Establishment of nursing care based on scientific knowledge of skin lesions induced by extravasation of catecholamines: an experimental study

Research Project

Project/Area Number	18K17466
Research Category	Grant-in-Aid for Early-Career Scientists
Allocation Type	Multi-year Fund
Review Section	Basic Section 58050:Fundamental of nursing-related
Research Institution	Iwate Medical University
Principal Investigator	Nozato Hitoshi 岩手医科大学, 看護学部, 助教 (10807225)
Project Period (FY)	2018-04-01 – 2021-03-31
Project Status	Completed (Fiscal Year 2020)
Budget Amount *help	¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000) Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords	カテコラミン製剤 / 血管外漏出 / 看護技術 / 罨法 / ステロイド剤 / 皮膚傷害 / 基礎研究 / 実証研究 / ステロイド / 潰瘍
Outline of Final Research Achievements	Using a rat model, the present study was conducted to establish a system of nursing care based on scientific knowledge of skin lesions induced by extravasation of catecholamines. The study produced three main findings: 1) the skin lesions induced by extravasation of catecholamines were attributable to an acute inflammatory reaction, 2) application of a hot poultice exacerbated the skin lesions, whereas a cold poultice was effective for prevention of the lesions, and 3) steroid ointments had no effect on the lesions. These results suggest that a cold poultice is effective for prevention of skin lesions induced by extravasation of catecholamines.
Academic Significance and Societal Importance of the Research Achievements	これまで、カテコラミン製剤の漏出時にはその薬理作用（血管収縮作用）から血管を拡張させることを目的に温罨法が推奨されてきた。しかし、本研究によりカテコラミン製剤も一般の薬剤（抗がん剤以外）と同様に、急性炎症を抑制するための冷罨法が有効であることが示唆され、臨床応用も検討する必要性が示された。これらの本研究で得られた知見は、カテコラミン製剤の血管外漏出時のエビデンス（実証データ）に基づく確かな看護ケアの確立につながり、漏出時の傷害に苦しむ患者のQOL向上に寄与すると考える。