- Air: preventing air embolism
- Particles: protecting the circulatory system against the undesirable effects of infusing particulate contamination, including flocculates and precipitates. Protecting the vein during peripheral infusion
- Enlarged lipid droplets: Significantly reducing the number of droplets (<5 μm) in emulsions
- Microbes: reducing the risk of infection due to inadvertantly contaminated infusates, particularly with fungi of clinical importance
Inadvertent Contamination of Parenteral Nutrition Preparations Can Have Serious Consequences
- Air can become entrained in infusions due to degassing, disconnection or run-dry. It may not be visible in lipid-containing preparations. It can be particularly problematic on central venous line infusions, leading to air embolism 1.
- Particulate contamination arises from infusion systems, components, manipulations 2and as precipitates due to interactions between nutrient components 3. Particles are deposited in the microvasculature of the lungs and other organs and may have serious clinical consequences 4. Gross precipitation in admixtures has proved fatal and may not be visible when lipid is present 3.
- Enlarged lipid droplets arise in admixtures due to instability. It has been suggested that the proportion of lipid present as droplets >5 μm should be minimized, since large numbers may lodge in the lung microvasculature and produce an embolic syndrome 5.
- Microbial contamination can arise in infusion systems inadvertently due to manipulations. Parenteral nutrition is an acknowledged risk for fungaemia, with Candida species being the most common organisms involved 6. Malassezia furfur is also emerging as an increasingly important pathogen in neonates 7. These fungi are able to survive and grow in lipid-containing preparations 7,8.
- Coppa. GF et al JPEN 1980;5:166-8.
- Foroni LA. et al J Parent Sci Technol 1993;47:311-4
- US FDA Safety Alert. Am J Hosp Pharm 1994;51:1427-8.
- Walpot H et al. Anaesthetist 1989;38:544-8.
- Driscoll DF et al. JPEN 1996;20:296-301
- Vazquez J et al. J Infect Dis 1993;168:195-201.
- Robinson R and Ball P. NZ Hosp Pharm Assoc. Oct 1996
- Scheckelhoff DJ et al. Am J Hosp Pharm 1986;43:73-7
|Filter Media||1.2 μm Polyethersulfone membrane|
|Tubing Extension||Non-phthalate microbore|
| Hold up Volume |
(filter housing + extension tubing)
|Maximum Recommended Flow Rate||10 mL/hour|
|Maximum Working Pressure||30 psi|
|Connectors||ISO male luer lock outlet & ISO female luer lock inlet|
|Usage|| Single patient use |
24 hours usage
|Pall Lipipor NEO Filter for Parenteral Nutrition||NLF1E||40 units per case|