CDC guidelines "Complete infusions of blood products within 4 hours of hanging the product". Per the package insert "Do not begin administration more than 4 hours after introduction of the administration set". We have always taken this as any albmin doses that we have prepared, must be infused within 4 hours. We have recently had a few patients on continuous infusions, replacing the container every 4 hours has been challenging. I am of the opinion that as long as you initiate the infusion within 4 hours of puncturing the container, that infusion should be allowed to hang for 24 hours.
Does anyone know if the CDC guidelines are referring to pharmaceutical products (such as albumin, IVIG, etc) or is it only referring to blood products (platelets, RBC's, etc.)
I wrote to the CDC at hip@cdc.gov and this is their response:
"The period of time for infusing blood after spiking comes from Blood Banking recommendations. The intent of out 2002 recommendation was for blood and blood components, not albumin. CDC has revised the Guidelines for Prevention of Intravenous Catheter Infections which should be released soon and the section on administration of blood and blood products has been removed.
Manufacturer instructions should be followed for the administration of their products. The statement “Do not begin administration more than 4 hours after introduction of the administration set” may not indicate that it must be infused within 4 hours. We suggest you contact the manufacturer for interpretation of that statement.
You may also wish to contact the FDA regarding albumin administration or determine if there are any USP or other pharmaceutical recommendations for albumin administration."
01-29-201212:33 AM - last edited on 01-30-201203:51 PM by MaeghanN
I believe the language in the package insert refers to storage and not administration (like USP 797). The language to me means that you can't spike it and let it sit around. Manufacturers and USP standards can't dictate the length of administration just the activites that occur prior to administration. I would recommend that you reach out to your hospital infection preventionist to discuss your concerns. They will be able to work with you to ensure that your practices are robust and consistent with CDC guidelines.
