Hanging bottle, an intravenous drip can say is we usually in the hospital commonplace things. As a minimal trauma medical procedures, intravenous now the majority is no longer the responsibility of the physician, and become one of the main tasks of nurses. Recently, about the amount of intravenous fluids is much larger than China's per capita foreign news has triggered concern in the community, then the infusion is not like the network said, as the great harm it? Its advantages and disadvantages are there? You infusion has a kind of point of view?
Intravenous infusion is good or bad
Intravenous infusion as a distinct mode of administration, has its unique advantages. First, intravenous injection of the drug directly into the blood circulation, it is possible to achieve a higher plasma concentration in a short time, to achieve satisfactory pharmacological effects. For example, a lot of blood, a lot of vomiting, diarrhea, loss of fluid in patients with burns, potassium sodium and other serious electrolyte imbalance, or severe hyperglycemia, intravenous drugs and the corresponding liquid rejuvenate effect, which can not be compared to other routes of administration ; secondly, the patient other ways inadequate nutritional intake, and add nutrients intravenously, can greatly improve the nutritional status of the patient, in extreme cases, completely stop oral intake powered by intravenous infusion, we have been able to ensure that patients achieve long-term survival (in years calculation). Third, intravenous drug bypasses the body's defenses, detoxification and filtration mechanisms (such as the liver first pass effect), to improve the bioavailability of drugs in certain organs can achieve high concentrations, thereby reducing the total drug dosage. Fourth, the intravenous injection can prevent a lot of adverse reactions other means of medication, such as mucous membrane damage.
Of course, after intravenous injection of a traumatic medical procedures, its shortcomings and risks need to be fully considered, and only when the benefits outweigh the risks intravenous injection, is a wise choice. First, since the intravenous injection site has the potential risk of infection, once infected, especially central venous catheter infection and other hospital-acquired infections, it will cause unnecessary medical spending and medical risks. Secondly, although the former have been listed on the drug dose safety tests, but because of the special nature of personal physical, very few patients can not exclude the situation can not tolerate regular doses appear. The onset time is short intravenous infusion once a drug overdose, the consequences are more serious, and more difficult to rescue Similarly, when drug allergies and other rare situation, if it is sensitizing drugs enter the body through the intravenous route, the consequences and more serious. Third, since the same intravenous drug to bypass the body's defenses, detoxification and filtration mechanisms, drug overdose, the risk of foreign body (fine particles) remaining increased. Fourth, long-term repeated use of a peripheral intravenous infusion, may cause damage to peripheral venous scarring occurs, even necrosis. Fifth, some may be caused by addictive drugs, intravenous addiction caused a stronger effect. Finally, "Needle phobia", which are commonly called "fainting", is also one of the factors to be considered before intravenous use.
Infusion real existence of "particles"
"Particle" as an intravenous injection is difficult to eliminate 100% of the "product", the harm is actually long been well known. Especially in the past, due to lack of understanding of the clinical, technical imperfections infusion, the drug is difficult to control the quality, size and number of particles in intravenous infusion is much higher than today. Particles injected intravenously into the bloodstream, bypassing the body's defense mechanisms and filtration, and difficult to remove by the immune system, resulting in long-term retention in the human body. Larger particles will clog small diameter vessels or stimulate coagulation, thrombosis, can cause severe tissue ischemia particle retention will stimulate the body to produce foreign body or allergic reactions, severe form of "foreign body granuloma"; particle will as pyrogenic cause fever patients. Visible particulate hazards are many. Based on the above understanding, national pharmacopoeia of intravenous drug use in the content of particles were carried out relevant regulations. "British Pharmacopoeia" (1998 edition) states: to no longer diluted injections per ml of the number of particles 5m or more can not be more than 100, the number of particles 10m or more can not be more than China Pharmacopoeia 2005 edition require large capacity injection per milliliter the number of particles number of particles larger than 10m should not more than 25, greater than 25m may not be more than USP standards similar to our country.
"Particle" come from?
The drug itself is strict quality control will be able to completely avoid particle harm? The answer is no. Because intravenous drug use inevitably subject to various pollution particles into the operation can not be ignored. In addition to the drug itself, the failure of the infusion, the operator hand hygiene, puncture the rubber stopper debris shedding, pharmacy airborne particles are place within the particulate pollution caused by the drug. Even in a very clean clean bench for drug preparation, because the compatibility, pH value changes etc. between different drugs may form new particles, the compatibility of traditional Chinese medicine injection particle formation more. Some scholars of Chinese medicine injections containing liquid flowing through the liquid membrane filter taken under a microscope and chemical analysis, found that insoluble particles as a main component of membranes of broken glass, rubber crumbs, activated carbon, drug residues and wool scrap cable strips. Visible pollution outside the drug particles should not be overlooked.
Today we look at how these drug particles it? On the one hand, as mentioned above, we should be aware of the potential hazards of the particles are many, both doctors and patients, infusion therapy should be strictly controlled indications, can be administered by way of non-infusion to avoid other on the one hand, we do not need to panic infusion therapy, so that the time taken intravenously skeptical. With the development of medical technology, drugs and infusion technologies are increasingly improved in the past that the incidence of serious complications of transfusion has become increasingly low. The quality of medicines in the national standards and more reliable than in the past to prepare drugs and drug infusion technology continues to improve, the infusion filter allows the use of more number of particles is greatly reduced. Disposable infusion mesh aperture typically 20m, can be reliably filter out more than 80% of the particles have recently aperture smaller, higher filtration rate of domestic filter available.
Further reading
Q: It is said that the injection into the body particles can accumulate in the body, the long run will cause microvascular thrombosis, hemorrhage, venous pressure, pulmonary hypertension, pulmonary fibrosis and cancer. I almost have to hang water once a year, it is not the body has accumulated a lot of particles? Worry.
Zhao Chengyuan: First, these problems do exist, especially in the infusion technology was not perfect in the 20th century, these clinical problems that people have continually improve drug quality, improve infusion means reasons. After strictly control the number and size of particles, the situation had changed. You know, the human body is a very rich capillary circulation of collateral, under normal circumstances, the majority of the capillary is closed, open only in the organization requires a lot of time for a lot of oxygen. Even a small capillaries are blocked particle diameter due to the presence of collateral, it will not cause tissue ischemia and hypoxia. Some small diameter capillary (4 _m in diameter or so) only allow red blood cells deformed by less than 20 _m particles leukocyte "Body" roughly the same, unless cause severe granulomatous inflammation, otherwise usually does not cause tissue disease Neo change. There is an extreme example, in the 1980s, a patient suffering from a serious intestinal illness lost the ability to eat by mouth, can only sustain life by infusion, in good health and care, the patient has been completely by infusion nutrition survive for decades, enter 2 000 mL of liquid per day or more, and in the meantime to conceive. Therefore transfusion history have friends need to fear.
Q: My grandparents have to hang a few days each year before the cold weather the water, saying it was clear the blood vessels, the prevention of cardiovascular disease, transfusion really have such a big role in it?
Wang Zhi (National Cerebrovascular Disease Prevention and Control Research Office, Beijing Neurosurgical Institute Director): The so-called "infusion through vessel" drug basically choose some blood circulation, dilation of cerebral blood vessels and other therapeutic agents. These drugs for the acute phase of cerebrovascular disease are effective, but for the prevention of cerebrovascular disease is currently no scientific basis. Although the probability of serious adverse transfusion reactions is not high, but many drugs are somewhat different side effects, it is not recommended to use the infusion of the way to prevent cardiovascular disease.
(This article from the "Health and Nutrition"; author: Zhao reprint, slightly abridged)
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