Abstract
PurposePlastic materials such as polyurethane (PUR), polyethylene (PE), polypropylene (PP) and polyvinyl chloride (PVC) are widely used in double-lumen extension tubing. The purposes of our study were to 1) compare in vitro drug delivery through the double extension tubes available on the market 2) assess the plastic properties of PUR in infusion devices and their impact on drug delivery.MethodsThe study compared eight double-lumen extension tubes in PUR, co-extruded (PE/PVC) plastic and plasticised PVC from different manufacturers. Isosorbide dinitrate and diazepam were used as model compounds to evaluate their sorption on the internal surface of the infusion device. Control experiments were performed using norepinephrine known not to absorb to plastics. Drug concentrations delivered at the egress of extension tubes were determined over time by an analytical spectrophotometric UV-Vis method. The main characteristics of plastics were also determined.ResultsSignificant differences in the sorption phenomenon were observed among the eight double-lumen extension tubes and between pairs of extension tubes. Mean concentrations of isosorbide dinitrate delivered at the egress of double-lumen extension tubes after a 150-minute infusion (mean values ± standard deviation in percentage of the initial concentrations in the prepared syringes) ranged between 80.53 ± 1.66 (one of the PUR tubes) and 92.84 ± 2.73 (PE/PVC tube). The same parameters measured during diazepam infusion ranged between 48.58 ± 2.88 (one of the PUR tubes) and 85.06 ± 3.94 (PE/PVC tube). The double-lumen extension tubes in PUR were either thermosetting (resin) or thermoplastic according to reference.ConclusionsClinicians must be aware of potential drug interactions with extension tube materials and so must consider their nature as well as the sterilisation method used before selecting an infusion device.
Highlights
Patients in intensive care units receive many drugs simultaneously, resulting in the need for multi-lumen extension tubes
Mean concentrations of isosorbide dinitrate delivered at the egress of double-lumen extension tubes after a 150-minute infusion ranged between 80.53 ± 1.66 and 92.84 ± 2.73 (PE/polyvinyl chloride (PVC) tube)
The same parameters measured during diazepam infusion ranged between 48.58 ± 2.88 and 85.06 ± 3.94 (PE/PVC tube)
Summary
Patients in intensive care units receive many drugs simultaneously, resulting in the need for multi-lumen extension tubes. [4] other characteristics of the device affect drug delivery and have to be taken into account. Plastic materials such as polyurethane (PUR), polyethylene (PE), polypropylene (PP) and polyvinyl chloride (PVC) are widely used in various medical devices. The evolution in infusion device materials may affect drug-device interaction and so drug delivery, especially with possible drug adsorption on the inner plastic surface of the container. This phenomenon leads to drug loss and results in reduced drug delivery to the patient. Plasticised PVC has high potential interaction with drugs, whereas PE or PP materials are subject to less. [11,12,13] Other criteria have to be taken into account, especially the mechanical properties of the materials, their ease of assembly and their manufacturing costs
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