Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Oct 2004
Randomized Controlled Trial Clinical TrialManagement of the changeover of inotrope infusions in children.
Inotropes are drugs that can assist the critically ill patient's heart to function more effectively by increasing contractility. Inotrope infusions are run continuously and fresh infusions are required on a regular basis. The two methods of changeover commonly used are the quick-change and the double-pump methods. Haemodynamic compromise can occur to some degree with both methods. Evidence regarding the most effective method is limited to individual experience and anecdote. Therefore, the aim of this project was to determine the best method of changing inotropic infusions in children. ⋯ There was no statistically or clinically significant difference detected in changes to MAP. A rescue bolus was required on only one occasion during quick-change over for a reduction in MAP of > or = 20% in the quick-change group. Therefore, a quick-change method can be considered more effective as it reduces the time required for changeover and the risk of tolerance to higher levels of inotrope, while maintaining haemodynamic stability in children after cardiac surgery.