Doesburg Frank, Middendorp Daniek, Dieperink Willem, Bult Wouter, Nijsten Maarten W, Touw Daan J
Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Vasc Access. 2020 Nov;21(6):945-952. doi: 10.1177/1129729820917262. Epub 2020 May 4.
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.
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.
Neither administration rate nor solvent affected the separator fluid volume (0.24 and 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, 0.001). Using 2-mL tubing required less separator fluid volume than 4-mL tubing for methylene blue (3.89 ± 0.57 mL vs 4.91 ± 0.88 mL, 0.01) and eosin yellow (4.41 ± 0.56 mL vs 5.63 ± 0.15 mL, 0.001). Extended tubing required less separator fluid volume/mL of tubing than smaller tubing for both methylene blue (2 vs 4 mL, 1.54 ± 0.22 vs 1.10 ± 0.19, 0.001) and eosin yellow (2 vs 4 mL, 1.75 ± 0.22 vs 1.25 ± 0.03, 0.001).
The separator fluid volume was neither affected by the administration rate nor by solvent. Glucose 5% required a marginally smaller separator fluid volume than NaCl 0.9%, however its clinical impact is debatable. A larger intravenous tubing volume requires a larger separator fluid volume. However, the ratio of separator fluid volume to the tubing's volume decreases as the tubing volume increases.
在不相容溶液之间注入隔离液可优化静脉通路的使用。影响安全分隔不相容溶液所需隔离液体积的因素尚不清楚。
用隔离液冲洗一根含有亚甲蓝染料的静脉输液管（2米长，2毫升，6法式），直至亚甲蓝浓度降至初始浓度的⩽2%。自变量为给药速率、染料溶剂（5%葡萄糖和0.9%氯化钠）和隔离液。在研究的第二部分，使用2毫升和4毫升（2×2米，4毫升，6法式）静脉输液管，以不同的给药方式注入亚甲蓝、隔离液和曙红黄。
给药速率和溶剂均未影响隔离液体积（分别为0.24和0.12）。5%葡萄糖作为隔离液时，其平均±标准差隔离液体积略小于0.9%氯化钠（3.64±0.13毫升对3.82±0.11毫升，P = 0.001）。对于亚甲蓝（3.89±0.57毫升对4.91±0.88毫升，P = 0.01）和曙红黄（4.41±0.56毫升对5.63±0.15毫升，P = 0.001），使用2毫升输液管所需的隔离液体积比4毫升输液管少。对于亚甲蓝（2毫升对4毫升，1.54±0.22对1.10±0.19，P = 0.001）和曙红黄（2毫升对4毫升，1.75±0.22对1.25±0.03，P = 0.001），输液管越长，每毫升输液管所需的隔离液体积越少。
隔离液体积既不受给药速率影响，也不受溶剂影响。5%葡萄糖所需的隔离液体积略小于0.9%氯化钠，但其临床影响尚存在争议。静脉输液管体积越大，所需的隔离液体积越大。然而，隔离液体积与输液管体积的比值随输液管体积的增加而降低。
