{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T22:19:09Z","timestamp":1771885149927,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T00:00:00Z","timestamp":1546905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011330","name":"Nottingham University Hospitals NHS Trust","doi-asserted-by":"publisher","award":["\u00a32500"],"award-info":[{"award-number":["\u00a32500"]}],"id":[{"id":"10.13039\/100011330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Plasma\u2010Lyte 148\u00ae is a balanced, crystalloid intravenous (IV) fluid which is both calcium\u2010free and isotonic. It prevents the hyperchloremic metabolic acidosis and iatrogenic hyponatremia seen with use of 0.9% sodium chloride and hypotonic solutions, respectively. However, data on compatibility with commonly used drugs are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the stability of Plasma\u2010Lyte 148\u00ae and Plasma\u2010Lyte 148\u00ae\u00a0+\u00a05% Glucose with eight commonly used therapeutic agents when compared with 5% glucose and 0.9% sodium chloride as diluents. We aimed to provide vital data which may facilitate the introduction of what appears to be a safer and more economic fluid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Plasma\u2010Lyte 148\u00ae and Plasma\u2010Lyte 148\u00ae\u00a0+\u00a05% Glucose were mixed with morphine, midazolam, fentanyl, ketamine, clonidine, aminophylline, salbutamol, and furosemide at set concentrations. Comparisons were made to 0.9% sodium chloride and 5% glucose fluid controls. Six repeats of each IV fluid and drug admixture were analyzed through high\u2010performance liquid chromatography at three time points: 0, 2, and 24\u00a0hours. A concentration change of &lt;5% was defined as chemically stable. Physical stability was assessed by observation of precipitate formation or color change. pH changes were measured using a Fisherbrand Hydrus 300 pH meter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Relative to starting concentration, all drugs except midazolam were stable to \u00b13%. All examined therapeutic agents were chemically stable at 2 and 24\u00a0hours relative to control solutions. No precipitate formed in any of the samples. All Plasma\u2010Lyte 148\u00ae and Plasma\u2010Lyte 148\u00ae\u00a0+\u00a05% Glucose drug admixtures remained in a safe, peripheral administration pH range of 5\u20109 and were closer to the pH of blood than standard fluid\u2010drug admixtures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Morphine, fentanyl, ketamine, salbutamol, aminophylline, and clonidine are stable for 24\u00a0hours when mixed with Plasma\u2010Lyte 148\u00ae and Plasma\u2010Lyte 148\u00ae+5% Glucose for administration at concentrations equivalent to those found at a typical Y\u2010site with maintenance fluid. Furosemide is stable at lower concentrations than those seen at a Y\u2010site, but midazolam displayed instability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.13554","type":"journal-article","created":{"date-parts":[[2018,11,25]],"date-time":"2018-11-25T14:26:00Z","timestamp":1543155960000},"page":"186-192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Physico\u2010chemical stability of Plasma\u2010Lyte 148\u00ae and Plasma\u2010Lyte 148\u00ae\u00a0+\u00a05% Glucose with eight common intravenous medications"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8225-7288","authenticated-orcid":false,"given":"Rachael","family":"Dawson","sequence":"first","affiliation":[{"name":"School of Medicine University of Nottingham Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Wignell","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Nottingham Nottingham UK"},{"name":"Paediatric Critical Care Unit Nottingham Children\u2019s Hospital Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Cooling","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Nottingham Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Barrett","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Nottingham Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harish","family":"Vyas","sequence":"additional","affiliation":[{"name":"School of Medicine University of Nottingham Nottingham UK"},{"name":"Paediatric Critical Care Unit Nottingham Children\u2019s Hospital Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6540-6368","authenticated-orcid":false,"given":"Patrick","family":"Davies","sequence":"additional","affiliation":[{"name":"School of Medicine University of Nottingham Nottingham UK"},{"name":"Paediatric Critical Care Unit Nottingham Children\u2019s Hospital Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet292"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm-2013-000400"},{"key":"e_1_2_9_4_1","first-page":"8","article-title":"Chloride\u2010liberal vs. chloride\u2010restrictive intravenous fluid administration and acute kidney injury: an extended analysis","volume":"41","author":"Yunos NM","year":"2014","journal-title":"Intensive Care Med"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12334"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365519209088389"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1097\/SLA.0000000000000324","article-title":"A randomized, controlled, double\u2010blind crossover study on the effects of 1\u2010l infusions of 6% hydroxyethyl starch suspended in 0.9% saline (Voluven) and a balanced solution (Plasma Volume Redibag) on blood volume, renal blood flow velocity, and renal cortical tissue perfusion in healthy volunteers","volume":"259","author":"Chowdhury AH","year":"2012","journal-title":"Ann Surg"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318293d81e"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31825074f5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1994.tb04450.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2014.253"},{"key":"e_1_2_9_12_1","first-page":"196","article-title":"Balanced crystalloid or saline in pediatric gastroenteritis: a randomized controlled trial","volume":"21","author":"Allen CH","year":"2014","journal-title":"Acad Emerg Med"},{"key":"e_1_2_9_13_1","first-page":"453","article-title":"Mixing medicines: how to ensure patient safety","volume":"294","author":"Bentley J","year":"2015","journal-title":"Pharm J"},{"key":"e_1_2_9_14_1","volume-title":"Mixing of Medicines Prior to Administration in Clinical Practice: Medical and Non\u2010medical Prescribing","author":"Department of Health","year":"2015"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2131\/jts.24.113"},{"key":"e_1_2_9_16_1","first-page":"S37","article-title":"Intravenous nursing standards of practice","volume":"23","author":"Intravenous Nurses Society","year":"2000","journal-title":"J Intraven Nurs"},{"key":"e_1_2_9_17_1","volume-title":"British National Formulary (online)","author":"Joint Formulary Committee","year":"2015"},{"key":"e_1_2_9_18_1","unstructured":"NHS Pharmaceutical Quality Assurance Committee.2017.Part 1 \u2013 aseptic preparations (small molecules). 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