Obtaining airtight seal with plastic infusion bottle using conventional intravenous set (original) (raw)
Intravenous (IV) Drip Rate Controlling and Monitoring for Risk-Free IV Delivery
International journal of engineering research and technology, 2020
Intravenous (IV) drip mode is one of the most used modes for drug delivery. It delivers the drug into the blood circulation directly. It is widely used because of its advantages like its affordability, safety, effectiveness and speed of delivery of pharmacological substances and other fluids. Albeit its many advantages, a few complications could arise in its usage if it is not administered properly. In this paper we discuss the advantages and risks of IV drip set, the importance IV drip rate, existing infusion pumps and their drawbacks, attempts made to overcome the drawbacks of infusion pumps and finally the need for next generation IV drip set which can not only monitor but also control the drip set.
Avoiding common problems associated with intravenous fluid therapy
The Medical journal of Australia, 2008
Inappropriate intravenous fluid therapy is a significant cause of patient morbidity and mortality and may result from either incorrect volume (too much or too little) or incorrect type of fluid. Fluid overload has no precise definition, but complications usually arise in the context of pre-existing cardiorespiratory disease and severe acute illness. Insufficient fluid administration is readily identified by signs and symptoms of inadequate circulation and decreased organ perfusion. Administration of the wrong type of fluid results in derangement of serum sodium concentration, which, if severe enough, leads to changes in cell volume and function, and may result in serious neurological injury. In patients whose condition is uncomplicated, we recommend a restrictive approach to perioperative intravenous fluid replacement, with initial avoidance of hypotonic fluids, and regular measurement of serum concentration of electrolytes, especially sodium.
Journal of Advanced Nursing, 2002
Background. The ideal duration of intravascular administration set use is unknown. Studies have compared the infective implications of one to seven days of use. The Centers for Disease Control recommend at least three days usage. No previous study has evaluated the accuracy of volume delivery or integrity of administration sets after prolonged use. Aim. To evaluate the accuracy and condition of intravascular administration sets used continuously for 7 days. Design. Prospective, randomised, experimental study in the laboratory setting. Methods. Four administration sets were randomly assigned to deliver 2 mL/h (IMED ® syringe set 2280-0000), 20, 50 or 100 mL/h (IMED ® infusion sets 2210-0500) of crystalloid solution continuously for 7 days through an IMED ® Gemini ® four channel infusion pump (PC4). At study commencement and daily for 7 days, a 4 hour volume measurement and an inspection for leaks/erosion of administration sets occurred for each administration set (total measurements = 32). Results. Mean volume outputs over four hours were 7.84mL (2mL/h), 80.66 mL (20mL/h), 205.35 (50 mL/h) and 406.37 (100 mL/h). These differed significantly from the programmed volumes (p = 0.00-0.01). Usage duration did not influence performance (F = 0.866, p = 0.55). Accuracy of volume delivery differed significantly with pump speed (F = 106.933, p < 0.001) exhibiting increased volume to 50 mL/h then a reduction at 100 mL/h. Differences were within manufacturer specifications (+/-5%) and were clinically acceptable. All administration sets remained in appropriate condition displaying no leakage or erosion. 3 Conclusion. There were small inaccuracies found between programmed and delivered volumes however there was no deterioration in performance over time. This suggests that inaccuracies were due to normal pump performance rather than the administration sets. Administration sets retain acceptable accuracy and condition after 7 days continuous use. Further research should assess the infective and other impacts of prolonged usage.
