Evaluation of cancer drug infusion devices prior to the implementation of a compounding robot

Introduction: Compounding robots are increasingly being implemented in hospital pharmacies. In our hospital, the recent acquisition of a robot (RIVA (TM), ARxIUM) for intravenous cancer drug compounding obliged us to replace the previously used infusion devices. The objective of the present study was to assess and qualify the new intravenous sets prior to their use in our hospital and prior to the implementation of the compounding robot. Materials and Methods: The ChemoLock (TM) (ICU Medical) was compared with the devices used previously for compounding (BD PhaSeal (TM), Becton-Dickinson) and infusion (Connect-Z (TM), Codan Medical). The connection/disconnection of infusion devices to/from 50 mL infusion bags was tested with a dynamometer (Multitest-i, Mecmesin). Leakage contamination was visualized by a methylene blue assay and was quantified in simulated pump infusions with 20 mg/mL quinine sulfate (N = 36/group); after the analytical assay had been validated, quinine was detected by UV-spectrophotometry at 280 and 330 nm. Groups were compared using chi-squared or Mann-Whitney U tests. Results: The connection/disconnection test showed that although all the devices complied with the current standard, there was a statistically significant difference in the mean +/- standard deviation compression force (51.5 +/- 11.6 for the Connect-Z (TM) vs. 60.3 +/- 11.7 for the ChemoLock (TM); p= 0.0005). Leaks were detected in 32 (29.1%) of the 110 tests of the ChemoLock (TM). The contamination rates were also significantly different: 13.9% for the BD PhaSeal (TM) versus 75.0% for the ChemoLock (TM); p < 0.0001). Discussion/conclusion: Our results showed that the new infusion device complied with current standards. However, the presence of contamination emphasizes the need for operators to use the recommended personal protective equipment. Further studies of contamination with cancer drugs are required.