Négrier Laura, Décaudin Bertrand, Treizebré Anthony, Guilbert Marie, Odou Pascal, Martin Mena Anthony
University of Lille, CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France.
University of Lille, CNRS, Centrale Lille, University Polytechnique Hauts-de-France, UMR 8520-IEMN-Institut d'Electronique de Microélectronique et de Nanotechnologie, F-59000 Lille, France.
Pharmaceuticals (Basel). 2024 Sep 17;17(9):1222. doi: 10.3390/ph17091222.
Drug incompatibilities are among the most common medication errors in intensive care units. A precipitate can form and block the catheter or cause an adverse event in the patient. Intensive care units have implemented various strategies for limiting the occurrence of these incompatibilities, which have already been studied in vitro under standardized conditions. The objective of the present in vitro study was to continue these assessments by determining the impact of the infusion line geometry and the drugs' position in the infusion set-up on the prevention of vancomycin-piperacillin/tazobactam incompatibility.
Infusion lines with a different common volume, a multilumen medical infusion device, a dilute vancomycin solution, and separate infusions of incompatible drugs were evaluated separately. The infusion line outlet was connected to a dynamic particle counter.
Reducing the common volume, using multilumen medical devices, or spacing out the two incompatible drugs on the infusion line did not prevent the occurrence of a significant particulate load. Only dilution of the vancomycin solution was associated with a significantly lower particulate load and the absence of drug incompatibility.
Our results show that under specific conditions, it is possible to reduce particulate contamination considerably.
药物配伍禁忌是重症监护病房中最常见的用药错误之一。沉淀物可能形成并堵塞导管或在患者身上引发不良事件。重症监护病房已实施多种策略来限制这些配伍禁忌的发生，这些策略已在标准化条件下进行了体外研究。本体外研究的目的是通过确定输液管路几何形状和药物在输液装置中的位置对预防万古霉素 - 哌拉西林/他唑巴坦配伍禁忌的影响来继续这些评估。
分别评估具有不同共同容积的输液管路、多腔医用输液装置、稀释的万古霉素溶液以及不相容药物的分开输注。输液管路出口连接到动态颗粒计数器。
减少共同容积、使用多腔医用装置或在输液管路上将两种不相容药物隔开并不能防止出现显著的颗粒负荷。只有万古霉素溶液的稀释与显著更低的颗粒负荷以及药物配伍禁忌的不存在相关。
我们的结果表明，在特定条件下，有可能大幅减少颗粒污染。
