A Retrospective Study Of The Relationship Between Intravenous Drug Therapy And Blood Pressure Variability And Phlebitis

Objective This article aims to explore the relationship between intravenous drug therapy and its two common adverse reactions,blood pressure variability and phlebitis,from the two aspects of solvent and drugs in intravenous therapy,and to provide a basis for the rationality and safety of clinical intravenous drug use.Methods This study was divided into two parts.The first part aims to investigate the effect of saline infusion on blood pressure variability(BPV)in patients with hypertension.A retrospective study was performed in 1010 patients with hypertension.The patients who received venous injection before surgery for continuous 3 to 5 days were divided into two groups according to the saline infusion volume during the hospitalization,which are more than 500 ml of saline per day group and less than 500 ml of saline per day group.And the incidence of BPV were calculated respectively.Chi-square test was used to clarified the relationship between abnormal BPV and saline infusion in hypertensive patients.And Logistic regression was used to assess the related risk factors.While in the second part aims to investigate the epidemiological characteristics of intravenous drug-induced phlebitis.Cases with suspected intravenous drug-induced phlebitis were collected from March 2014 to December 2018 in the cardiology department of Zhongnan Hospital.And retrospective analysis was conducted on the patients’ gender,age,primary diseases,categories of suspected drugs,treatment and outcomes by using Excel 2016 software.Results The first part involved 1010 cases in total.The Logistic regression result indicated that more than 500 ml of daily saline injection for continuous 3 to 5 days(P <0.01,OR=1.911,95% C.I.for OR 1.226-2.977),medical history of diabetes mellitus(P <0.01,OR=4.856,95% C.I.for OR 3.118-7.563)and cardiovascular diseases(P <0.01,OR=2.498,95% C.I.for OR 1.549-4.029)may be risk factors of abnormal BPV;while diuretics medication(P <0.01,OR=0.055,95% C.I.for OR 0.024-0.125)may be the protective factor.Additionally,the overall incidence of abnormal BPV was 11.58%.And the incidence of abnormal BPV of less than 500 ml of saline per day group among 698 patients was 9.17%,while that of more than 500 ml of saline per day group among 312 patients was as high as 16.99%,the difference was statistically significant(P<0.01).While the second part showed that a total of 123 cases were collected,and 32 kinds of intravenous drugs were involved,mainly for traditional Chinese medicine injections(49.60%),antibacterials(16.26%),and cardiovascular drugs(17.07%);there were irrational application of intravenous drug in 63 cases,mainly for irrational solvent(57.4%)and irrational concentration(39.68%).Conclusion Our study suggested that more than 500 ml of daily saline injection for continuous 3 to 5 days may have disadvantages in the blood pressure control for hypertensive patients,especially for the patients with diabetes mellitus and cardiovascular diseases.And a variety types of intravenous drugs can induce drug-related phlebitis in the department of cardiology of Zhongnan Hospital,which ought to be noticed,and intravenous drugs should be rationally used under the package inserts in combination with the specific condition of patients.