RESIDUAL VOLUMES AND FINAL WEIGHTS IN DIFFERENT TYPES OF PLASTIC INFUSION CONTAINERS
Objective: To compare the residual volumes, the drained volumes, and the final weights of different infusion containers with different volumes and degrees of flexibility. The risk of drug error can be aggravated by a high residual volume remaining in a drained intravenous container. A high residual volume can also increase the final weight of the container after drainage.
Methods: A total of 80 infusion containers containing normal saline of four different brands (ViafloÂ® and FreeflexÂ® flexible bags and KabiPacÂ® and EcoflacÂ® Plus semi-rigid containers) in two different volumes (250 and 500 ml) were tested. Every container type was tested ten times under close-vent conditions. Residual and total drained volumes and weights of drained containers before and after drying were assessed.
Results: The residual volume that remained in the intravenous containers tested was lower than 2% of the declared volume, with only one exception (KabiPacÂ® 250 ml), in which the residual volume was higher than 10% of the declared volume. Using gravity drainage, among the 250 ml containers, only one (ViafloÂ®) reached the full declared total drained volume of 250Â ml. By contrast, among the 500 ml containers, only one failed to reach the declared drained volume. There were significant differences in favor of flexible bags in the final weights of containers after drainage, and in one case (250 ml KabiPacÂ® semi-rigid container) the residual volume accounted for more than a half of the final container weight.
Conclusion: All four types of containers can be used with the same resulting quality of parenteral treatment. Selection of a specific type of container will be affected primarily by the price (both acquisition and waste disposal costs) and requirements of personnel for handling the container.
Keywords: Infusion therapy, Flexible, and semi-rigid containers, Residual volume
Ong VM, Subasyiny S. Medication errors in intravenous drug preparation and administration. Med J Malays 2013;68:52-7.
National Home Infusion Association. http://www.nhia.org/about-home-infusion.cfm. [Last accessed on 20 Aug 2015].
Harper D. Infusion therapy: much more than a simple task. Nursing 2014;44:66-7.
McDowell SE, Mt-Isa S, Ashby D, Ferner RE. Where errors occur in the preparation and administration of intravenous medicines: a systematic review and bayesian analysis. Quality Safety Health Care 2010;19:341-5.
Westbrook JI, Rob MI, Woods A, Parry D. Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience. BMJ Quality Safety 2011;20:1027-34.
Lannoy D, DÃ©caudin B, Von Martius K, Odou P. Comparison of container system residual volumes and the implications for medication error. Eur J Hosp Pharm 2012;23:1-4.
Maki DG, Rosenthal VD, Salomao R, Franzetti F, Rangel-Fausto MS. Impact of switching from an open to a closed infusion system on rates of central lineâ€“associated bloodstream infection: a meta-analysis of time-sequence cohort studies in 4 countries. Infection Control Hospital Epidemiology 2011;32:50-8.
Maki DG, Goldman DA, Rhame FS. Infection control in infusion therapy. Ann Intern Med 1973;79:867-87.
Gabay M, Von Martius K. Comparative evaluation of collapsible versus semi-rigid intravenous containers. Technol Health Care 2008;16:429-35.
Kollef MH. Inadequate antimicrobial treatment: an important determinant of outcome for hospitalized patients. Clin Infect Dis 2000;31 Suppl 4: S131-8.
Stoneham MD. An evaluation of methods of increasing the flow rate of i.v. fluid administration. Br J Anaesth 1995;75:361-5.
Simon N, DÃ©caudin B, Lannoy D, BarthÃ©lÃ©my C, Lemdani M, Odou P. Mathematical and physical model of gravity-fed infusion outflow: application to soft-bag-packed solutions. Eur J Drug Metab Pharmacokinet 2011;36:197-203.
Plagge H, Golmick J, Bornard D, Duster S. Evaluation of the dead volume in short-term intravenous infusion. Eur J Hosp Pharm 2010;16:31-7.