[Incompatibility of injectable drugs in neonatal intensive care: from assessment to implementation of a preventive tool].

Abstract

Introduction: Complex administration patterns in neonatal intensive care lead to the mixing of several active ingredients on the same route. The aim of this study was to assess the frequency of these concomitant administrations and their physico-chemical compatibility, and then to establish a specific compatibility table.

Material and methods: A prospective, observational, single-center study was carried out in a neonatal intensive care unit between February 15 and April 2, 2024. Data (patients, approaches, parenteral nutrition, injectable drugs (dose, dilution, administration methods)) were collected from computerized prescriptions and observation of connections at the patient's bed. Compatibilities were assessed using Stabilis® and the Handbook of Injectable Drugs®.

Results: Forty-nine prescriptions containing 385 Y combinations were included: 36% were compatible, 3% incompatible and 46% not studied. A compatibility table was created, including 24 of the most commonly prescribed molecules (anti-infectives and nervous system drugs specifically).

Discussion and conclusion: Y-combinations appear inevitable in patient management. Although few incompatible associations have been observed, the absence of data for many molecules should lead to increased vigilance. The creation of a specific compatibility table would appear to be a tool that would reduce the risk of incompatibility. An evaluation of this tool should be envisaged, as well as an extension of the project to the establishment's various pediatric departments.