Scientific Reports, 2019
Medical tubings in plasticized polyvinylchloride (pVc) are widely used for the infusion of medications but are known in some cases to cause content-container interactions (drug sorption and plasticizer release). The aim of this study was to assess interactions between drugs and five alternative materials to a reference plasticized pVc intravenous (iV) infusion tubing: three were pVc coextruded with polyethylene (pe), polyurethane (pU) or a thermoplastic elastomer (Styrene-ethyleneButadiene-Styrene (SEBS)) and two were SEBS or thermoplastic olefin (TPO) monolayer tubings. Diazepam and insulin were chosen as respective reference of absorption and adsorption while paracetamol acted as a negative control. The concentration of each drug was quantified with liquid chromatography to evaluate a potential loss after a static contact condition and simulated infusion at 1 mL/h and 10 mL/h dynamic condition by an electric syringe pump. A characterization of each material's surface was performed by Fourier transform infrared spectroscopy in attenuated total reflection mode (ATR-FTIR) and by measurement of surface zeta potential. Plasticizer release was quantified by gas chromatography coupled with mass spectrometry (GC-MS). For all tubings except PVC/PU, no loss of paracetamol was observed in any condition. Diazepam sorption appeared to be less important with PVC/PE, PVC/SEBS, SEBS and TPO tubings than with PVC, but was more important when using PVC/PU tubings. pVc tubings induced the least loss of insulin amongst all the studied materials. Surface analysis by ATR-FTIR highlighted the presence of a plasticizer (that could be attributed to Tris (2-Ethylhexyl) Trimellitate (TOTM)) in the coextruded SEBS layer of PVC/SEBS, which could have influenced drug sorption, probably as a consequence of a migration from the PVC layer. Coextruded PVC/SEBS and PVC/PE presented the lowest zeta potential of all studied materials with respective values of −39 mV and −36 mV and were related to the highest sorption of insulin while PVC/PU with the highest zeta potential (about −9 mV) presented the highest absorption of diazepam. Coextruded layered materials appeared to have a lower plasticizer release than PVC alone. As a conclusion, PVC/PE and thermoplastic elastomers alone or coextruded with pVc could be interesting alternatives to pVc tubings with regards to sorption phenomena and plasticizer release. Because of its good mechanical properties combined with a low cost of fabrication, PVC has been widely used for the manufacture of IV tubings. Yet this material is not completely inert when infusing drug solutions. It can affect drug solutions by releasing compounds into the infusate or by retaining the drug (sorption) thus potentially affecting infusion safety and effectiveness. Sorption phenomena can cause a loss of active pharmaceutical ingredient (API) 1,2 or protective excipients 3 and are mediated by different physicochemical parameters/properties 4-6 that are still incorrectly evaluated. The phenomena can be detailed in two steps: adsorption then absorption. Adsorption is the result of a weak interaction between a compound in solution and a surface. This phenomenon
Hospital Pharmacy, 2009
ence on the Safety of Intravenous Drug Delivery Systems was convened to evaluate the relative safety of the nonelectronic IV drug delivery systems then available. An interdisciplinary expert panel consisting of pharmacists, physicians, and nurses reviewed the existing literature and listened to presentations regarding the safety, cost, and simplicity of use of these systems. These included manufacturerprepared products, pharmacy-based IV admixture systems, point-ofcare activated systems, IV push systems, augmented IV push systems (such as syringe pumps), and volume-control chambers. The systems were ranked using a decisionanalysis methodology based on 4 domains: safety, cost, simplicity of use, and education and training needed for operation. In the final report from the conference, 3 drug delivery systems had higher overall scores and were deemed superior sys tems by the expert panel: manufacturerprepared, point-of-care activated, and pharmacy-based IV admixture programs. Manufacturer-prepared products were considered the safest IV drug delivery systems overall because of quality assurance during the production process.
Drug Compatibility with a New Generation of VISIV Polyolefin Infusion Solution Containers
International journal of pharmaceutical compounding
A new generation of VISIV polyolefin intravenous solution containers, made of a new and different proprietary polymer, were evaluated for sorption and leaching potential with a cadre of drugs known to exhibit those phenomena with polyvinylchloride containers. Sorption potential was evaluated for amiodarone hydrochloride, carmustine, regular human insulin, lorazepam, nitroglycerin, sufentanil citrate, and thiopental sodium. Leaching potential was evaluated for tacrolimus and teniposide as well as the vehicles of docetaxel and paclitaxel. Representative concentrations of the drugs in infusion solutions or undiluted were placed into the new generation of VISIV containers and left in contact for up to 24 hours at room temperature. High performance liquid chromatography was used to determine drug concentrations and the presence of plasticizer or other plastic components, if any. Only regular human insulin exhibited any substantial loss of concentration in the polyolefin containers that c...
Infusion technology: a cause for alarm
Pediatric Anesthesia, 2002
Background: Volumetric infusion pumps are widely used in paediatric practice. Tissue extravasation is a hazard. The occlusion pressure limit alarm, although not intended to detect extravasation, is the only warning sign present to indicate flow faults in the infusion systems. Methods: Extravasations were created in the subcutaneous plane of 20 limbs of five piglets with normal saline via an infusion pump. Five flow rates were used with each piglet allocated to one: 100 mlAEh)1 , 200 mlAEh)1 , 300 mlAEh)1 , 400 mlAEh)1 , 500 mlAEh)1. The occlusion pressure limit was first set at low and adjusted to medium, then to high, upon alarm activation. Line pressure at 5-min intervals and upon alarm activation and volume of infusate given were measured. Limb diameters before and after infusion were measured. Results: Six out of 20 cases failed to activate any alarm. The low, medium and high occlusion pressure limit alarms were activated in 14, 1 and 0 instances, respectively. The incidence of alarm activation is higher in the forelimb compared with the hindlimb (P ¼ 0.001). The tissue compliance and volume infused at alarm activation are significantly lower in the former (P < 0.05). Line pressure increases with increase in flow rates for the same limb (P ¼ 0.013 Fore, P ¼ 0.005 Hind). Conclusions: Occlusion pressure limit alarm cannot reliably detect extravasation especially at sites with high compliance, low flow rates, even at low occlusion limit. Line pressure depends on interplay of site (compliance) and flow rate and is independent of volume extravasated. Users must be aware of the set occlusion pressure limit. Repeated clinical assessment remains vital.