Abstract
BackgroundIn critically ill patients, drug incompatibilities frequently occur because of the number of drugs to be administered through a limited number of infusion lines. These are among the main causes of particulate contamination. However, little data is available to quantify particle exposure during simultaneous IV-drug infusion. The objective of this study was to evaluate the particulate matter potentially administered to critically ill patients.MethodsThe particulate matter (between 1 μm and 30 mm) of infused therapies used in ICUs for patients suffering from either septic shock or acute respiratory distress syndrome was measured in vitro over 6 h using a dynamic image analysis device, so that both overall particulate contamination and particle sizes could be determined. Data is presented according to the recommendations of the European Pharmacopoeia (≥ 10 and 25 μm).ResultsFor the six experimental procedures (continuous infusion of norepinephrine, midazolam, sufentanil, heparin, 5% glucose, binary parenteral nutrition and discontinuous administrations of omeprazole, piperacillin/tazobactam and fluconazole), the overall number of particles over the 6-h infusion period was 8256 [5013; 15,044]. The collected values for the number of particles ≥ 10 and 25 μm were 281 [118; 526] and 19 [7; 96] respectively. Our results showed that discontinuous administrations of drugs led to disturbances in particulate contamination.ConclusionsThis work indicates the amount of particulate matter potentially administered to critically ill adult patients. Particulate contamination appears lower than previous measurements performed during multidrug IV therapies in children.
Highlights
In critically ill patients, drug incompatibilities frequently occur because of the number of drugs to be administered through a limited number of infusion lines
The objective of this study was to evaluate the particulate matter potentially administered to critically ill patients by reproducing in vitro the most common intravenous system and drug combinations used in intensive care unit (ICU) for patients suffering from either septic shock or acute respiratory distress syndrome (ARDS)
Our results showed that discontinuous administrations of drugs led to disturbances in particulate contamination, resulting in increased particle release between T0 + 3 h and T0 + 4 h30 with 76% of the total number of particles recorded (Fig. 2)
Summary
Drug incompatibilities frequently occur because of the number of drugs to be administered through a limited number of infusion lines. These are among the main causes of particulate contamination. Little data is available to quantify particle exposure during simultaneous IV-drug infusion. The objective of this study was to evaluate the particulate matter potentially administered to critically ill patients. Little data is available on the clinical implications of intravenous drug incompatibilities in critically ill patients [1]. One study conducted in a paediatric intensive care unit (ICU) reported a reduction in the incidence of severe complications in the filter group [2]. Other data from literature mainly reports total parenteral nutrition-associated pulmonary complications [6, 7]
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