Stability of Epinephrine in a Normal Saline Solution.

Anesthesia progress Pub Date : 2024-09-09 DOI:10.2344/998301
Caroline M Sawicki, Daniel B McKim, Hongrui Wang, Morgan Vasas, Joshua J Blakeslee, Courtney A Jatana, Patrick Dib, Bryant W Cornelius, Spencer D Wade
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Abstract

Objective: Dilution of concentrated epinephrine prior to intravenous use during clinical emergencies can delay urgent interventions. The objective of this study was to determine whether diluted epinephrine remains stable and sterile over time in common hospital settings.

Methods: Epinephrine samples were prepared by clinically relevant double dilution techniques. Samples were stored in 10-mL syringes and incubated under 1 of 4 simulated hospital environments with a mixture of lighting and temperature settings: 4°C/20°C, with or without fluorescent lighting. Samples were incubated for 0, 15, 30, 60, or 90 days. Capillary zonal electrophoresis was used to quantify the concentration of epinephrine and/or presence of any degradation products. All samples were tested for the presence of bacterial growth using blood agar cultures.

Results: Diluted epinephrine samples remained stable for up to 90 days in all 4 simulated clinical storage conditions. No bacterial colony-forming units were detected in any of the environmental samples regardless of incubation duration, light, or temperature conditions.

Conclusion: Diluted epinephrine for anticipated clinical emergencies may remain clinically useful for up to 90 days, thus improving patient safety, access to medications, and overhead costs by reducing waste.

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正常生理盐水中肾上腺素的稳定性
目的:在临床急诊中静脉注射浓缩肾上腺素前对其进行稀释可能会延误紧急干预。本研究旨在确定稀释后的肾上腺素是否能在普通医院环境中保持稳定和无菌:方法:采用临床相关的双重稀释技术制备肾上腺素样本。将样本保存在 10 毫升注射器中,并在 4 种模拟医院环境中的一种环境下进行培养,其中包括混合照明和温度设置:4°C/20°C,带或不带荧光灯。样品分别培养 0、15、30、60 或 90 天。毛细管带状电泳用于量化肾上腺素的浓度和/或降解产物的存在。使用血琼脂培养物检测所有样本中是否存在细菌生长:结果:稀释后的肾上腺素样本在所有 4 种模拟临床储存条件下都能保持稳定长达 90 天。无论培养时间长短、光照或温度条件如何,环境样本中均未检测到细菌菌落形成单位:结论:稀释后的肾上腺素可用于预期的临床紧急情况长达 90 天,从而通过减少浪费来提高患者安全性、药物可及性和间接成本。
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