An infusion set is a commonly used medical device, which is an infusion tool for injecting a large dose of injection into the body by intravenous drip. With the rapid development of medical technology, the current infusion tools have developed from a single ordinary infusion set to a variety of products such as precision filter infusion, non-PVC infusion, micro-dose adjustable infusion, and high efficiency light-avoiding infusion sets. The emergence of different functional infusion sets, however, in the process of clinical use, how to choose the appropriate infusion set to ensure the safety of medication has become a problem. Here is a brief discussion on how to choose a safety infusion set with different functions according to the nature of the drug.
The difference between the precision filter infusion set and the ordinary infusion set is that the material and pore size of the filter membrane of the infusion set are different.
The ordinary infusion set is the earliest disposable infusion set used in my country. It is cheap and widely used. It uses a fiber filter membrane with a pore size of 15 microns. The fibrous membrane will fall off after encountering strong acid and strong alkaline drugs, and the pore size will become larger, causing most of the particles to enter the patient's body, resulting in blood vessel blockage, phlebitis, allergic reactions and adverse infusion reactions. Therefore, when using strong acid or strong alkaline drugs, try not to choose ordinary infusion sets, such as ciprofloxacin, nimotop and other drugs.
At present, a disposable precision filtration infusion set has been developed, which uses nuclear track membrane or polyethersulfone membrane, and the pore size has different specifications such as 5 microns and 3 microns. It has the advantages of high filtration accuracy and no foreign body falling off. It can also effectively filter particles, reduce local irritation, prevent the occurrence of painful phlebitis, and provide a certain guarantee for the safety of infusion.
The main raw material of most disposable infusion sets is polyvinyl chloride (PVC). In order to ensure the flexibility and resilience of the infusion set, it is necessary to add 30% to 40% plasticizer (such as DEHP) to the PVC resin. At the same time, in order to improve the thermal stability of the PVC resin during processing, it is necessary to add a certain amount of thermal stabilizer to the PVC resin. Since plasticizers and heat stabilizers will migrate out into the drug solution under certain conditions, it will inevitably bring potential harm to the health of patients. In addition, the PVC infusion tube can adsorb some drugs, resulting in a decrease in the content of the drug in the infusion or a change in the quality of the drug, thereby affecting the therapeutic effect. Moreover, plasticizers are easily precipitated when lipophilic drugs are infused in ordinary infusion sets, such as paclitaxel, amiodarone, etc. In the infusion of alcohol-soluble drugs, fat-soluble drugs, tumor drugs, its adsorption is relatively large, such as nitroglycerin, insulin, carmustine and so on.
Now ultra-low density polyethylene infusion sets (TPE infusion sets) have been developed. And the material is non-PVC. It does not contain plasticizers, heat stabilizers, and has no adsorption effect on drugs. It is also suitable for lipophilic drugs, circulatory system drugs, Use of antineoplastic drugs.
The light-proof infusion set is made of medical light-proof material. Due to the particularity of the chemical structure of some drugs in clinical practice, complex reactions such as ring splitting, rearrangement, hydrolysis, polymerization, oxidation and isomerization may occur under the influence of light during the instillation process, resulting in drug discoloration, precipitation and the decrease of drug valency. And it even produces toxic substances, which are harmful to human health. Therefore, these drugs should be protected from light during the infusion process, and a light-proof infusion set should be used. For example, if nitroprusside sodium is not protected from light during the infusion, it will decompose 13.5% within 10 minutes, and the drug will change color. Other drugs that require the use of light-shielding safety infusion sets include fleroxacin, pefloxacin mesylate, cisplatin, oxaliplatin, etc.
The function of the micro-dose infusion set is to adjust the infusion rate, which can meet various clinical needs. In clinical practice, some drugs such as fluorouracil, vindesine sulfate, homoharringtonine, paclitaxel liposome, etc. can use constant-speed infusion set to reduce the flow rate error caused by changes in liquid level and patient position. This not only achieves the purpose of strictly and correctly implementing the doctor's orders and enables the patient to receive effective treatment, but also reduces the workload of the nurses constantly adjusting the flow rate of the liquid medicine.
To sum up, in clinical practice, infusion sets with different functions must be correctly selected according to the properties of drugs, so as to prevent the damage of insoluble particles to the blood vessels of patients and reduce the occurrence of drug-induced allergic reactions. It can also reduce the adsorption of drugs, avoid the potential harm to the health of patients caused by plasticizers and heat stabilizers, and ensure the safety and effectiveness of clinical medication.