General IV Filter question

[mlbdestined]

Hey all, concerning adult patients (no open foramen ovale or anything like that, just regular patients) I know that certain meds like mannitol needs a IV filter on it, but I don't know the reasoning for this? All I was able to see online is that the precipitate can cause phlebitis? Is this the reasoning. I didn't think this was why. Any info? Thanks guys

[meandragonbrett]

Mannitol requires a filter because it will crystallize just from you looking at it.

[Spacklehead, MSN, NP]

Yep, mannitol precipates very quickly, so you want to be sure the crystals aren't being infused into the patient.

[HamsterRN, ADN, RN]

All standard IV primary tubing should contain an in-line particulate filter.

Add-on filters are typically used for filtering air, not particulates. Our policy is to place an add-on air filter for all patients with a PFO or other R to L shunt, and when running "frothy" IV solutions such as amiodarone regardless of PFO.

[mlbdestined]

so the filters are for air rather than particulate? Nice to know thanks all

[iluvivt, BSN, RN]

Filters come in a variety of sizes and configurations so its best to know what kind you need and what it does.

1. The most common one you will see in clinical setting is the 0.22 micron filter. It can come as an add on or as an integral part of the tubing. This is the filter you will use for TPN, Mannitol, Dilantin in in a mini bag.

It is considered an absolute filter as it traps bacteria and air and particulate matter. INS recommends this as well for routine IV therapy but many do not use it b/c of the added cost. IF you have to add on this type of filter always put it at the most distal tubing

2. A 1.2 micron filter does the same but b/c it is larger you can filter lipids through it when you need to mix Lipids and TPN into one bag. This is often seen in TPN at home patients.

3 A 170 micron blood/blood product filter will trap cellular debris

4 A 20-40 microaggregate filter is used for blood transfusion to trap the microaggregates (cellular degradation from stored blood) This is used when large volumes of blood are infused to prevent lung injury

5 1-5 micron particulate matter filter used in medication preparation. Pharmacy will use this in medication preparation such as when preparing many brands of IVIG

[fiveofpeep]

Mannitol requires a filter because it will crystallize just from you looking at it.

hahaha so true!! Ive made quite a few crystal gardens atop my iv pumps

[maianh]

Hi iluvivt

I am looking for a list of commercial antibody or biological IV medicines that requires the use of in line filter during infusion. Could you recommend some sources to look up? Thanks

[iluvivt, BSN, RN]

The best IV medication book on the market in my opinion is Betty L. Gahart RN

2017 Intravenous Medications: A Handbook for Nurses and Health Professionals.......You would need to look up each drug of interest to see what the manufacturer recommends.

[IVRUS, BSN, RN]

Filters come in a variety of sizes and configurations so its best to know what kind you need and what it does.

1. The most common one you will see in clinical setting is the 0.22 micron filter. It can come as an add on or as an integral part of the tubing. This is the filter you will use for TPN, Mannitol, Dilantin in in a mini bag.

It is considered an absolute filter as it traps bacteria and air and particulate matter. INS recommends this as well for routine IV therapy but many do not use it b/c of the added cost. IF you have to add on this type of filter always put it at the most distal tubing

2. A 1.2 micron filter does the same but b/c it is larger you can filter lipids through it when you need to mix Lipids and TPN into one bag. This is often seen in TPN at home patients.

3 A 170 micron blood/blood product filter will trap cellular debris

4 A 20-40 microaggregate filter is used for blood transfusion to trap the microaggregates (cellular degradation from stored blood) This is used when large volumes of blood are infused to prevent lung injury

5 1-5 micron particulate matter filter used in medication preparation. Pharmacy will use this in medication preparation such as when preparing many brands of IVIG

Good Post ILUVIVT... But also remember that the TPN that can infuse via .22 micron filter is one that is without LIPIDS. AND, The filters should NEVER be ADD ONs. Filters should be an integral part of the IV administration set as add-ons increase bacterial contamination introduction from all the manipulation.