Dr. Șerban Bubenek, president of the Romanian Intensive Care Society, emphasized, in an intervention at Digi24, the importance of treating patients in such a way that they can leave the hospital in the best possible condition, adding the lack of the notion of patient abandonment in the Romanian legislation.
What is Noradrenaline, the drug at the center of investigations at the Pantelimon Hospital – Photo Inquam
“Throughout my career as a physician and teacher, I have emphasized to all my residents and colleagues that our goal is to treat the patient in such a way that they can leave the hospital tomorrow. The notion of patient abandonment does not exist in Romanian legislation.”said the president of the Romanian Intensive Care Society, Dr. Șerban Bubenek, according to Digi24.
Dr. Şerban Bubenek explained what is and how noradrenaline is administered, the drug involved in the deaths at the Saint Pantelimon Hospital, investigated by the Control Body.
The treatment is used to keep patients' blood pressure within normal limits. Dr. Șerban Bubenek, president of the Romanian Society of Intensive Care, detailed the administration procedure of this medicine and the aspects that doctors must pay attention to.
“Noradrenaline is normally secreted every second by the adrenal gland in every human body, and it is secreted in larger amounts in any state of stress. The synthetic substance noradrenaline is mainly used in shock states of any kind with vasodilatation, hypotension, in predominantly right-sided heart failure, and the purpose of administration is to restore blood pressure, with the role of maintaining perfusion pressure to vital organs. It is usually supplied in ampoules of 1 or 2 mg, in various pharmaceutical forms. It is never administered as such, one ampoule at a time to a patient, but diluted. In every hospital there must be an institutional protocol. For example, 1 mg is dissolved in 50 mg of physiological saline in a 50 ml syringe and put into the injectomat, and the doctor sets the dose between 10 nanograms per kg/body per minute and 1000 nanograms.”, said doctor Șerban Bubenek, president of the Romanian Intensive Care Society, to Digi 24.
The dose of noradrenaline is set by the doctor according to the needs of each patient. It is important that doctors carefully monitor the effects of noradrenaline administration and be aware of possible adverse effects, Dr. Şerban Bubenek also said.
“This medicine is administered over a long period of time. It is administered even for days, weeks, when needed. The doctor is obliged to monitor the effects he expects to obtain, but he must also be aware of the appearance of possible negative effects, such as cardiovascular or negative effects on renal function or pulmonary circulation, with the appearance of severe pulmonary hypertension, also the absence intended effect, which may occur despite escalating doses.”, added the doctor.
Four investigations are underway after the death of 17 patients from the ATI ward: a criminal one at the Prosecutor's Office of the Bucharest Court, an internal one at the Pantelimon Hospital, an investigation by the College of Doctors and a check by the Control Body of the Minister of Health. Patients in Intensive Care would have received treatment in doses ten times lower than necessary. The director of care informed the manager in writing about these matters. A nurse at the Saint Pantelimon Hospital raised suspicions about these deaths.
