How do 1.2 µm IV filters can improve the safety of lipid parenteral nutrition?

It is important for commercially available intravenous fat emulsions that the PFAT5 (the percentage of fat droplets with a size >5 µm) is consistently <0.05%. If the PFAT5 level is >0.05%, the lipid emulsions may be instable and potentially harmful to patients^1. ​

Driscoll et al. from the Harvard Medical School conducted a study to investigate if​:

• a commercially available 1.2 µm in-line filter (Pall TNA1 1.2 µm filter) protect against the passage of abnormally large and potentially dangerous lipid droplets (sizes of >5 µm) in asimulated infusion model with a parenteral infusion pump^2.

The authors noted four results^2.​

1. The 1.2 µm TNA1 in-line filter reduced significantly clinically meaningful unstable lipid droplets (>5 µm).​
2. Not once in the 24-hour infusion period did the filter occlude nor was the flow rate accuracy of the pump compromised, despite the influence of highly unstable Total Nutrient Admixtures formulations with PFAT concentrations a high as 2.75% in the pre-filtrate.​
3. As the 1.2 µm TNA1 in-line filter was able to trap enlarged and potentially dangerous lipid droplets, it also did not induce instability in the otherwise stable lipid droplets.
4. ​No significant interaction effects were noted between treatment and time.

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References

1. _{Blackmer A.B. & Partipilo M.L. (2015). Three-in-One Parenteral Nutrition in Neonates and Pediatric Patients: Risks and Benefits. Nutrition in Clinical Practice; 30(3): 337–
   343​}
2. _{Driscoll D.F. et al. (1996). Effects of in-line filtration on lipid particle size distribution in total nutrient admixtures. JPEN J Parenter Enteral Nutr; 20(4): 296-301}

Author bio

Dr. Volker Luibl is a Sr. Marketing Manager Medical Content with knowledge in medical device and clinical science.