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Quantitative assessment of required separator fluid volume in multi-infusion settings.

ABSTRACT: BACKGROUND:Administering a separator fluid between incompatible solutions can optimize the use of intravenous lumens. Factors affecting the required separator fluid volume to safely separate incompatible solutions are unknown. METHODS:An intravenous tube (2-m, 2-mL, 6-French) containing methylene blue dye was flushed with separator fluid until a methylene blue concentration ?2% from initial was reached. Independent variables were administration rate, dye solvent (glucose 5% and NaCl 0.9%), and separator fluid. In the second part of the study, methylene blue, separator fluid, and eosin yellow were administered in various administration profiles using 2- and 4-mL (2?×?2?m, 4-mL, 6-French) intravenous tubes. RESULTS:Neither administration rate nor solvent affected the separator fluid volume (p?=?0.24 and p?=?0.12, respectively). Glucose 5% as separator fluid required a marginally smaller mean?±?SD separator fluid volume than NaCl 0.9% (3.64?±?0.13?mL vs 3.82?±?0.11?mL, p?

SUBMITTER: Doesburg F

PROVIDER: S-EPMC7675775 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Quantitative assessment of required separator fluid volume in multi-infusion settings.

Doesburg Frank F Middendorp Daniek D Dieperink Willem W Bult Wouter W Nijsten Maarten W MW Touw Daan J DJ

The journal of vascular access 20200504 6

<h4>Background</h4>Administering a separator fluid between incompatible solutions can optimize the use of intravenous lumens. Factors affecting the required separator fluid volume to safely separate incompatible solutions are unknown.<h4>Methods</h4>An intravenous tube (2-m, 2-mL, 6-French) containing methylene blue dye was flushed with separator fluid until a methylene blue concentration ⩽2% from initial was reached. Independent variables were administration rate, dye solvent (glucose 5% and Na ...[more]

PMID: 32364801

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Project description:BackgroundMulti-drug intravenous (IV) therapy is one of the most common medical procedures used in intensive care units (ICUs), operating rooms, oncology wards and many other hospital departments worldwide. As drugs or their solvents are frequently chemically incompatible, many solutions must be administered through separate lumens. When the number of available lumens is too low to facilitate the safe administration of these solutions, additional (peripheral) IV catheters are often required, causing physical discomfort and increasing the risk for catheter related complications. Our objective was to develop and evaluate an algorithm designed to reduce the number of intravenous lumens required in multi-infusion settings by multiplexing the administration of various parenteral drugs and solutions.MethodsA multiplex algorithm was developed that schedules the alternating IV administration of multiple incompatible IV solutions through a single lumen, taking compatibility-related, pharmacokinetic and pharmacodynamic constraints of the relevant drugs into account. The conventional scheduling procedure executed by ICU nurses was used for comparison. The number of lumens required by the conventional procedure (LCONV) and multiplex algorithm (LMX) were compared.ResultsWe used data from 175,993 ICU drug combinations, with 2251 unique combinations received by 2715 consecutive ICU patients. The mean?±?SD number of simultaneous IV solutions was 2.8?±?1.6. In 27% of all drug combinations, and 61% of the unique combinations the multiplex algorithm required fewer lumens (p <?0.001). With increasing LCONV, the reduction in number of lumens by the multiplex algorithm further increased (p <?0.001). In only 1% of cases multiplexing required >?3?lm, versus 12% using the conventional procedure.ConclusionThe multiplex algorithm addresses a major issue that occurs in ICUs, operating rooms, oncology wards, and many other hospital departments where several incompatible drugs are infused through a restricted number of lumens. The multiplex algorithm allows for more efficient use of IV lumens compared to the conventional multi-infusion strategy.

Dataset Information

Quantitative assessment of required separator fluid volume in multi-infusion settings.

Publications

Quantitative assessment of required separator fluid volume in multi-infusion settings.

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