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Dear NICU colleagues, I want to know whether the use of in line filters during administration of TPN fluids is standard practice in all NICUs?

I also want to know what brand of Filter do you all use ?

I would also like to find out how your experience has been with the filters that you use ? (pros and cons)

Furthermore i am keen to find out whther you 'piggyback' the intralipid to the Dex/AA solution ( that is connect the intralipid to the same line as Dex/AA solution) or give the intralipid seperately?

As for our centre, we do use in line filters during administration of all TPN fluids.

The only filter that is available to us from the hospital management is BAXA syringe filter 0.22 microns ( Order no. H938 21002 3 from BAXA). You can find out what I am speaking about here

http://www.baxa.com/PharmacyProducts/IVAdmixture/ProductDetail/?id=05D0F880-B7BE-3350-F859947305B0F420

Our experience has generally been good with occasional filter induced resistance in the system (IV administration system). On few occasions we had hypoglycemia in preterms because the TPN fluid was 'stuck' behind the filter and the IV pump kept on 'pumping' without detecting this block , ultimately resulting in the baby not getting any fluids for 2-3 hours. After these accidents we are more vigilant, at the slightest hint that the resistance in the IV circuit is increasing ( as indicated by the IV Pump), we physically detach all connections and check whether the filter is ok or not.

We generally prefer to separate our Dex/AA lines and intralipid in our unit. We are apprehensive about precipitation if intralipid and Dex/AA lines are mixed.

Am Eager to find out current practices in your NICU.

We use filters in all our TPN lines. The company is Hospira. It has a 0.2 micron filter. I'm not aware of any problems with them.

We run our TPN and lipids through a bifuse tubing. There is very little actual mixing, We use a microbore tubing that has only a 0.2 cc fill (where the mixing occurs, total fill of the system is 0.4cc). We've never had any problems running them this way. (I've been doing it this way for 30 years.)

Debby

  • Author
We use filters in all our TPN lines. The company is Hospira. It has a 0.2 micron filter. I'm not aware of any problems with them.

Debby

Can you give me some more info on this product. I visited the Hospira website but could not locate the product. Maybe a website link to the relevant product info page would be most helpful.

  • 2 weeks later...

Sorry. Apparently I was looking at a different piece of tubing. Here's the correct information.

ICU Medical, Inc

800-824-7890

I think this is the product number 12120

Non-DEHP Smallbore Bifuse EXT set with 2 Clave, 2 clamps, rotating luer

This is the labeling on the packaging.

The tpn filter is from Hospira. Packaging reads Macrobore extension set

List No. 20668-28

How many of the 99NICU members are using 'Photooxidation " protection of the TPN solns. in their units ( covering the TPN bag/bottle and tubings)?,

How many of the 99NICU members are using 'Photooxidation " protection of the TPN solns. in their units ( covering the TPN bag/bottle and tubings)?,

We don't.

This question was discussed some time ago, in this thread:

http://www.99nicu.org/forum/showthread.php?t=110

thanks

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