The use of in-line intravenous filters in sick newborn infants

Lingen, RA van; Baerts, W; ACM, Marquering; GJHM, Ruijs

doi:10.1080/08035250410026608

Cited by 15 publications

(13 citation statements)

References 22 publications

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“…Less information exists for the influence of filtration on severely ill patients. One single-center trial on 88 preterm newborns showed a trend toward decreased morbidity in the treatment group [8]. However, the incidence of sepsis could not be reduced by in-line filtration [20].…”

Section: Discussionmentioning

confidence: 99%

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Analysis of particulate contaminations of infusion solutions in a pediatric intensive care unit

et al. 2010

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PurposeTo examine the physical properties and chemical composition of particles captured by in-line microfilters in critically ill children, and to investigate the inflammatory and cytotoxic effects of particles on endothelial cells (HUVEC) and macrophages in vitro.MethodsProspective, observational study of microfilters following their use in the pediatric intensive care unit. In vitro model utilizing cytokine assays to investigate the effects of particles on human endothelial cells and murine macrophages.ResultsTwenty filter membranes from nine patients and five controls were examined by electron microscopy (EM) and energy dispersion spectroscopy (EDX). The average number of particles found on the surface of the used membranes was 550 cm2. EDX analysis confirmed silicon as a major particle constituent. Half of the filter membranes showed conglomerates containing an uncountable number of smaller particles. In vitro, glass particles were used to mimic the high silicon content particles. HUVEC and murine macrophages were exposed to different contents of particles, and cytokine levels were assayed to assess their immune response. Levels of interleukin-1beta, interleukin-6, interleukin-8, and tumor necrosis factor alpha were suppressed.ConclusionsParticle contamination of infusion solutions exists despite a stringent infusion regiment. The number and composition of particles depends on the complexity of the applied admixtures. Beyond possible physical effects, the suppression of macrophage and endothelial cell cytokine secretion in vitro suggests that microparticle infusion in vivo may have immune-modulating effects. Further clinical trials are necessary to determine whether particle retention by in-line filtration has an influence on the outcome of intensive care patients.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-010-1775-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…Use of in-line filtration almost completely prevents particulate infusion [6]. Recent studies have evaluated the clinical effect of in-line filtration and showed significant reduction in thrombophlebitis [7] and a trend towards reduction of complications in neonates such as sepsis, thrombosis, and necrotizing enterocolitis [8]. …”

Section: Introductionmentioning

confidence: 99%

Analysis of particulate contaminations of infusion solutions in a pediatric intensive care unit

et al. 2010

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“…In Switzerland, a color code system was implemented over 5 years and helped decrease the risk of mixing incompatible drugs in care units . Inline filters can be a solution to limit particles in infusions, particularly in neonatal and pediatric units . Indeed, Jack et al recently showed that using inline filters resulted in a decrease in overall complications and inflammation, such as the Systemic Inflammatory Response Syndrome (SIRS) in pediatric intensive care units .…”

Section: Introductionmentioning

confidence: 99%

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

Perez

Décaudin

Chahla

et al. 2015

Pediatric Blood & Cancer

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“…Furthermore, in-line IV filters add cost [ 19 – 21 ]. Some reports have suggested the benefit of in-line IV filters [ 1 , 20 , 22 , 23 ], whereas other reports have rejected their routine use [ 3 , 24 – 26 ]. To date, the routine use of in-line IV filters is not standard.…”

Section: Discussionmentioning

confidence: 99%

IV injection of polystyrene beads for mouse model of sepsis causes severe glomerular injury

et al. 2014

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BackgroundInfusion fluids may be contaminated with different types of particulates that are a potential health hazard. Particulates larger than microvessels may cause an embolism by mechanical blockage and inflammation; however, it has been reported that particulates smaller than capillary diameter are relatively safe. Against such a background, one report showed that polystyrene beads smaller than capillary diameter decreased tissue perfusion in ischemia–reperfusion injury. This report suggested that polystyrene beads from 1.5- to 6-μm diameter (dia.) may have unfavorable effects after pretreatment.Here, we investigated whether injection of polystyrene beads (3- and 6-μm dia.) as an artificial contaminant of intravenous fluid after lipopolysaccharide (LPS) injection affected mortality and organ damage in mice.MethodsMice were divided into four groups and injected: polystyrene beads only, LPS only, polystyrene beads 30 min after LPS, or saline. A survival study, histology, blood examination, and urine examination were performed.ResultsThe survival rate after LPS and polystyrene bead (6-μm dia.) injection was significantly lower than that of the other three groups. In the kidney sections, injured glomeruli were significantly higher with LPS and polystyrene bead injection than that of the other three groups. LPS and polystyrene bead injection decreased the glomerular filtration rate and led to renal failure. Inflammatory reactions induced with LPS were not significantly different between with or without polystyrene beads. Polystyrene beads were found in urine after LPS and polystyrene bead injection.ConclusionsInjection of polystyrene beads after LPS injection enhanced glomerular structural injury and caused renal function injury in a mouse sepsis model.

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The use of in-line intravenous filters in sick newborn infants

Abstract: The use of this in-line filter leads to a significant decrease in major complications and substantial cost savings.

Cited by 15 publications

References 22 publications

Analysis of particulate contaminations of infusion solutions in a pediatric intensive care unit

Analysis of particulate contaminations of infusion solutions in a pediatric intensive care unit

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

IV injection of polystyrene beads for mouse model of sepsis causes severe glomerular injury

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