The rate of IV drug delivery is affected by many factors including characteristics of the drug, IV flow rate, and site of injection into the system. Because of the frequent use of CS in pediatric patients, we examined the rate of CS delivery from a standard pediatric IV infusion set (BuretrolR-Travenol). Using 3 flow rates, and 3 injection sites (buretrol, y site, flashball), timed samples of the IV fluid delivered from the set were collected for 6 hr and analyzed for CS by an HPLC method. We found large differences in the delivery time (min) for 95% of the injected CS:
To assess the clinical significance of these differences, CS and C steady state serum concentrations (6 samples over 6 hr; measured by HPLC) were studied in fifteen patients (age 0.2-15 yr) receiving CS, 25 mg/kg, injected into the buretrol and flashball on consecutive days. Flashball injections resulted in higher peak CS cone (p<0.001) and peak C cone (p<0.005) in a shorter time from the start of infusion (p<0.005). At flow rates >7 m1/hr, trough cone and area under the curve were similar with the two sites. These data show the importance of defining IV flow rates and drug injection sites when monitoring single serum CS or C cone or when calculating kinetic parameters.
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Nahata, M., Powell, D., Glazer, J. et al. 349 EFFECT OF INTRAVENOUS (IV) INFUSION METHODS ON AVAILA-BILITY OF CHLORAMPHENICOL (C) AND ITS SUCCINATE ESTER (CS). Pediatr Res 15, 498 (1981). https://doi.org/10.1203/00006450-198104001-00360