Why is Particulate Contamination a Risk in Paediatrics?

Infused particles are known as an additional risk for intensive care patients.⁵ They increase the risk of thrombosis, impaired microcirculation and modulated immune response.⁶

For children and neonates, the risk of particulate contamination is particularly high.

Several studies have reported the consequences for critically ill children. The infusion of particles in children:

• May cause pulmonary granulomata.⁷
• May cause alterations in microcirculation, inducing systemic inflammatory response with adverse effects on organs.⁶
• May lead to severe complications⁸ or death.^{9, 10} 
   

Neonates in the intensive care unit are particularly at risk because of their physiological condition and the fact that they are frequently administered multiple injectable drugs simultaneously. Even very low amounts of liquid may lead to incomplete drug dissolution and increase the risk of drug incompatibility.¹¹

In neonates, the infusion of particles may increase complications such as inflammation, sepsis, and enterocolitis.¹²

Compared to adults, injecting particulate matter into paediatric patients has a more drastic effect. One reason for this could be the difference in cardiovascular characteristics. Neonates have a smaller number and diameter of blood vessels in the pulmonary capillaries.^{13, 14}

How to Reduce the Risk of Particulate Contamination?

To reduce the risk of particulate contamination, pay attention to the following:

• Use quality products like vial stoppers that do not produce particles.
• Use plastic containers instead of glass ampoules as they have a low intrinsic particle load.
• Avoid drug incompatibility.
• Use intravenous inline filters.

Let’s take a closer look at that last point.

The British Pharmaceutical Nutrition Group (BPNG) recommends that appropriate filters should be used when administering parenteral nutrition to immunocompromised patients such as children and neonates to avoid contamination with insoluble particles.¹⁵

Inline filters have been suggested to limit the load of particles infused through central venous lines and to prevent bacterial and endotoxin infusion.¹⁶

Inline filtration can reduce the incidence of severe complications caused by particulate contamination in critically ill paediatric and neonatal patients, such as SIRS (systemic inflammatory response syndrome), sepsis, circulatory failure, ARDS (acute respiratory distress syndrome), thrombosis, acute renal and acute liver failure.⁶

The overall complication rate of these severe events was reduced by 10% (from 40.9% to 30.9%) when IV filters were used.¹⁷

The Functions of IV Inline Filtration at a Glance

• Retention of particles
• Elimination of endotoxins*
• Retention of air bubbles
• Filtration of bacteria

_{*Applies to Intrapur® filters in our portfolio}

Process standardisation can prevent severe complications in intensive care and increase patient safety. Include the use of appropriate filters in your regular paediatric and neonatal ICU workflow to minimise the risk of particulate contamination in your paediatric and neonatal patients.

In addition to reduced morbidity for paediatric patients, reducing particle contamination also shortens length of stay and duration of mechanical ventilation.¹⁷ As a result, young patients can be discharged earlier from the ICU and return home to their families sooner to simply grow up and be children.

Want to know more about the risk of particulate contamination? Read more about the general risk.