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Watch Particles in an Infusion Line Entering a Patient’s Bloodstream

Have You Noticed Particles in an Infusion Line Entering a Patient’s Bloodstream?

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Most likely, the answer is no, you haven’t seen particles infused into a patient in real-time. And that is part of the problem: Because if more health-care professionals could see what they inadvertently infuse into a patient, they would probably be more willing to do something about it.

Watch the video and see the motion of particles at the egress of a catheter.1

 

Detection of Particles at the Egress of the Catheter by the Qicpic Instrument

 

Perez, M., Décaudin, B., Abou Chahla, W. et al. Effectiveness of in-Line Filters to Completely Remove Particulate Contamination During a Pediatric Multidrug Infusion Protocol. Sci Rep 8,7714 (2018).

https://doi.org/10.1038/s41598-018-25602-6

 

Video can be obtained from Electronic supplementary material under

https://www.nature.com/articles/s41598-018-25602-6#additional-information

 

Link to Public License: https://creativecommons.org/licenses/by/4.0/legalcode

 

Link to the Creative Commons license: http://creativecommons.org/licenses/by/4.0/

 

The video was produced in the context of a study conducted by Maxime Perez, a hospital pharmacist at the University of Lille, France, and his colleagues at the university’s neonatology and intensive care departments. The authors measured particles in simulated multi-drug infusions over a 24-hour period, using various combinations of catheters, single- and multi-lumen infusion and extension sets, stopcocks and central venous lines, with or without Pall intravenous in-line filters (AEF1NTE). What is shown in the video is that particles  had precipitated at the distal end of IV infusion lines, and which were invisible to the naked eye. In addition, the authors demonstrated that adding extension sets or stopcocks significantly increases overall particulate matter, and that a Pall IV intravenous in-line filter (AEF1NTE) connected to the ventral venous catheter significantly decreased the overall particulate contamination compared to infusions without filters.

 

In light of the potentially serious damage particles can cause – blockages of blood vessels due to large particles2-4, systemic hypercoagulability due to the activation of the coagulation system5, impairment of the microcirculation6,7, immune-modulation effects and / or systemic inflammatory reactions5,8-11 – the authors stress two clear conclusions of this study:

 

  1. Intravenous in-line filters effectively prevent particle administration to patients.
  2. Intravenous in-line filters should be positioned as closed as possible to the patient.

 

Regarding the placement of IV intravenous filter the Infusion Nursing Society (INS) and the American Parenteral Nutrition Society (ASPEN) recommend:

 

  • “Locate the in-line filter on the administration set as close to the VAD hub as possible. Add-on components (eg, extension sets, stopcocks) below or after the filter will result in additional particulate matter infusing to the patient.”12
  • “Filters should be placed as close to the patient as possible on the administration system.”13
 

References

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Dr. Volker Luibl, MBA

Dr. Luibl is Pall Medical’s accomplished Demand Generation Marketing Manager with extensive expertise in medical device and clinical science.
Dr. Luibl is Pall Medical’s accomplished Demand Generation Marketing Manager with extensive expertise in medical device and clinical science.
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