In practice whose standards are you accoutable to when there is a conflict. Specifically INS says to filter lipids with a 1.2 micron filter. Manufacturer of Liposyn 111 states do not filter.
INS standards state "For lipid infusion or toral nutrient admixtures that require filtration, a 1.2 micron filter containg a membrane this is particulate-retentive and air-retentive shall be used." Gahart's Intravenous Medications states Do not use filters with fat emulsions as they will disturb the emulsion. Filtration is necessary when there is a total nutrient admixture, meaning that all solutions including the fat emulsion is mixed together in one large bag. This admixture can cause the emulsion to crack and that is the reason for the filtration. This is also recommended by the FDA in a previous communication about fat emulsion and Gahart lists this FDA statement as well. So the answer to your question is that it depends on how you are infusing the emulsion - alone, piggybacked into other parenteral nutrition or as a total nutrient admixture. If alone, do not filter. If piggybacked, connect below the 0.22 micron filter on the PN. If a TNA, use a 1.2 micron filter for all the infusion. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861