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Keywords = multilumen device

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9 pages, 2835 KB  
Case Report
Drug Incompatibilities and Complex Assemblies: Let Us Remain Vigilant!
by Cordélia Salomez-Ihl, Anthony Martin Mena, Marie-Carmen Molina, Romane Chapuis, Marjorie Durand, Sébastien Chanoine, Julien Leenhardt, Philippe Py, Marie-Dominique Brunet, Yung-Sing Wong, Marie Chevallier, Bertrand Décaudin, Pascal Odou, Pierrick Bedouch and Roseline Mazet
Pharmaceuticals 2025, 18(5), 626; https://doi.org/10.3390/ph18050626 - 25 Apr 2025
Viewed by 2816
Abstract
Background/Objectives: Multi-lumen devices that limit physicochemical incompatibilities (PCIs) are frequently used in neonatal intensive care units where premature infants receive numerous infusions. The aim of the study was to investigate a PCI that occurred despite the use of a device of this [...] Read more.
Background/Objectives: Multi-lumen devices that limit physicochemical incompatibilities (PCIs) are frequently used in neonatal intensive care units where premature infants receive numerous infusions. The aim of the study was to investigate a PCI that occurred despite the use of a device of this type (EDELVAISS® Multiline NEO, Doran International, Toussieu, France). Case Summary: A 7-week-old preterm infant received ganciclovir at therapeutic dosage for cytomegalovirus (CMV) infection. After the fifth administration of ganciclovir, a PCI occurred, leading to a white precipitate. The peripheral inserted central catheter (PICC) (PREMICATH®2Fr, Vygon, Ecouen, France) had to be replaced. Laboratory reproduction of the administrations during 72 h, nuclear magnetic resonance (NMR) analysis and particle counting were carried out to analyse the occurrence of events leading to PCIs. The precipitate was linked to a PCI of parenteral nutrition associated with a dilution error of ganciclovir (omission of a 10-fold dilution step, resulting in ganciclovir being administered at 30 mg/L instead of 3 mg/L). Due to the presence of lipids in the parenteral nutrition, visual detection of the white precipitate was difficult. Conclusions: Multi-lumen infusion devices limit but do not prevent the occurrence of PCIs, particularly in the event of a preparation error. Despite the use of this type of device, great vigilance is still required, particularly with regard to prescription analysis and reconstitution procedures. Full article
(This article belongs to the Section Pharmaceutical Technology)
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15 pages, 4140 KB  
Article
Evaluation of the Impact of Infusion Set Design on the Particulate Load Induced by Vancomycin–Piperacillin/Tazobactam Incompatibility
by Laura Négrier, Bertrand Décaudin, Anthony Treizebré, Marie Guilbert, Pascal Odou and Anthony Martin Mena
Pharmaceuticals 2024, 17(9), 1222; https://doi.org/10.3390/ph17091222 - 17 Sep 2024
Cited by 1 | Viewed by 2030
Abstract
Introduction: 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 [...] Read more.
Introduction: 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. Methods: 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. Results: 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. Conclusions: Our results show that under specific conditions, it is possible to reduce particulate contamination considerably. Full article
(This article belongs to the Special Issue Pharmaceutical Preparations, Challenges in Formulations and Compatibility Studies)
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