The Use of Non-Primed Peripheral and Central IV Tubing for Nesiritide Infusion is Reliable and Cost-Effective

The Medicine Forum

Jorde MD, Ulrich P.⁴  Newman PhD, Karel²  Colombo MD, Paolo C.³  Onat PhD, Duygu³  Rose MD, Andrew B.³  Stathopoulos MD, John¹ 

[1] Albert Einstein College of MedicineAlbert Einstein College of MedicineAlbert Einstein College of Medicine;Biosite IncorporatedBiosite IncorporatedBiosite Incorporated;Columbia University College of P&SColumbia University College of P&SColumbia University College of P&S;New York University School of MedicineNew York University School of MedicineNew York University School of Medicine

关键词: Non-Primed Peripheral;    Central IV Tubing;    Nesiritide Infusion;    Reliable;    Cost-Effective;    Thomas jefferson university;    department of medicine;    the medicine forum;    philadelphia;   

DOI  :  

学科分类：医学（综合）

来源: Thomas Jefferson University

【 摘 要 】

BackgroundPrescribing information of nesiritide mandates primingof intravenous tubing with 25 mL of nesiritide prior toconnecting the intravenous (IV) line to the patient, sincethe drug may partially absorb to the line. Thus, 10% ofa reconstituted vial is wasted, with a cost of $40-50 perline used. No study has quantified the binding effect ofnesiritide to intravenous tubing, tested bindingproperties of different materials, or analyzed bindingeffect of central lines, where priming cannot occur.Furthermore, prescribing information states thatnesiritide must not be administered through a centralheparin-coated catheter, since it may bind to heparin.However, no study quantified this binding effect.Methods1.5 mg vials of nesiritide were reconstituted into 250 mL0.9% NS bags. A 23.3mL bolus, followed by 7mL/h 2-hour infusion (2ug/kg bolus, 0.01ug/kg/min infusion fora 70kg pt) were run, in duplicate, through 5 separateexperimental tubing systems: 1) Standard PVCperipheral IV tubing primed with a 25 mL of nesiritide;2) Standard non-primed PVC peripheral IV tubing; 3)Non-primed polyethylene peripheral IV tubing,commonly used for NTG infusion; 4) Non-primed PVCperipheral IV tubing, connected distally to a central IVpolyurethane catheter; 5) Non-primed PVC peripheralIV tubing, connected distally to a heparin-coatedpulmonary artery PVC catheter. Nesiritide concentration was measured,in triplicate, in the initial bags andsamples collected from the five IV settings, using BiositeBNP test (Beckman Coulter).Presented at 2004 Heart Failure Society of America?C Eighth Annual Scientific Meeting

【 授权许可】

Unknown