Plastic particle migration during intravenous infusion assisted by a peristaltic finger pump in an animal model.

The contamination of intravenously administered fluid with foreign material has always been of major concern, but the in-vivo impact of silicone embolisation from administration of fluid via a peristaltic finger pump (PFP) has not previously been assessed. To determine whether silicone particles enter the lungs and to review the histological response, 10 rabbits received an IV infusion of 0.9% saline at 10 ml/kg per hour over a 72-h period, via an IVAC 591 PFP. The lungs were analysed for silicone particles with scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDXA). These results were compared with a control group of non-infused animals. Silicone particles were found in 8 of 10 animals in the experimental group and in 2 of 9 control animals, indicating that silicone particles are dislodged during pump-assisted IV infusions. The difference between the control and infused animals was statistically significant using Fisher's exact test (P = 0.023). However, silicone plastic particles in control animals suggest that there is also environmental exposure to silicone in addition to those particles that come from a therapeutic source. The additional finding of elemental silicon (which is one of the constituents of silicone plastic) in both infused and control animals in which silicone plastic was not found indicates that not all elemental silicon in animals reflects the presence of silicone plastic. The clinical significance of each of these two findings is yet to be determined.

Plastic migration from implanted central venous access devices.

BACKGROUND: This is the first reported study of histologically confirmed migration from intravenous access devices in children. METHODS: The capsules from around intravenous access devices were examined by light microscopy to determine the extent of the foreign body response; energy dispersive x ray analysis was performed to document the elemental content of the foreign material. RESULTS: A fibroconnective tissue capsule was found around all the samples. Elemental silicon was found in six of 13 tissue samples, and a foreign body giant cell reaction was seen in three of these. CONCLUSIONS: The pseudocapsule that surrounds an implanted vascular access device often has residual foreign material, including silicone.

An in vitro study of silicone migration from intravenous fluid tubing.

Migration of particulate matter from plastic tubing and solid plastic implants has been documented in a number of studies, including some with the use of cardiac bypass, haemodialysis, and pump-assisted intravenous infusions. In order to ascertain whether silicone embolisation occurs when children have an Ivac 560 pump-assisted IV infusion, we passed 180 ml of pumped fluid through a microfilter and compared the scanning electron micrographs of those filters with unused filters and with others through which a similar volume had been passed without using the pump. The particles on the filters were analysed for their elemental content using energy-dispersive X-ray analysis. In addition, the appearance of the silicone tubing used in the pump over 3 and 72 h was assessed and compared to that of flow-only and unused tubing. More particles were found on the microfilter when fluid had been delivered via the pump than on those through which non-pumped fluid had passed or that were unused. Elemental silicon-containing particles were only found on the filter when a pump had been attached to the IV line. The flow-only and unused tubing were found to have adherent particles on the inner surface that were not seen once the tubing had been used for 3 h in the Ivac 560 pump. Also, after 72 h use, the silicone tubing had a deformed inner layer. The clinical significance of these findings is yet to be determined, but it does appear that silicone embolisation occurs during pump-assisted infusions in children.