1098.
[27] 张克标,古满平. 2种续泵方式对使用血管活性药物患者的影响[J]. 护理学报,2013(14):54-56.
Zhang KB,Gu MP.Effects of different pump refills on patients with vasoactive drugs infusion[J]. J Nurs,2013(14):54-56.
[28] Nguyen TT,Surrey A,Barmaan B,et al.Utilization and extra-vasation of peripheral norepinephrine in the emergency de-partment[J]. Am J Emerg Med,2021,39:55-59.
[29] 李鹏兰,张智霞. 集束化护理在老年病人血管活性药物使用管理中的应用[J]. 护理研究,2023,37(6):1107-1109.
Li PL,Zhang ZX.Application of cluster nursing in the usage management of vasoactive agents in elderly patients[J]. Chin Nurs Res,2023,37(6):1107-1109.
[30] Datar S,Gutierrez E,Schertz A,et al.Safety of phenylephrine infusion through peripheral intravenous catheter in the neurological intensive care unit[J]. J Intensive Care Med,2018, 33(10):589-592.
[31] 冯芳,杨伟伟,张正馨,等. 影响感染性休克患者经外周静脉输注去甲肾上腺素安全性的危险因素分析[J]. 中华危重病急救医学,2021,33(3):276-280.
Feng F,Yang WW,Zhang ZX,et al.Safety of administration of norepinephrine through peripheral vein line in patients with septic shock[J]. Chin Crit Care Med,2021,33(3):276-280.
[32] 杜娟,余静,王琳. 集束化护理在危重症患者血管活性药物使用管理中的应用观察[J]. 贵州医药,2021,45(11):1829-1830.
Du J,Yu J,Wang L.Observation on the application of cluster nursing in the management of vasoactive drugs in critically ill patients[J]. Guizhou Med J,2021,45(11):1829-1830.
[33] 余玲,吕丽敏,陈亚丹. 临床护士《血管活性药物静脉输注护理》团体标准的执行情况[J]. 中国卫生标准管理,2023,14(7):7-12.
Yu L,Lü LM,Chen YD.Investigation on the implementation of intravenous infusion of vasoactive drugs among clinical nurses[J]. China Health Stand Manag,2023,14(7):7-12.
[34] 洪中,李远珍,殷勤. 血管活性药物外渗的护理研究进展[J]. 护士进修杂志,2019,34(18):1655-1657.
Hong Z,Li YZ,Yin Q.Nursing research progress of extravasa-tion of vasoactive drugs[J]. J Nurses Train,2019,34(18):1655-1657.
