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Concurrent intravenous drug administration to critically ill children: Evaluation of frequency and compatibility

Melany Gaetani1, Helena Frndova2, Winnie Seto3

  • 1Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research & Learning [PGCRL], 686 Bay Street, 11th floor, Toronto, Ontario M5G 0A4, Canada.

Journal of Critical Care
|June 4, 2017
PubMed

Insights

Concurrent intravenous drug administration is common in critically ill children. While some drug-drug incompatibilities are known, many remain unknown, complicating patient care and highlighting research needs.

Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Pharmacy
  • Pharmacology

Background:

  • Critically ill children often receive multiple intravenous medications concurrently.
  • Managing complex medication regimens in pediatric intensive care units (PICUs) presents significant challenges.

Purpose of the Study:

  • To determine the frequency of concurrent intravenous drug administration in critically ill children.
  • To assess the rate of drug-drug incompatibilities among concurrently administered medications in this population.

Main Methods:

  • Retrospective analysis of intravenous drug administration in a single pediatric critical care center over a ten-year period.
  • Inclusion criteria: patients admitted for at least 6 hours receiving two or more intravenous drug administrations.
  • Drug compatibilities were evaluated using local reference documents.

Main Results:

  • Over 16,800 patients received over 3.6 million concurrent administrations.
  • Approximately 62% of administrations were concurrent, with only 9% confirmed compatible and 8% incompatible.
  • A significant portion (21%) had unknown compatibility, and 8% required pharmacist consultation.

Conclusions:

  • Concurrent intravenous drug administration is a frequent occurrence in critically ill children.
  • Known drug-drug incompatibilities are present, but a substantial number of drug pairs have unknown compatibility.
  • The high frequency of unknown compatibilities complicates bedside management and indicates a need for further research.
Abstract

Keywords:
Critical careIntravenous drug administrationPediatricPharmacologySafety

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