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Inflammatory Potential of Foreign Particulates in Parenteral Drugs

GORDON G. DORRIS, MS^*, BRACK A. BIVINS, MD, ROBERT P. RAPP, Pharm D, DANIEL L. WEISS, MD, PATRICK P. DeLUCA, PhD^||, and MARK B. RAVIN, MD^**

*Research Preceptee, Anesthesiology, University of Kentucky, Lexington, Kentucky 40506. Clinical Instructor in Anesthesia and Surgery, University of Kentucky, Lexington, Kentucky 40506. Associate Professor, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40506. Professor, Department of Pathology, University of Kentucky, Lexington, Kentucky 40506. ||Professor, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40506. **Professor and Chairman, Department of Anesthesiology, University of Kentucky, Lexington, Kentucky 40506.

Abstract

Particulate and bacterial contamination of IV fluids and drugs have been implicated in venous thrombosis, infusion phlebitis, suppurative thrombophlebitis, pyrogenic reactions, and systemic sepsis. In a study of the inflammatory potential of the filterable residue of sodium cephalothin, we have found a tissue-specific reaction with venous endothelium but not with cutaneous or subcutaneous tissues. In a controlled animal model, removal of particulates from an infusion by use of a 0.45 µ in-line membrane filter reduces the incidence and severity of infusion phlebitis.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999