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Infusion Reactions

Hello. At my institution we infuse many different drugs, Chemo and no-chemo. I have heard anecdotally of incidents where a patient was receiving Paclitaxel or Docetaxel and while the the medication was being Run Down (which for us is to fill the IV tubing  with the medication, to the VAD, before starting the actual infusion)  the patient experiences a hypersensitivity reactine before the medication "reaches" the patient based on the tubing volume. Our tubing is 25cc in volume. Even if we run down 20cc (5cc short of the patient) there are reported reactions. Do you see this in your practice, and if so, has it been investigated to understand that happens?  What drugs has it occured with? We use Alaris pumps and tubing. Thank you.

What signs and symptoms are

What signs and symptoms are you seeing? Hypersensitivity can be from several causes. Has there been any VAD insertion or access? Not enough information to provide an answer. 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Info Gathering

Thanks for your input Lynn. Unfortunatly, this is all anecdotal. We are starting to use different ways to collect specific data on any such hypersensitivity reactions. It has not happend to me, but many nurses I have spoken with state it happens. Will update if we find any situations where we can understand the circumstances of the reaction.



We observed similar incidence, and we contributed this to potentially taxol diluent is heavier and therefore reached patient's IV site faster. We added a coloring on a wasted taxol for testing under control condition and noticed some of the dyed taxol reached down faster. We now do VTBI at 12 mL (half the tubing) and run it at maximum 200 mL/hr for priming the tubing with taxol and so far we haven't had any problem. 


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