<i>In vitro</i> analysis of overall particulate contamination exposure during multidrug IV therapy: Impact of infusion sets

Perez, M.; Décaudin, Bertrand; Chahla, Wadih Abou; Nelken, Brigitte; Barthélémy, Christine; Lebuffe, Gilles; Odou, Pascal

doi:10.1002/pbc.25442

Cited by 21 publications

(28 citation statements)

References 33 publications

(34 reference statements)

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“…In this way, interactions between simultaneously infused medications are minimised. Its advantage has been demonstrated in preventing drug incompatibilities [13, 14] as well as mass flow rate disturbances both in vitro and on animals [7, 8, 14]. Our work supports its use in an HDU context and suggests a link between minimising interactions of simultaneous infused drugs and time spent in hypoglycaemia.…”

Section: Discussionsupporting

confidence: 72%

Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial

Genay

Décaudin

Ethgen

et al. 2017

Ann. Intensive Care

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BackgroundGlucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomised study was conducted in a fifteen-bed perioperative high dependency unit (HDU) in a university hospital. In total, 172 eligible patients receiving insulin therapy agreed to participate in the study. Subcutaneous continuous glucose monitoring was set up for all patients and an optimised system with a dedicated insulin infusion line for half of the patients.ResultsEighty-six patients were infused via the optimised infusion line and 86 patients via the standard infusion line. No significant difference was found according to the glycaemic lability index score [mean difference between groups (95% CI): −0.09 (−0.34; 0.16), p = 0.49 after multiple imputation]. A glucose control monitoring system indicated a trend towards differences in the duration of hypoglycaemia (blood glucose level below 70 mg dl−1 (3.9 mmol l−1) over 1000 h of insulin infusion (9.7 ± 25.0 h in the standard group versus 4.4 ± 14.8 h in the optimised group, p = 0.059) and in the number of patients experiencing at least one hypoglycaemia incident (25.7 vs. 12.9%, p = 0.052). Time in the target range was similar for both groups.ConclusionsThe use of optimised infusion line with a dedicated insulin infusion line did not reduce glycaemic variability but minimised the incidence of hypoglycaemia events. The choice of the medical devices used to infuse insulin seems important for improving the safety of insulin infusion in perioperative HDU.

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Section: Discussionsupporting

confidence: 72%

Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial

Genay

Décaudin

Ethgen

et al. 2017

Ann. Intensive Care

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“…[50,51] Some studies indicated the advantage of using multi-lumen catheters in reducing the contact between incompatible drugs. [52,53] Perez et al studied the infusion of vancomycin hydrochloride with several incompatible drugs, using a standard and multi-lumen infusion set. The authors observed that the overall particulate contamination decreased by 68% when a multi-lumen infusion set is used instead of a standard infusion set.…”

Section: Complications Of Drug Incompatibilitiesmentioning

confidence: 99%

Nanomedicine: a new paradigm to overcome drug incompatibilities

Abdelkader

Fathi

Hamad

et al. 2020

Journal of Pharmacy and Pharmacology

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Objectives Drug incompatibilities may compromise the safety and effectiveness of combined drugs and result in mild‐to‐serious clinical complications, such as catheter obstruction, loss of drug efficacy, formation of toxic derivatives and embolism. Various preventive strategies have been implemented to overcome drug incompatibilities with limited success. This review presents an innovative approach to prevent drug incompatibilities via isolating the incompatible drugs into nanostructures. Key findings Several examples of incompatible drugs may be loaded separately into nanostructures of various types. Physicochemical characteristics and biocompatibility of the nanomaterials that are being utilized to prevent physicochemical incompatibilities should be carefully considered. Conclusions There is a new era of exploiting nanomaterials in overcoming various types of physicochemical incompatibilities, with additional benefits of further improvements in pharmacokinetic profiles and pharmacological actions of the administered drugs.

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“…Most particles range from 1 to > 100 µm in size (even up to > 500 µm), with the majority at around 2 µm [8]. The present authors opted for a detection limit of 1 µm suggesting that particulate contamination has so far been underestimated.…”

Section: Number and Characteristicsmentioning

confidence: 99%

“…A visual examination method based on the Tyndall effect has recently been assessed [82], but the authors concluded that an evaluation of drug compatibility and parenteral nutrition could not be obtained only through the visual detection of particles. Recently, Perez et al [8] directly analysed overall particulate contamination exposure during IV therapy in children by connecting the infusion sets to a dynamic analyser system which showed that patients may receive up to millions of particles per day.…”

Section: Number and Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Particulate Matter in Injectable Drugs: Evaluation of Risks to Patients

Perez

Maiguy-Foinard

Barthélémy

et al. 2016

Pharmaceutical Technology in Hospital Pharmacy

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AbstractOne of the fundamental principles guiding the pharmaceutical quality of parenteral products is to prevent injecting contaminants from microbiological, chemical or physical sources. It is just as difficult to ensure the absence of chemical and particulate contaminants in injectable products as it is to weigh up the microbiological risk. The problem of particulate matter is mainly related to the preparing and administrating of injectable drugs rather than through the contamination of marketed products. Particulate contamination also arises

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In vitro analysis of overall particulate contamination exposure during multidrug IV therapy: Impact of infusion sets

Abstract: This study demonstrates that a large number of particles can be administered during parenteral multidrug infusion. The choice of drug concentration and/or the type of infusion set may reduce this. Further studies are required to evaluate adverse clinical effects.

Cited by 21 publications

References 33 publications

Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial

Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial

Nanomedicine: a new paradigm to overcome drug incompatibilities

Particulate Matter in Injectable Drugs: Evaluation of Risks to Patients

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