Low Dose Accuracy in Neonatology

“In a 500g newborn infant, enteral drugs are often prescribed in volumes as small as 0.1ml or even 0.01ml.” However, “Laboratory testing shows a mid-tolerance [ENFit™] connector pair in a female to male orientation displaces a mean average of 0.148 ml […] of fluid“.

Extract of ISO 80369-3:2016

Concerns about drug administration with a dose less than 2 ml

Delivering the right dose to a neonate is critically important. Underdosing can result in a lack of efficacy, and overdosing can result in adverse effects.

The Children’s Hospital of Philadelphia shared data showing that more than 80 different oral medications are administrated in volumes less than 2ml and 1,250 of these doses are prepared every day, representing 48% of their daily administrated oral doses. (1)    

 

 

 

Neonatal survey on the accuracy needs

Neonatal survey on the accuracy need for low dose administration of drugsAs a survey conducted in NICUs from 11 countries shows, very low volumes of enteral drugs (0.05ml – 0.1ml) are administered daily to neonatal patients. Misdosing of many enteral medicines can be detrimental for patient health, so a high level of accuracy in drug administration is required. The design of the ENFit™ connector, with a possible 0.148ml overdose, is judged by the 126 neonatal specialists interviewed, to provide inadequate dose accuracy for ENFit™ ‘s universal use in neonatology.

Summary  

 

The Children’s Hospital of Philadelphia shared data showing that more than 80 different oral medications are administered in volumes less than 2 ml and 1,250 of these doses are prepared every day, representing 48% of their daily administered oral doses. (1)

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References

  • (1) Update on implementation of the new ENFit™ enteral connectors – ISMP newsletter – June 30, 2015