Hung J C, Mahoney D W, Johnston D L, Gibbons R J
Nuclear Medicine, Department of Diagnostic Radiology, Mayo Clinic, Rochester, Minn 55905, USA.
J Nucl Cardiol. 1998 Mar-Apr;5(2):161-6. doi: 10.1016/s1071-3581(98)90199-4.
Adenoscan (Fujisawa USA, Inc., Deerfield, Ill.) has been initially packaged in a 30 ml glass vial for single use only because it contains no preservative. This restricted usage has generated considerable waste and high cost for the patient. Although the new 20 ml vial of Adenoscan provides some reduction in waste, the savings offered by the 20 ml and 30 ml vial system is still not optimal. The purpose of this study was to investigate an optimal dual-size vial system that would provide limited amounts of waste while maintaining its practicality to satisfy different patient populations.
The least waste for each potential combination (n = 344) of two vials was calculated by assuming that patient weights (30 to 200 kg) follow a normal distribution. The 6 ml and 15 ml vial combination had the least expected waste for lighter patient populations, and the 9 ml and 15 ml vial system had the least expected waste for heavier populations. The calculated wastes for 4207 patients (83 +/- 19 kg) undergoing adenosine stress myocardial perfusion studies at the Mayo Clinic were 10.5 +/- 9.3 ml (30 ml vial), 5.1 +/- 2.9 ml (20 ml and 30 ml vial system), 1.6 +/- 1.0 ml (6 ml and 15 ml vial system), and 1.8 +/- 1.2 ml (9 ml and 15 ml vial system).
In general, both the 6 ml and 15 ml and 9 ml and 15 ml vial systems perform better than either the single 30 ml vial or the 20 ml and 30 ml vial system. Furthermore, the 6 ml and 15 ml vial combination offers the lowest expected waste for the actual patient population that underwent the adenosine stress myocardial perfusion imaging studies at our institution.
腺苷注射液（美国藤泽公司，伊利诺伊州迪尔菲尔德）最初包装在30毫升玻璃小瓶中，仅供单次使用，因为它不含防腐剂。这种受限的使用方式给患者带来了大量的浪费和高昂的费用。尽管新的20毫升腺苷注射液小瓶减少了一些浪费，但20毫升和30毫升小瓶系统所节省的费用仍不理想。本研究的目的是探索一种最佳的双规格小瓶系统，既能减少浪费，又能保持实用性以满足不同患者群体的需求。
通过假设患者体重（30至200千克）呈正态分布，计算了两种小瓶每种潜在组合（n = 344）的最少浪费量。对于较轻的患者群体，6毫升和15毫升小瓶组合的预期浪费最少；对于较重的患者群体，9毫升和15毫升小瓶系统的预期浪费最少。在梅奥诊所接受腺苷负荷心肌灌注研究的4207名患者（83±19千克）中，使用30毫升小瓶时计算出的浪费量为10.5±9.3毫升，使用20毫升和30毫升小瓶系统时为5.1±2.9毫升，使用6毫升和15毫升小瓶系统时为1.6±1.0毫升，使用9毫升和15毫升小瓶系统时为1.8±1.2毫升。
总体而言，6毫升和15毫升以及9毫升和15毫升小瓶系统的表现均优于单个30毫升小瓶或20毫升和30毫升小瓶系统。此外，对于在我们机构接受腺苷负荷心肌灌注成像研究的实际患者群体，6毫升和15毫升小瓶组合的预期浪费最低。
