| Title: |
Design and evaluation of several strategies allowing to prevent drug incompatibilities during simultaneous multidrug infusion ; Conception et évaluation de plusieurs stratégies permettant d'administrer simultanément des médicaments injectables incompatibles entre eux |
| Authors: |
Négrier, Laura |
| Contributors: |
Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 (GRITA); Université de Lille-Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Université de Lille; Bertrand Décaudin; Gilles Lebuffe |
| Source: |
https://theses.hal.science/tel-04072182 ; Médecine humaine et pathologie. Université de Lille, 2023. Français. ⟨NNT : 2023ULILS003⟩. |
| Publisher Information: |
CCSD |
| Publication Year: |
2023 |
| Collection: |
LillOA (HAL Lille Open Archive, Université de Lille) |
| Subject Terms: |
Antibiotics; Hplc-Uv; Particulate matter; Intensive care units; Infusion medical devices; Drug incompatibility; Antibiotiques; Clhp-Uv; Charge particulaire; Soins intensifs; Dispositifs médicaux de perfusion; Incompatibilité médicamenteuse; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Description: |
The purpose of the PhD focused on the assessment of intravenous infusion modalities involving a risk of physicochemical incompatibility in critical care units. It was based on the analysis of an infusion protocol for adult patients combining vancomycin and piperacillin/tazobactam, a drug incompatibility well described in the literature.A literature review was first performed to overview the different available strategies against drug incompatibility and with a mention of clinical assessment. This first part identified possible solutions to be implemented within infusion setups.The second part of this work was devoted to the problem encountered by the medical intensive care unit of the Saint-Antoine Hospital in Paris, but also by many resuscitation units. It focused on the simultaneous combination of vancomycin and piperacillin/tazobactam by central venous infusion. Several solutions described in the first part were explored using an in vitro reproduction of the infusion line with a multimodal approach. The first solution tested involved a restricted contact time between the drugs by using short multi-lumen infusion devices with a low residual volume and paired with a decrease of the drug concentrations by adding a fluid support. This work could be secondary extended by the evaluation of other identified strategies such as the use of in-line filters or the dilution of the initial vancomycin concentration in its infusion container. The work was based on the analysis of the following parameters:1) The particle load. One of the objectives was to define the critical periods of particulate release and to establish hypotheses concerning the factors of its aggravation in order to try to limit it in a second phase.2) Potential drug loss, using High Performance Liquid Chromatography with UV detection (HPLC-UV) as an analytical technique.The third part of this work focused on the search of clinical or in vivo parameters attesting to the potential consequences of the various modifications of parameters previously showed in ... |
| Document Type: |
doctoral or postdoctoral thesis |
| Language: |
French |
| Relation: |
NNT: 2023ULILS003 |
| Availability: |
https://theses.hal.science/tel-04072182; https://theses.hal.science/tel-04072182v1/document; https://theses.hal.science/tel-04072182v1/file/2023ULILS003.pdf |
| Rights: |
https://about.hal.science/hal-authorisation-v1/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.DD133FD7 |
| Database: |
BASE |