The control catheter was a 5.5 F × 5 cm, triple-lumen catheter with a standard port distance of 1.6cm between the proximal and medial ports and 1.6 cm between the medial and distal ports respectively, for a total distance of 3.2 cm between the distal port and the proximal port (Arrow International). The experimental triple-lumen catheter, with decreased port to port distances, was inserted into the right femoral vein, and the control catheter was inserted into the left femoral vein under direct visualization. The femoral veins in both hind limbs were isolated by the cut-down technique. A peripheral vein was isolated and cannulated for fluid and anesthetic administration as necessary during the experiment. A lead II electrocardiogram was monitored continuously along with temperature, respiration, and blood pressure. The trachea was intubated with a #5 or #6 uncuffed endotracheal tube and controlled ventilation was instituted to maintain normal blood gases. Ten domestic swine weighing 10–20 kg were anesthetized with ketamine 10 mg/kg intramuscularly, atropine 0.01 mg/kg intravenously, and isoflurane for continuous anesthesia. This study looked at a modified 5.5 F × 5 cm, triple-lumen catheter with a port distance of 0.4 cm between the medial and proximal ports and 1.3 cm between the distal and medial ports (Arrow International), with a total distance of 1.7 cm between the distal port and the proximal port, to assess if decreased port spacing between lumens causes precipitation when incompatible intravenous solutions are administered simultaneously. A previous study has shown that in vivo simultaneous intravenous infusion of physically incompatible substances through a commercially available multiple lumen intravenous catheter, double-lumen peripheral venous catheter (IV–01100, Arrow International, Reading, Pennsylvania, USA) did not cause precipitation in the vascular system or other adverse clinical effects. The complexity of delivering these substances becomes more difficult when the size and length of the catheter is limited, as in the pediatric population. The use of a triple-lumen catheter with a distance of 0.4cmbetween the proximal port and the medial port and 1.3 cm between the medial portand the distal port, for the in vivo simultaneous administration ofincompatible solutions does not result in precipitates large enough to causeadverse clinical effects.Ī multilumen central venous catheter is the preferred vascular access route for critically ill patients requiring multiple drug infusions, parenteral hyperalimentation, and other potentially incompatible drugs. No particles were identified by phase microscope,light microscope, or Wright stain smear. Histograms of particle size did not show any alteration of thehistogram that would suggest particle size > 2 μm in diameter in thestudy or control samples. Samples were also examined under the microscope forparticles. Histograms were generated for particle sizeand concentration. Samples were taken from two sites during the bolus and at 1, 5, and15 min during phenytoin infusion. Total parenteral nutrition was administered through the distalport and phenytoin was administered as a bolus and as an infusion in eachgroup. Ten domestic swine, 10–20 kg in weight, were divided into twogroups of five. We studied thesimultaneous administration of incompatible drugs using a new triple-lumencatheter with decreased length and port to port distances. Multilumen catheters are commonly used in critically ill children.Their use, however, is associated with significant morbidity.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |