-Original-

Utility of a Compatibility Chart for Continuous Infusions in the Intensive Care Unit

Masayoshi Kondo¹, Chie Tanaka², Takashi Tagami³, Makihiko Nagano¹, Kazutoshi Sugaya¹, Naoya Tagui¹, Junya Kaneko², Saori Kudo², Masamune Kuno², Kyoko Unemoto² and Hisamitsu Takase¹

¹Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
²Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
³Department of Emergency and Critical Care Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan

Background: In the intensive care unit (ICU), multiple intravenous drugs are often administered through the same catheter line, greatly increasing the risk of drug incompatibility. We previously developed a compatibility chart including 27 drugs and have used it to avoid drug incompatibilities in the ICU. This retrospective study evaluated the utility of this chart by analyzing prescriptions and incidents of incompatibilities in an ICU.
Methods: We analyzed 257 ICU prescriptions of two or more continuous infusions on the same day during the period between March 2016 and February 2017 and investigated the rate of compliance with the compatibility chart. Drug combinations were classified as "compatible," "tolerable compatible," "incompatible," and "no data." For all combinations, the compliance rate was defined as the ratio of compatible and tolerable compatible combinations. Additionally, using our hospital incident report database, we analyzed 27,117 injections administered in the ICU between March 2016 and February 2017 and investigated incidents related to incompatibility.
Results: Three hundred infusion combinations were identified in the prescriptions. The compliance rate was 97% (n = 293). Of the 113 combinations judged to be tolerable compatible, 98% (n = 111) consisted of three or more continuous medications injected through the same intravenous line. Of the two incidents related to incompatibility in the incident report database, the combination "nicardipine and furosemide" was defined as incompatible in the compatibility chart.
Conclusions: The high rate of compliance with the compatibility chart suggested it was useful in preventing drug incompatibility.

J Nippon Med Sch 2022; 89: 227-232

Keywords
compatibility chart, intensive care unit, drug incompatibility, incident

Correspondence to
Masayoshi Kondo, Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
kondomasayoshi@nms.ac.jp

Received, April 16, 2021
Accepted, August 4, 2021