Benlabed Malik, Martin Mena Anthony, Gaudy Romain, Perez Maxime, Genay Stéphanie, Hecq Jean-Daniel, Odou Pascal, Lebuffe Gilles, Décaudin Bertrand
Univ. Lille, EA 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France.
CHU Lille, Pharmacie, F-59000, Lille, France.
Intensive Care Med Exp. 2018 Oct 11;6(1):38. doi: 10.1186/s40635-018-0205-2.
In critically ill patients, drug incompatibilities frequently occur because of the number of drugs to be administered through a limited number of infusion lines. These are among the main causes of particulate contamination. However, little data is available to quantify particle exposure during simultaneous IV-drug infusion. The objective of this study was to evaluate the particulate matter potentially administered to critically ill patients.
The particulate matter (between 1 μm and 30 mm) of infused therapies used in ICUs for patients suffering from either septic shock or acute respiratory distress syndrome was measured in vitro over 6 h using a dynamic image analysis device, so that both overall particulate contamination and particle sizes could be determined. Data is presented according to the recommendations of the European Pharmacopoeia (≥ 10 and 25 μm).
For the six experimental procedures (continuous infusion of norepinephrine, midazolam, sufentanil, heparin, 5% glucose, binary parenteral nutrition and discontinuous administrations of omeprazole, piperacillin/tazobactam and fluconazole), the overall number of particles over the 6-h infusion period was 8256 [5013; 15,044]. The collected values for the number of particles ≥ 10 and 25 μm were 281 [118; 526] and 19 [7; 96] respectively. Our results showed that discontinuous administrations of drugs led to disturbances in particulate contamination.
This work indicates the amount of particulate matter potentially administered to critically ill adult patients. Particulate contamination appears lower than previous measurements performed during multidrug IV therapies in children.
在重症患者中，由于要通过有限数量的输液管路输注多种药物，药物不相容情况经常发生。这些是微粒污染的主要原因之一。然而，关于同时进行静脉药物输注时微粒暴露量的数据很少。本研究的目的是评估可能输注给重症患者的微粒物质。
使用动态图像分析设备，在体外对重症监护病房中用于感染性休克或急性呼吸窘迫综合征患者的输注疗法的微粒物质（1微米至30毫米之间）进行了6小时的测量，以便确定总体微粒污染情况和颗粒大小。数据根据欧洲药典的建议（≥10和25微米）呈现。
对于六个实验程序（去甲肾上腺素、咪达唑仑、舒芬太尼、肝素、5%葡萄糖的连续输注，二元肠外营养以及奥美拉唑、哌拉西林/他唑巴坦和氟康唑的间断给药），6小时输注期间的微粒总数为(8256[5013;15044])。≥10微米和25微米的微粒数量收集值分别为(281[118;526])和(19[7;96])。我们的结果表明，药物的间断给药会导致微粒污染的干扰。
这项工作表明了可能输注给成年重症患者的微粒物质数量。微粒污染似乎低于先前在儿童多药静脉治疗期间进行的测量结果。
