Protocolo para orientações sobre o uso de medicamentos vasoativos injetáveis em unidade de terapia intensiva adulto

Abstract

Introduction - Resolution of the Collegiate Board (RDC) No 7, of February 24, 2010, defines the Intensive Care Unit (ICU) as the critical area intended for the hospitalization of seriously ill patients, who require specialized professional attention on an ongoing basis, specific materials and technologies necessary for diagnosis, monitoring and therapy. In this context, vasopressor and inotropic medications are the basis of supportive therapy in ICU patients. They are considered potentially dangerous as they pose a high risk of causing serious or even fatal harm to patients when used incorrectly. Objective - To develop a quick access protocol with guidance on vasoactive medications to be consulted by the interprofessional team forming part of the Intensive Care Unit. Material and Methods - This work involves the elaboration of a protocol with the aim of offering guidance on vasoactive medications to be consulted by the interprofessional team that is part of the Adult Intensive Care Unit of the Hospital Universitário Onofre Lopes, considering publications from the last 5 years, in English, Spanish and Portuguese, found in the technical notes of the manufacturers of the medicines involved and in the main databases described below, using the following descriptors: dilution, intravenous administration, cardiovascular drugs, routes of drug administration, drug stability and incompatibility of medicines. Referenced databases: Infostab/Stabilis; UpToDate; Trissel, Lawrence A.Handbook on Injectable Drugs; MEDLINE (Medical Literature Analysis and Retrieval System Online) - PubMed; SciELO (Scientific Electronic Library Online); Capes and Elsevier/Scopus/Science Journal Portal. Results - The protocol and table are offered to be consulted quickly, in situations that require greater urgency or speed of resolution and in the unavailability of the clinical pharmacist. Results and discussion - The Protocol consists of AGHU and ATC code, Brazilian Common Denomination (DCB), standardized presentations in the institution, manufacturers, routes of administration, reconstitution (diluents and corresponding volume), dilution (diluents and volume), including minimum volume for patients with fluid restriction, maximum concentration, maximum infusion rate and/or infusion time and pertinent observations. In addition, a summary table for quick consultation of drug incompatibilities. Final Considerations – The protocol awaits analysis by the head of the hospital pharmacy sector, after which it will be sent for validation by the Quality Management and Health Surveillance sector and subsequently approved by the Health Care Management. It will be made available for consultation on Wiki- Huol, laminated and available to remain in the adult ICU for immediate access.