A large amount of microscopic precipitates are inevitably injected during infusion therapy without an in-line filter

Shinya Shimoyama; Daisuke Takahashi; Syuhei Arai; Yuji Asami; Kimiko Nakajima; Kentaro Ikeda; Takumi Takizawa; Tomio Kobayashi

doi:10.1093/omcr/omab134

A large amount of microscopic precipitates are inevitably injected during infusion therapy without an in-line filter

Oxf Med Case Reports. 2022 Feb 19;2022(2):omab134. doi: 10.1093/omcr/omab134. eCollection 2022 Feb.

Authors

Shinya Shimoyama¹, Daisuke Takahashi², Syuhei Arai¹, Yuji Asami¹, Kimiko Nakajima¹, Kentaro Ikeda¹, Takumi Takizawa³, Tomio Kobayashi¹

Affiliations

¹ Department of Pediatric Cardiology, Gunma Children's Medical Center, Shibukawa 377-8577, Japan.
² Department of Pharmacy, Gunma Children's Medical Center, Shibukawa 377-8577, Japan.
³ Department of Pediatrics, Graduate School of Medicine, Gunma University, Maebashi 371-8511, Japan.

Abstract

Infusion route problems can have a significant impact on hemodynamics in children with severe heart failure. Here, we report the case of a 13-year-old girl with dilated cardiomyopathy. Her condition fluctuated due to frequent occlusion of the central venous catheter (CVC) route. However, a quick check revealed no apparent abnormalities in the CVC, infusion route, in-line filter or infusion pump. Scanning electron microscopy revealed that dobutamine and heparin had crystallized and that the in-line filter membrane was occluded. This case emphasizes the importance of proper infusion route management in pediatric patients with severe heart failure. Even drugs that are used daily may form microscopic crystals at several concentrations and administration rates. Without an in-line filter, microscopic particles are injected into the body, and there is no evidence that the injected crystals do not cause permanent damage.

Publication types

Case Reports