In-vivo evaluation of simultaneous administration of incompatible drugs in a central venous catheter with a decreased port to port distance

Background:
Multilumen catheters are commonly used in critically ill children.
Their use, however, is associated with significant morbidity. We studied the
simultaneous administration of incompatible drugs using a new triple-lumen
catheter with decreased length and port to port distances.

      Methods:
      Ten domestic swine, 10–20 kg in weight, were divided into two
            groups of five. Total parenteral nutrition was administered through the distal
            port and phenytoin was administered as a bolus and as an infusion in each
            group. Samples were taken from two sites during the bolus and at 1, 5, and
            15 min during phenytoin infusion. Histograms were generated for particle size
            and concentration. Samples were also examined under the microscope for
            particles.


      Results:
      Histograms of particle size did not show any alteration of the
            histogram that would suggest particle size > 2 μm in diameter in the
            study or control samples. No particles were identified by phase microscope,
            light microscope, or Wright stain smear.


      Conclusions:
      The use of a triple-lumen catheter with a distance of 0.4cm
            between the proximal port and the medial port and 1.3 cm between the medial port
            and the distal port, for the in vivo simultaneous administration of
            incompatible solutions does not result in precipitates large enough to cause
            adverse clinical effects.