Stability and preservative effectiveness of treprostinil sodium after dilution in common intravenous diluents

“…Of interest, treprostinil with Flolan sterile diluent or normal saline are both bactericidal against Staphylococcus aureus . 19,20 The effect of increasing the pH of the treprostinil infusion on the incidence of CR-BSI will be tracked in the future.…”

Section: Discussionmentioning

confidence: 99%

Closed-Hub Systems with Protected Connections and the Reduction of Risk of Catheter-Related Bloodstream Infection in Pediatric Patients Receiving Intravenous Prostanoid Therapy for Pulmonary Hypertension

Ivy

Calderbank

Wagner

et al. 2009

Infect. Control Hosp. Epidemiol.

Self Cite

View full text Add to dashboard Cite

BACKGROUND Intravenous prostanoids (epoprostenol and treprostinil) are effective therapies for pulmonary arterial hypertension but carry a risk of catheter-related bloodstream infection (CR-BSI). Prevention of CR-BSI during long-term use of indwelling central venous catheters is important. OBJECTIVE To evaluate whether using a closed-hub system and waterproofing catheter hub connections reduces the rate of CR-BSI per 1,000 catheter-days. DESIGN Single-center open observational study (January 2003–December 2008). PATIENTS Pediatric patients with pulmonary arterial hypertension who received intravenous prostanoids. METHODS In July 2007, CR-BSI preventive measures were implemented, including the use of a closed-hub system and the waterproofing of catheter hub connections during showering. Rates of CR-BSI before and after implementing preventive measures were compared with respect to medication administered and type of bacterial infection. RESULTS Fifty patients received intravenous prostanoid therapy for a total of 41,840 catheter-days. The rate of CR-BSI during the study period was 0.51 infections per 1,000 catheter-days for epoprostenol and 1.38 infections per 1,000 catheter-days for treprostinil, which differed significantly (P < .01). CR-BSIs caused by gram-negative pathogens occurred more frequently with treprostinil than with epoprostenol (0.91 infections per 1,000 catheter-days vs 0.08 infections per 1,000 catheter-days; P < .01). Patients treated with treprostinil after the implemented changes had a significant decrease in CR-BSI rate (1.95 infections per 1,000 catheter-days vs 0.19 infections per 1,000 catheter-days; P < .01). CONCLUSION The closed-hub system and the maintenance of dry catheter hub connections significantly reduced the incidence of CR-BSI (particularly infections caused by gram-negative pathogens) in patients receiving intravenous treprostinil.

show abstract

“…Unresolved issue 5. Prostanoid reconstitution: Category II (14,(17)(18)(19)(20) a. Unopened vials may be stored at ambient room temperature according to the manufacturer's storage guidance. Do not use vials beyond expiration date on vial.…”

Section: Pulmonary Hypertensionmentioning

confidence: 99%

“… General principles (14) Hand hygiene (14) Catheter hub (10–12,14,15) Catheter site care (14,16) Prostanoid reconstitution: Category II (14,17–20) Prostanoid administration (14,17,19) Normal saline and heparin flush solutions: Category II (14) Antibiotic lock solution (14) Do not routinely use antibiotic lock solutions. Use prophylactic antibiotic lock solution only in special circumstances (e.g.…”

mentioning

confidence: 99%

Guidelines for the prevention of central venous catheter-related blood stream infections with prostanoid therapy for pulmonary arterial hypertension

Doran

Ivy

Barst

et al. 2008

International Journal of Clinical Practice

107

View full text Add to dashboard Cite

SUMMARY Intravenous prostanoids are the backbone of therapy for advanced pulmonary arterial hypertension (PAH) and have improved long-term outcome and quality of life. Currently, two prostanoids are approved by the US Food and Drug administration for parenteral administration: epoprostenol (Flolan) and treprostinil (Remodulin). Chronic intravenous therapy presents considerable challenges for patients and caregivers who must learn sterile preparation of the medication, operation of the pump, and care of the central venous catheter. Patients are routinely counseled and advised regarding the risks of CR-BSIs and catheter care before central line insertion. Central line infections as well as bacteremia are well documented risks of chronic intravenous therapy and may significantly contribute to morbidity and mortality. Recent reports have suggested a possible increase in CR-BSI; therefore, the Scientific Leadership Council of the Pulmonary Hypertension Association decided to provide guidelines for good clinical practice regarding catheter care. Although data exits regarding patients with central venous catheters and the risk of blood stream infections in patients with cancer or other disorders, there is little data regarding the special needs of patients with pulmonary arterial hypertension requiring central venous access. These guidelines are extrapolated from the diverse body of literature regarding central venous catheter care.

show abstract

Stability and preservative effectiveness of treprostinil sodium after dilution in common intravenous diluents

Cited by 26 publications

References 0 publications

Stability and antimicrobial effectiveness of treprostinil sodium in Sterile Diluent for Flolan

Stability and antimicrobial effectiveness of treprostinil sodium in Sterile Diluent for Flolan

Closed-Hub Systems with Protected Connections and the Reduction of Risk of Catheter-Related Bloodstream Infection in Pediatric Patients Receiving Intravenous Prostanoid Therapy for Pulmonary Hypertension

Guidelines for the prevention of central venous catheter-related blood stream infections with prostanoid therapy for pulmonary arterial hypertension

Contact Info

Product

Resources

About