Intralipid (20%) infusion administration - page 2

by harryalexx 9,130 Views | 15 Comments

Hi PICU nurses, I have a question regarding practice in your unit about intralipid infusions (20% fat emulsion). Do you run them independently of the PN (if PN is also on board)? Do you run them via central access if... Read More


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    If the Dextrose concentration is less then 10 % it is then PPN and if it higher than 10% it is TPN.
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    I always put ppn and lipids on different modules and hook the lipids to the lowest port on the ppn line. Change all lines every 24 hours. I always program my pump to exactly 24 hours later too... I've seen too many lipid bags hanging for too long.
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    Please take advantage of PHARMACIST discussion regarding medication and infusion compatibilities. They are a tremendous resource often overlooked and should be go-to person to help devise a policy regarding Lipid infusions.
    Last edit by NRSKarenRN on Mar 27, '13 : Reason: spelling oops
    harryalexx likes this.
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    I work in a pediatric CICU at a major Children's Hospital. We run our TPN/IL together via a Y-site. Anything >12.5% Dextrose must run through a central line. We Y several medications into TPN/IL.. Some I can think off the top of my head are PGE, Milrinone, Lasix (never with milrinone though), Potassium Boluses, Octreotide, certain intermittent antibiotics. I know there are several others that may be compatible as well but dependent on the dextrose concentration. We have a dedicated pharmacist for our unit and does give us permission to run some of those combinations together. Hope this helps and good luck!
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    I work in a CVICU at a children's hospital as well. We often use tpn as the major line in a manifold with milrinone, sedation, vasoactive, etc running through the manifold. We then put intralipids through a y site as close to the patient as possible. This, of course, is for our kids with central access. We recently started bolusing sedation from pumps which needs a dedicated lumen or piv. In our unit, lasix is always a dedicated line with a saline carrier if needed. Lasix has been on back order though so we have been using bumex which has a slightly better compatibility.
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    Quote from NRSKarenRN
    Please take advantage of PHARMACIST discussion regarding medication and infusion compatibilities. They are a tremendous resource often overlooked and should be go-to person to help devise a policy regarding Lipid infusions.
    Thanks so much for the reference...I wasn't even aware of this resource! I'll check in over there as well.

    Since initially posting this, I took this problem (with a couple other nurses) to a higher administrative council within the hospital. Basically, it came down to the fact that our unit uses too many infusions of milrinone to have our IL 20% in-line (Y-site) with MIVF + drips. C'est la vie.

    Thanks for everyone's input and practice experience. Much appreciated
    Last edit by harryalexx on May 28, '13 : Reason: Left out the "quote"


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