Microvascular Pulmonary Emboli Secondary to Precipitated Crystals in a Patient Receiving Total Parenteral Nutrition

Reedy, Jeremiah S.; Kuhlman, Janet E.; Voytovich, Marta

doi:10.1378/chest.115.3.892

Cited by 53 publications

(35 citation statements)

References 7 publications

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“…This score was based on five criteria adapted from the study of Barrons [26]: time needed to classify 5 drug pairs, design (presentation), usefulness, reliability and ergonomics (navigability). 6 The 5 drug pairs were no. 9 in I 1 ; no.…”

Section: Comprehensivenessmentioning

confidence: 99%

“…Physical incompatibilities between IV drugs may lead to precipitation and catheter obstruction, blood-vessel irritation or embolism. Nevertheless, the real clinical consequences of drug precipitation have only been documented for a few drugs and parenteral nutrition [4][5][6][7]. Paediatric drugs are characterised by frequent off-label and unlicensed use [8].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of tools to prevent drug incompatibilities in paediatric and neonatal intensive care units

et al. 2010

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Thériaque proved outstanding as a drug-incompatibility tool. However, all resources showed some shortcomings. The large ranges of pharmacists' NCAs shows that such an assessment is subject to different interpretations. Standard operating procedures for drug-incompatibility assessment should be implemented in drug-information centres. Tools with low NCA percentage, such as the pH or CHUV tables, may be useful for nurses in ICUs.

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Section: Comprehensivenessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of tools to prevent drug incompatibilities in paediatric and neonatal intensive care units

et al. 2010

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“…2 On the other hand, major incidents of venous occlusion, organ damage, pulmonary embolism and granulomatosis in patients following injection of a parenteral drug containing foreign particulates have been reported in the past forty years. [3][4][5][6] To prevent future clinical incidents and ensure product safety, regulatory agencies require parenteral drugs to be "essentially free" of solid contaminants before reaching the consumers. 2 To meet this requirement, manufacturers make extensive use of automated particle detection systems, since it is quicker and more consistent than human inspectors, who are subjective and experience fatigue.…”

Section: Introductionmentioning

confidence: 99%

Gas-Phase Surface Engineering of Polystyrene Beads Used to Challenge Automated Particle Inspection Systems

Labonté

Marion

Virgilio

2016

Ind. Eng. Chem. Res.

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Container challenge sets, used in the qualification and validation of automated visible particle inspection systems in the parenteral drug industry, are prepared by seeding a single standardized polystyrene-divinylbenzene (PS-DVB) bead inside the commercial product to mimic foreign particulates. Due to its low surface energy and wettability, the bead adheres to container walls, hindering its detection by the motion based inspection system. The aim of this research is to modify the surface properties of the bead in such a way that it repulses the inner walls and stays in suspension inside the liquid product. The surface treatment consists of a photoinduced chemical vapor deposition (PICVD) process using syngas and UVC light. Following 2 treatment, newly grafted C-OH, C-O-C, C=O and COOH functional groups on the bead's surface are observed by XPS and FTIR spectroscopy, leading to an increase in the surface energy from 31 ± 1 to 65 ± 2 mJ/m 2 , and a corresponding zeta potential decrease from -38 mV to -61 mV.Finally, treated 100 µm, 200 µm and 500 µm PS-DVB beads suspended in water exhibit higher dispersion stability over time than untreated beads. These results show the potential of syngas PICVD to provide an effective solution to the stability issue of containers challenge sets for the validation of automated particle inspection systems, enabling significant savings of time and money to the parenteral drug industry.

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“…1,2 These studies have suggested that the precipitated material is calcium phosphate. 1,2 Precipitation is usually the result of incorrect compounding of the parenteral formula.…”

Section: Case Reportmentioning

confidence: 99%

Pulmonary microcrystalline cellulose deposition from intravenous injection of oral medication in a patient receiving parenteral nutrition

Ott¹,

Khoór²,

Scolapio³

et al. 2003

J Parenter Enteral Nutr

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A 50-year-old man who had been dependent on home parenteral nutrition (HPN) for 24 years presented with shortness of breath. A computed tomography scan of the lungs revealed a diffuse micronodular parenchymal infiltrate. On bronchoscopy, a crystalloid material was identified. This organic material was determined to be consistent with codeine. The patient had been injecting codeine into his intravenous catheter.

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Microvascular Pulmonary Emboli Secondary to Precipitated Crystals in a Patient Receiving Total Parenteral Nutrition

Cited by 53 publications

References 7 publications

Evaluation of tools to prevent drug incompatibilities in paediatric and neonatal intensive care units

Evaluation of tools to prevent drug incompatibilities in paediatric and neonatal intensive care units

Gas-Phase Surface Engineering of Polystyrene Beads Used to Challenge Automated Particle Inspection Systems

Pulmonary microcrystalline cellulose deposition from intravenous injection of oral medication in a patient receiving parenteral nutrition

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