Received an outside hospital transfer with dobutamine infusing in Yellow Pa Port on a swan that wasn't being used. I know we don't usually infuse in the PA. What is the reasoning or effects of this?Thanks
Advanced Practice Columnist / Guide juan de la cruz, MSN, RN, NP 9 Articles; 4,338 Posts Specializes in APRN, Adult Critical Care, General Cardiology. Has 31 years experience. Nov 14, 2014 Why was the patient on Dobutamine infusion? Sounds very unconventional and even unsafe since we know that vasoactive medications were tested for their effects using intravenous administration and not intraarterial administration. It is also against vascular catheter manufacturer recommendation. I'm not aware of any study that determined the effects of direct pulmonary artery administration of Dobutamine or any other drug for that matter. What we do know, however, is that case reports of intraarterial infusion of medications have resulted in various adverse effects some of which can be life threatening (i.e, thrombosis, inflammation of the vessel, necrosis of surrounding tissues). I'd be interested to find out if this was an error or deliberate as part of a study.
Here.I.Stand, BSN, RN 5,047 Posts Specializes in SICU, trauma, neuro. Has 16 years experience. Nov 14, 2014 First of all, the drug is supposed to be given intravenously. Second, depending on the drip rate I'd be concerned about giving the pt a fluid embolus. I'm not sure how much fluid it would take to do that to be honest, but I'm sure as heck not going to infuse anything faster than a pressure line in there
Esme12, ASN, BSN, RN 4 Articles; 20,908 Posts Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 43 years experience. Nov 21, 2014 I have never infused in the PA/distal portthread moved for best response
CVmursenary 240 Posts Specializes in Cardiothoracic ICU. Has 1 years experience. Nov 26, 2014 In addition to infusing in the distal port; it is also unsafe to have a PA without transducing it as it could be wedged. Sounds like it should have been pulled.