title: Compatibility of medications during multi-infusion therapy: A controlled in vitro study on a multilumen infusion device.
abstract: OBJECTIVE
  Drug incompatibilities can jeopardize the safety and effectiveness of intravenous drug therapies, especially in the field of anaesthesia and intensive care. Patients receive many drugs simultaneously through limited venous accesses. This study was designed to confirm the impact of a multilumen infusion device on the occurrence of known physical drug incompatibilities.
  
  
  METHODS
  In vitro laboratory work.
  
  
  METHODS
  Two infusion devices were studied: a standard single-lumen set and a multilumen infusion access device (Edelvaiss Multiline-8, Doran International). Up to six drugs were infused simultaneously: three acidic solutions of midazolam, amiodarone and dobutamine, and three alkaline solutions of furosemide, pantoprazole and amoxicillin/clavulanate. Saline, Ringer' solution and 5% dextrose were used as hydration vehicles with an infusion rate initially set at 100 mL/h and with stepwise decreases of 10 mL/h until precipitation. Two methods were used to highlight physical drug compatibility according to the European Pharmacopoeia: visual inspection of the extension set and an obscured-light sub-visible particle count test of infusions. The lowest infusion rate value for vehicle infusion to satisfy the two tests in all trials is reported for each infusion device.
  
  
  RESULTS
  The standard set did not satisfy the test in 82% of the assessed drug combinations. The Edelvaiss Multiline-8 was able to prevent the occurrence of drug incompatibilities in 49% of the drug combinations tested. This device is therefore advantageous, especially when simultaneously infusing two or four incompatible drugs.
  
  
  CONCLUSIONS
  Infusion device characteristics have an impact on physical drug incompatibilities. Our results confirm that the Edelvaiss Multiline-8 device prevents physical drug incompatibilities under specified conditions.
authors: Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France; Department of Pharmacy, CHRU Lille, 59037 Lille, France.
authors: Maxime
authors: M
authors: Perez
authors: Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France; Department of Pharmacy, CHRU Lille, 59037 Lille, France. Electronic address: bertrand.decaudin@univ-lille2.fr.
authors: Bertrand
authors: B
authors: Décaudin
authors: Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France.
authors: Aurélie
authors: A
authors: Foinard
authors: Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France.
authors: Christine
authors: C
authors: Barthélémy
authors: Department of Anesthesia and Intensive Care, Poitiers University Hospital, Inserm U1070, 86021 Poitiers, France.
authors: Bertrand
authors: B
authors: Debaene
authors: Department of Anesthesia and Intensive Care Medicine, Lille University Hospital, EA 1046, IFR 114, 59037 Lille, France.
authors: Gilles
authors: G
authors: Lebuffe
authors: Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRITA, UFR Pharmacie, 59037 Lille, France; Department of Pharmacy, CHRU Lille, 59037 Lille, France.
authors: Pascal
authors: P
authors: Odou
mesh_terms: D004344:Drug Incompatibility; D004867:Equipment Design; D007263:Infusions, Parenteral / Q000295:instrumentation*
keywords: Drug delivery systems/instrumentation; Drug incompatibilities; Infusions; Material testing; Parenteral