Let's analyse why it is inappropriate to use blood transfusion device for transfusion?
At present, 90% of the materials of domestic blood transfusion tubes and transfusion funnels are polyvinyl chloride PVC, with a filtration aperture of 170 μm to 260 μm, and when the aperture is too small, it is easy to be blocked by microaggregates of platelet leukocytes in the blood cells, which affects the effective filtration area. The infusion particles whose diameters are mostly in the range of 1～15μm, and a few can be in the range of 50～300μm, are non-metabolic particles impurities existing in the liquid, and the larger particles can cause local vascular blockage or insufficient blood supply, tissue hypoxia, promote phlebitis and oedema, granuloma, and even promote the formation of tumours, and the insoluble particles can cause allergic reactions and pyrogenic-like reactions. The particles larger than 10μm in the drug solution only accounted for about 1%, less than 10μm particles accounted for about 98% of the larger filter aperture of the transfusion device, is not filtered out of these infusion particles, so it is not suitable for infusion. And precision filtration infusion device selection of the filter membrane is nuclear pore membrane, with double-layer filtration media, high filtration precision, pore size has a strict classification, according to the clinical needs of the selection of the appropriate pore size: 5 μm, 3 μm, 2 μm, 1.2 μm, 0.2 μm. Can effectively filter infusion particles, to ensure the safety of patient infusion.
1. the type of infusion device and filter aperture now clinical use of infusion devices are basically three kinds: one is an ordinary PVC infusion device, the filter aperture of 15um; a precision infusion device containing PVC, the filter aperture of 3um, 5um, or even smaller aperture; the other for the TPE infusion device does not contain PVC plasticisers, filter aperture 15um, which can prevent the impact of the infusion device on the patient's health and safety. 15um, can prevent the adsorption of emulsions, oils such as nitroglycerin, butyl peptide injection and some chemotherapy drugs.
2.the material of the transfusion device and filter aperture at present, 90% of the domestic transfusion device pipeline and transfusion funnel material for polyvinyl chloride PVC, filter aperture of 170 um ~ 260um, aperture is too small, it is easy to be blocked by the platelet leukocyte blood cells in the microaggregate, affecting the effective filtration area. Effective filtration area.
3、Concentrated red blood cells are characterised by the diameter of a single red blood cell of 6 to 9 microns. But concentrated red blood cells due to the removal of most of the plasma and platelets, white blood cells, red blood cell concentration increases, often many red blood cells bonded together, so the viscosity of concentrated red blood cells than whole blood, fluidity is only 60% of whole blood.
4. a variety of drug infusion requirements for the infusion apparatus (1) proprietary drug infusion: due to the preparation of proprietary drug preparations in the process of preparation, the purification process lacks the existence of impurities, or the powdered injection soluble in insufficient, resulting in an increase in the number of particles, so the infusion should be selected with a drug filtration device precision infusion to filter pore size of 2 to 9 microns. Insufficient, resulting in an increase in the number of particles, so the infusion should be selected with a precision infuser with a drug filtration device, with a filter pore size of 2.2 ~ 5μm, drug adsorption < 28.6% is good. (2) Nutritional agents: the US 2016INS filter article mentions the use of 0.2 micron filters for fat-free parenteral nutritional solutions and 1.2 micron filters for fat-containing emulsions, and the filters should be changed every 24 hours.
5. Infusion particulate contamination and filters 2016 US INS Filter Article mentions that constantly updated research evidence suggests the existence of effects of particulate matter (e.g., rubber, glass, latex) on capillary endothelial cells, and that tiny air bubbles in fluids may cause cerebral and pulmonary ischemia; and that the use of filters with particulate retention and air elimination features can prevent potential damage from air/particulate matter (e.g., right-to-left shunt cardiac malformations).
Transfusion particles are non-metabolic particles present in fluids, mostly in the range of 1-15 µm in diameter, and a few can be in the range of 50-300 µm. Larger particles can cause local vascular occlusion or insufficient blood supply, tissue hypoxia, promote phlebitis and oedema, granulomas, and even tumour formation. Insoluble particles can also cause allergic reactions and pyrogen-like reactions.
6. PVC material adsorption of drugs PVC material on some alcohol-soluble, fat-soluble drugs have a strong adsorption, so that the prescription is not allowed to use drugs, affecting the therapeutic effect.
These drugs are mainly paclitaxel, nitroglycerin injection, isosorbide mononitrate injection, nimodipine, clonazepam, diazepam, chlorpromazine, urokinase, insulin, fat emulsion, opuntia oil, chuanxiongxiongzine, ethamidofuranone, fentanyl, tinidazole, curcuma oil, and so on. In summary, given the PVC material of the transfusion device and the large filter aperture, it means that the transfusion device is a specialised infusion device set up to accommodate blood and its products, and it is not suitable for infusion.
