Intravenous solution compatibility and filter-retention characteristics of trace-element preparations

The compatibility of recently published AMA formulations of the four trace-element injections (zinc, copper, chromium, and manganese) with a representative total parenteral nutrition (TPN) formulation and commonly used intravenous solutions was evaluated in glass and plastic containers. The effect of in-line filtration on trace-element concentration was also studied. Individual metal-ion concentrations, pH, color, and clarity were measured at 0-, 12-, 24-, and 48-hour intervals following mixture in TPN, 5% dextrose injection, 0.9% sodium chloride injection, and 8.5% amino acid injection (Travasol, Travenol Laboratories). Multiple trace elements were studied in one-liter glass bottles of 5% dextrose and 0.9% sodium chloride injection. Trace-element contaminants were measured in the intravenous solutions and trace-element injections. The four trace-element preparations were added individually and in combination to the solutions in plastic or glass containers. The trace-element admixtures were passed through in-line i.v. filters (IVEX-2, Abbott Laboratories) during a three-hour period at controlled-flow rates. Concentrations of trace elements remained within 99% confidence limits in all i.v. solutions, with both individual trace elements and combinations of the four trace elements. Trace-element concentrations did not change when the admixtures were passed through the in-line filter unit. It is concluded that there are no obvious compatibility problems associated with admixture nor any detectable retention by the i.v. filter of trace elements.