Inadvertent Contamination of Intravenous Infusion Solutions Can Have Serious Consequences
Particulate contamination arises from a variety of sources, intrinsically in infusates and equipment or extrinsically due to manipulations1. Particles cause phlebitis on peripheral infusion lines and have serious systemic effects, damaging the lung and solid organs by irritation of the endothelium and by deposition in the microvasculature2.
Microbiological contamination of IV administration systems arises inadvertently due to manipulations3. Some bacteria can grow rapidly in infusion fluids, increasing the infection risk4.
Endotoxins have serious effects on the inflammatory and coagulation systems. They are released by Gram-negative bacteria and have been shown to penetrate conventional IV filters4. Only filters that retain endotoxins can safely be used for more than 24 hours5.
Entrained air can arise from infusion solutions degassing, incomplete priming or disconnections. Air can be particularly problematic on central lines, leading to air embolism, which can be fatal6.
Ball, P.A. (2003) Intravenous in-line filters: filtering the evidence. Curr Opin Clin Nutr Metab Care, 6:319-25.
Lehr, H.A. et al. (2002) Particulate matter contamination of intravenous antibiotics aggravates loss of functional capillary density in postischemic striated muscle. Am J Respir Crit Care Med, 165:514-20.
Trautmann, M. et al. (1997) Bacterial colonization and endotoxin contamination of intravenous infusion fluids. J Hosp Infect, 37:225-36.
Richards, C. & Thomas, P. (1990) Use of endotoxin retentive intravenous filters with pediatric total parenteral nutrition solutions. J Clin Pharm Ther, 15:53-8.
Richards, C. & Grassby, P.F. (1994) A comparison of the endotoxin-retentive abilities of two '96-h' in-line intravenous filters. J Clin Pharm Ther, 19:199-202.
Coppa, G.F. et al. (1981) Air embolism: a lethal but preventable complication of subclavian vein catheterization. JPEN J Parenter Enteral Nutr, 5:166-8.
Muth, C.M. & Shank, E.S. (2000) Gas embolism. N Engl J Med, 342 (7):476-482.
How to Prime the Pall Posidyne ELD Filter
Remove the protective cap from the Posidyne ELD filter inlet without removing protective cap from needle adapter. With a twisting motion, connect the administration set to the Posidyne ELD inlet.
Hold the Posidyne ELD filter and needle adapter upright and below solution container. Open the clamp of the IV administration set, priming the Posidyne ELD filter and extension tubing. Close administration set clamp.
Verify that all the air has been removed from the patient side of the Posidyne ELD filter and extension tubing. If air is observed in the tubing or in the Y-injection site, open the clamp slightly to re-establish flow and gently tap the Posidyne ELD filter and extension tubing.
After priming the Posidyne ELD models with the Y-injection sites, close the slide clamp. Perform venipuncture in the usual manner and attach the Posidyne ELD filter to the venipuncture device. Tape the Posidyne ELD filter to the patient at or near the infusion site.
Posidyne ELD Filter
With microbore extension tubing (USA only)
With microbore extension tubing and downstream slide clamp (Europe only)
With microbore extension tubing and Y injection site (USA only)
With microbore extension tubing, Y injection site, and downstream slide clamp (Europe only)
With microbore extension tubing and needleless Y injection site (USA only)
With standard bore extension tubing and Y injection site (USA only)
With standard bore extension tubing, Y injection site, and downstream slide clamp (Europe only)
With standard bore extension tubing and needleless Y injection site (USA only)