炭酸ナトリウム含有注射薬の溶解後の炭酸ガス発生による空気塞栓の問題点

Abstract

Injectable medicines containing sodium carbonate produce carbon dioxide gas upon dissolution.The generated carbon dioxide causes a drop in liquid level in the drip cylinder during infusion,which may facilitate the entry of air into the bloodstream.In this study,we examined the influence of the amount of sodium carbonate in injectable medicines on the extent of lowering of the liquid level and investigated the risk of air embolism due to carbon dioxide,using seven injections and five half kit products.Regardless of the injection-half kit combination,the injection liquid level was decreased when the injections were dissolved.The drop in the liquid level was up to 10mm.Except for cefozopram hydrochloride,the lowering of the liquid level seemed to be dependent on the amount of sodium carbonate.The liquid level was markedly lower for two port products than it was for TN or bag products,and was also lower at an infusion rate of 100mL/120min than it was at 100mL/60min.In conclusion,besides sodium carbonate amount,infusion rate and hermeticity also seemed to be risk factors for air embolism following the dissolution of injectable medicines containing sodium carbonate.