Reduce Lipid Related Embolisms in Preemies

MPS Medical’s neonatal medical device products were designed specifically for infants in neonatal intensive care. These products offer low priming volumes for small patients while incorporating safety measures to reduce the potential for infection.

A recent issue has arisen regarding filtering of intralipids. The following is a quote from the Institute of Safe Medication Practices (ISMP).

A change in the package insert for nutritional fat emulsions indicates that a 1.2 micron filter should be used during administration, which could stop fat emboli, air emboli, microorganisms, and particulate matter from reaching the circulation. Keep in mind, some drug information resources or products with older labels may still state that filters are not needed, or that a filter of less than 1.2 micron pore size must be used. ISMP Quarterly Action Agenda, Jan/Feb 2016

When lipids are infused separately from dextrose/amino acids, a 0.2 micron filter is used for the dextrose/amino acid solution and the lipid emulsion must be infused below the 0.2 micron filter (eg during “piggyback”).  Separate lipid emulsions may not require filtration; consult manufacturers’ direction for use.  If required, a 1.2 micron filter is used on the separate lipid emulsion. (J Infusion Nursing;39(1S):S1-)

One of the major manufacturers of 20% intralipids is Fresenius Kabi in Uppsala, Sweden. This company manufactures intralipids distributed in the United States by Baxter Healthcare Corporation. This package insert, revised in May 2015 states the following:

Use a 1.2 micron filter with INTRALIPID 20%.  Filters of less than 1.2 micron pore size must not be used.

One should avoid having the intralipids infuse through a 0.2 micron filter as the fat will occlude the filter. Conversely, parenteral nutrition (dextrose and amino acids) should be filtered with a smaller micron filter, a 0.2 micron filter to clear any possible precipitation that would not otherwise be filtered out with a larger micron filter.

MPS Medical’s 1.2-micron and 0.22-micron filter series of Admin products allow the NICU flexibility and ease of use when infusing lipids or filtering three-in-one solutions. These all-in-one filter sets are preassembled and patient ready.

MPS has specifically designed these filter IV sets according to the new practice recommendations and safety consensus recommendations. The product design ensures that the practitioner does not deviate from the standardized guidelines recommended by the latest infusion standards, further enhancing patient safety in the NICU.

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