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  • Technical response to the Neonatal and Paediatric Pharmacist Group’s proposal to standardise intravenous infusion concentrations for children in the UK

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Letter
Technical response to the Neonatal and Paediatric Pharmacist Group’s proposal to standardise intravenous infusion concentrations for children in the UK
  1. Joseph Bulmer1,
  2. Michael Drinnan1,
  3. Jon Smith2
  1. 1 Medical Physics, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  2. 2 Cardiothoracic Directorate, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  1. Correspondence to Joseph Bulmer, Medical Physics, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; joseph.bulmer{at}nhs.net

https://doi.org/10.1136/archdischild-2022-325053

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    Recently, the Neonatal and Paediatric Pharmacist Group (NPPG), with support from the Royal College of Paediatrics & Child Health (RCPCH), proposed a national standard for intravenous infusion concentrations in children.1 The RCPCH recommendations are an important move towards ‘safer and more efficient’ standardisation,1 for example, by mitigating avoidable misdosing incidents, and are overwhelmingly a welcome development. Nevertheless, we note that if infusion concentration is standardised, then the infusion flow rate is determined. Here, we report a consequential risk not acknowledged in the proposal.

    In table 1, we compare current practice in our paediatric intensive care unit with the new standard for a 0.1 µg/kg/min epinephrine infusion to a 3 kg infant. The proposal would mean our infusion rate being halved …

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    Footnotes

    • Twitter @jonhaydensmith

    • Contributors JS initiated the response. JB and MD performed the bench testing and subsequent data modelling. All authors reviewed the proposal in the context of the literature and contributed to this communication in response.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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