Intravenous drug delivery in infants with limited i.v. access and fluid restriction

Physical compatibility of total parenteral nutrition and drugs in Y-site administration to children from neonates to adolescents

“…Co‐administration of several drugs in Y‐site is often necessary when treating critically ill hospitalized patients. Few access sites for administration of the many drugs needed in addition to nutrients are a constant challenge . There is a lack of compatibility data for drugs administered to paediatric patients .…”

“…Drug concentrations may also differ from those used in adults as, for example, more diluted drugs are often needed to provide a manageable volume to administer . On the other hand, fluid restriction might require administration of more concentrated drug solutions . Different dosages, drug concentrations, total parenteral nutrition (TPN) composition and infusion times might lead to different mixing ratios in the line compared with those used in adults.…”

Evaluation of tools to prevent drug incompatibilities in paediatric and neonatal intensive care units

“…The location of the injection site is further away from the delivery system than that in adults, allowing parents to carry their baby in their arms. This prolongs the time required for drug delivery [10]. Under some conditions (e.g., in very small infants), the infusion rates are so slow that the time required for the onset of drug infusion may be as long as several hours [11].…”

“…Completeness score = Number of drug pairs 9 6.25 8 Comprehensiveness score = [Number of items/ 2.08] 9 [40/number of drug pairs] 9 Applicability score (adapted from Barrons [26] 10 Global score = Accuracy score ? Completeness score ?…”

Intravenous drug delivery in neonates: lessons learnt

“…What we do know from the literature2 7 15 21 22 28 30–33 and from our own experimental work5 6 is that it is not possible to make assumptions regarding the drug delivery rate in neonates when the primary intravenous lines have very low flow rates.…”