Concomitant administration of intravenous drugs in the ICU: evaluation of physico-chemical compatibilities

Details

Serval ID
serval:BIB_A4DE331851C5
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Concomitant administration of intravenous drugs in the ICU: evaluation of physico-chemical compatibilities
Title of the conference
ESCP-GSASA 38th symposium on clinical pharmacy 30 years of clinical pharmacy; a bright future ahead.
Author(s)
Humbert-Delaloye V., Voirol P., Gattlen L., Berger L., Pannatier A.
Address
Geneva, Switzerland, November 3-6, 2009
ISBN
0928-1231
Publication state
Published
Issued date
2010
Peer-reviewed
Oui
Volume
32
Series
Pharmacy World and Science
Pages
224-225
Language
english
Notes
Meeting Abstract
Abstract
Background and objective:
Patients in the ICU often get many intravenous (iv) drugs at the same time. Even with three-lumen central venous catheters, the administration of more than one drug in the same iv line (IVL) is frequently necessary. The objective of this study was to observe how nurses managed to administer these many medications and to evaluate the proportion of two-drugs associations (TDA) that are compatible or not, based on known compatibility data.
Design:
Observational prospective study over 4 consecutive months. All patients receiving simultaneously more than one drugs in the same IVL (Y-site injection or mixed in the same container) were included. For each patient, all iv drugs were recorded, as well as concentration, infusion solution, location on the IVL system, time, rate and duration of administration. For each association of two or more drugs, compatibility of each drug was checked with each other. Compatibilities between these pairs of drugs were assessed using published data (mainly Trissel LA. Handbook on Injectable Drugs and Trissel's Tables of Physical Compatibility) and visual tests performed in our quality control laboratory.
Setting:
34 beds university hospital adult ICU.
Main outcome measures:
Percentage of compatibilities and incompatibilities between drugs administered in the same IVL.
Results:
We observed 1,913 associations of drugs administered together in the same IVL, 783 implying only two drugs. The average number of drugs per IVL was 3.1 ± 0.8 (range: 2-9). 83.2% of the drugs were given by continuous infusion, 14.3% by intermittent infusion and 2.5% in bolus. The associations observed allowed to form 8,421 pairs of drugs (71.7% drug-drug and 28.3% drug-solute). According to literature data, 80.2% of the association were considered as compatible and 4.4% incompatible. 15.4% were not interpretable because of different conditions between local practices and those described in the literature (drug concentration, solute, etc.) or because of a lack of data. After laboratory tests performed on the most used drugs (furosemide, KH2PO4, morphine HCl, etc.), the proportion of compatible TDA raised to 85.7%, the incompatible stayed at 4.6% and only 9.7% remain unknown or not interpretable.
Conclusions:
Nurses managed the administration of iv medications quite well, as only less than 5% of observed TDA were considered as incompatible. But the 10% of TDA with unavailable compatibility data should have been avoided too, since the consequences of their concomitant administration cannot be predictable. For practical reasons, drugs were analysed only by pairs, which constitutes the main limit of this work. The average number of drugs in the same association being three, laboratory tests are currently performed to evaluate some of the most observed three-drugs associations.
Keywords
Compatibility, Intravenous, Intensive Care Unit
Web of science
Create date
23/06/2010 9:47
Last modification date
20/10/2020 14:41
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