How efficient are air elimination filters used in IV infusion systems?

"With increasing recognition, various preventive measures have emerged, the most important of which is the use of air-eliminating filters" Lee and Bulsara (2020).

Abstract:

The presence of gaseous air emboli in the vasculature has the potential to cause significant morbidity and mortality. Once viewed as a rare complication of high-risk surgeries, air embolism is now also being associated with even minor and routine procedures such as peripheral venous catheterization. With increasing recognition, various preventive measures have emerged, the most important of which is the use of air-eliminating filters. However, studies on these devices are currently lacking. Therefore, in this present study, we aimed to evaluate the effectiveness of two commercially available filters in removing air within intravenous (IV) lines. An IV infusion system was created, designed to resemble standard conditions used in real clinical practice. Testing was completed using a .9% NaCl solution at room temperature with a flow rate set at 75 mL/h and involving three different filter orientations. The test bed was configured to inject air every 2 minutes with volumes ranging between 5 and 600 μL. The two filter models tested were GVS .2-μM and Braun SUPOR membrane air-eliminating filters. Data was collected at pre-filter and post-filter sites. The Braun SUPOR membrane filter (B Braun, Bethlehem, PA) reduced air micro-emboli by 100.0% (p < .0001) both by volume and count compared with -.6 ± 3.5% by volume and -.8 ± 1.5% by count for the control. The reduction seen with the GVS .2-μM filter was 99.8 ± .2% (p < .0001) by volume and 86.2 ± 21.1% (p < .0001) by count compared with the control. There was no statistically significant difference in the removal efficacy between the two filter models. As the use of air-eliminating filters becomes a common standard of care, establishing the validity of the commercially available filter models is important to minimize the risk of vascular air embolism.

Reference:

Lee, S. and Bulsara, K. R. (2020) Assessing the Efficacy of Commercially Available Filters in Removing Air Micro-Emboli in Intravenous Infusion Systems. The Journal of Extra-Corporeal Technology. 52(2), p.118–125. https://doi.org/10.1182/ject-1900037 (epub ahead of print).

Safety IV catheter