[Use of microfilters within the scope of infusion therapy].

OBJECTIVE

The aim of our review is to summarize risks and benefits using 0.2-micron in-line filters in intravenous infusion therapy.

DATA SOURCES: Own data and the accessible medical literature according to current electronic information sources were exploited.

RESULTS

Problems associated with intravenous infusion therapy include contamination of fluids with bacteria, endotoxins, and foreign particles. These factors may be important in the pathogenesis of sepsis, adult respiratory distress syndrome, and multiorgan failure. Elimination of bacteria, endotoxins, and particles can be achieved by 0.2-micron in-line filters. A significant reduction in the rate of phlebitis due to peripheral venous catheters has been demonstrated. However, a reduction in the rate of sepsis by the elimination of bacteria and endotoxins or the prevention of adult respiratory distress syndrome and multiorgan failure by retention of foreign material by these filters has not yet been conclusively proved. The longer intervals between changing of the whole infusion systems with the use of these filters (from 24 h without filter to 96 h with filter) result in cost-effectiveness, waste reduction, and reduction in nursing time. Due to adherence to the filter, small doses of drugs (i.e., < 5 micrograms/ml or < 5 mg/24 h) should not be given through filters. The size of the filter pores (0.2 micron) does not allow for the application of blood products or emulsions. Retention of foreign material results in increasing resistance, so that measurements of central venous pressure may be affected. Filters are constructed so that a potential increase in pressure and a following break would not result in a leakage.

CONCLUSION

0.2-micron in-line filters are useful for the elimination of the bacterial and endotoxic load to the patient and for the removal of foreign material. Thus, they represent a useful and cost-effective adjunct, but not a prerequisite in modern intravenous therapy.