In order to circumvent these drug incompatibility issues we propose a novel administration method called multiplex infusion. When the number of available lumens is too low to facilitate the safe administration of these solutions, additional (peripheral) IV catheters are often required, causing physical discomfort, increasing the risk for catheter related complications, increased workload and associated treatment costs. As drugs or their solvents are frequently chemically incompatible, many solutions must be administered through separate lumens in order to avoid precipitation or inactivation of components. In the intensive care unit (ICU), operating rooms, and in oncology wards patients usually receive multiple IV solutions simultaneously from multiple infusion pumps. Utilizing an infusion pump, solutions are typically delivered into the bloodstream at a preset and fixed rate. Intravenous (IV) therapy is one of the most common treatment modalities in hospitals worldwide. The multiplex algorithm allows for more efficient use of IV lumens compared to the conventional multi-infusion strategy. The multiplex algorithm addresses a major issue that occurs in ICUs, operating rooms, oncology wards, and many other hospital departments where several incompatible drugs are infused through a restricted number of lumens. In 27% of all drug combinations, and 61% of the unique combinations the multiplex algorithm required fewer lumens ( p 3 lm, versus 12% using the conventional procedure. The mean ± SD number of simultaneous IV solutions was 2.8 ± 1.6. We used data from 175,993 ICU drug combinations, with 2251 unique combinations received by 2715 consecutive ICU patients. The number of lumens required by the conventional procedure (L CONV) and multiplex algorithm (L MX) were compared. The conventional scheduling procedure executed by ICU nurses was used for comparison. MethodsĪ multiplex algorithm was developed that schedules the alternating IV administration of multiple incompatible IV solutions through a single lumen, taking compatibility-related, pharmacokinetic and pharmacodynamic constraints of the relevant drugs into account. Our objective was to develop and evaluate an algorithm designed to reduce the number of intravenous lumens required in multi-infusion settings by multiplexing the administration of various parenteral drugs and solutions. When the number of available lumens is too low to facilitate the safe administration of these solutions, additional (peripheral) IV catheters are often required, causing physical discomfort and increasing the risk for catheter related complications. As drugs or their solvents are frequently chemically incompatible, many solutions must be administered through separate lumens. CONCLUSION: Because measurements of central venous pressure may not always be comparable for all three ports of a triple-lumen catheter, care should be taken to distinguish when changes in pressure readings are a result of a change in port site rather than in the patient's condition.Multi-drug intravenous (IV) therapy is one of the most common medical procedures used in intensive care units (ICUs), operating rooms, oncology wards and many other hospital departments worldwide. In some patients, the difference between central venous pressure obtained from the distal port and pressure obtained from the proximal or the medial port may be clinically significant. Post hoc univariate F tests showed significant differences between the proximal and distal ports and between the medial and distal ports. ![]() RESULTS: A repeated-measures analysis of variance showed significant differences across port sites. ![]() Data were evaluated for variation among the three ports of the catheter for readings taken at a single point. The flush system was single-transducer, trifurcated pressure tubing system. Catheters were placed in either the right or left subclavian vein or the right or left internal jugular vein. METHODS: Measurements of central venous pressure in 48 adult ICU patients were obtained via each of the three ports of a triple-lumen catheter. OBJECTIVE: To determine if a difference exists between measurements of central venous pressure obtained via the proximal, medial, and distal ports of a triple-lumen catheter. However, no scientifically based literature is available that guides clinical practice and indicates which of the lumens is most appropriate for obtaining these measurements. ![]() BACKGROUND: Measurements of central venous pressure are generally obtained through one of the three ports of centrally placed triple-lumen catheters.
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