Abstract
After prolonged parenteral nutrition a 12 month old infant died with pulmonary hypertension and granulomatous pulmonary arteritis. A review of necropsy findings in 41 infants who had been fed parenterally showed that two of these also had pulmonary artery granulomata, while none of 32 control patients who died from sudden infant death syndrome had similar findings. Particulate contaminants have been implicated in the pathogenesis of such lesions and these were quantified in amino acid/dextrose solutions and fat emulsions using automated particle counting and optical microscope counting respectively. Parenteral feed infusions compounded for a 3000 g infant according to standard nutritional regimens were found to include approximately 37,000 particles between 2 and 100 microns in size in one day's feed, of which 80% were derived from the fat emulsion. In-line end filtration of intravenous infusions may reduce the risk of particle associated complications. A suitable particle filter is required for use with lipid.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bainborough A. R., Jericho K. W. Cor pulmonale secondary to talc granulomata in the lungs of a drug addict. Can Med Assoc J. 1970 Dec 5;103(12):1297–1298. [PMC free article] [PubMed] [Google Scholar]
- Bavikatte K., Hilliard J., Schreiner R. L., Mirkin D., Williams B., Lemons J. A., Gresham E. L. Systemic vascular cotton fiber emboli in the neonate. J Pediatr. 1979 Oct;95(4):614–616. doi: 10.1016/s0022-3476(79)80782-9. [DOI] [PubMed] [Google Scholar]
- Falchuk K. H., Peterson L., McNeil B. J. Microparticulate-induced phlebitis. Its prevention by in-line filtration. N Engl J Med. 1985 Jan 10;312(2):78–82. doi: 10.1056/NEJM198501103120203. [DOI] [PubMed] [Google Scholar]
- Garvan J. M., Gunner B. W. Particulate contamination of intravenous fluids. Br J Clin Pract. 1971 Mar;25(3):119–121. [PubMed] [Google Scholar]
- Holmes C. J., Kundsin R. B., Ausman R. K., Walter C. W. Potential hazards associated with microbial contamination of in-line filters during intravenous therapy. J Clin Microbiol. 1980 Dec;12(6):725–731. doi: 10.1128/jcm.12.6.725-731.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hopkins G. B. Pulmonary angiothrombotic granulomatosis in drug offenders. JAMA. 1972 Aug 21;221(8):909–911. [PubMed] [Google Scholar]
- Hunt J., Farthing M. J., Baker L. R., Crocker P. R., Levison D. A. Silicone in the liver: possible late effects. Gut. 1989 Feb;30(2):239–242. doi: 10.1136/gut.30.2.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kanke M., Simmons G. H., Weiss D. L., Bivins B. A., DeLuca P. P. Clearance of 141C3-labeled microspheres from blood and distribution in specific organs following intravenous and intraarterial administration in beagle dogs. J Pharm Sci. 1980 Jul;69(7):755–762. doi: 10.1002/jps.2600690703. [DOI] [PubMed] [Google Scholar]
- Mehrkens H. H., Klaus E., Schmitz J. E. Moglichkeiten materieller Verunreinigungen durch Zusatzinjektionen. Klin Anasthesiol Intensivther. 1977;(14):106–113. [PubMed] [Google Scholar]
- SARRUT S., NEZELOF C. [A complication of intravenous therapy: giant cellular macrophagic pulmonary arteritis]. Presse Med. 1960 Feb 24;68:375–377. [PubMed] [Google Scholar]
- Shaw N. J., Lyall E. G. Hazards of glass ampoules. Br Med J (Clin Res Ed) 1985 Nov 16;291(6506):1390–1390. doi: 10.1136/bmj.291.6506.1390. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Waller D. G., George C. F. Ampoules, infusions, and filters. Br Med J (Clin Res Ed) 1986 Mar 15;292(6522):714–715. doi: 10.1136/bmj.292.6522.714. [DOI] [PMC free article] [PubMed] [Google Scholar]