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Product Provides Alternative to IVs for Kids
Amanda Palleschi / St. Louis Post-Dispatch
August 18, 2008
One day in March, Karen Flood rushed into the emergency room at St. John’s Mercy Children’s Hospital drenched in tears and panic.
Her 18-month-old son Jackson was back in the ER with a recurring rotavirus. Three months earlier, Jackson ended up in the hospital for three days for dehydration — a trademark of the condition.
The young mom from St. Charles remembered the first visit: watching as ER doctors and nurses strapped Jackson to a board and held him for 45 minutes while they searched for a tiny vein to hold an IV, hearing him screaming and crying, resisting the imposing-looking needle and IV.
“I thought, ’I’ll do anything for my son, I just don’t want to give him fluids this way and have to spend the night again,’” Flood said.
Jackson got his injection. But this time, there was no staying overnight, no being strapped to a board, no poking around for a vein, no screaming.
Instead, Jackson received an injection that packs the punch of an IV needle without having to find a vein.
Consider that it can take up to 45 minutes to insert an IV into a small child, and that’s if the veins aren’t too dehydrated to collapse. Hospitals recently have tried various ways to ease the giving of IVs to hard-to-stick patients, including an infrared lightlike device that helps locate veins.
The product Jackson got — Hylenex — can be given anywhere where there is enough skin tissue. It takes 30 seconds.
St. John’s Mercy Children’s Hospital was one of 12 hospitals nationwide to participate in a recently concluded clinical trial of Hylenex. Now the injection can be given to any child who comes through the ER. It has a nearly 100 percent success rate, said Laura Kuensting, a pediatric nurse practitioner and clinical nurse specialist at the hospital. Kuensting believes Hylenex will become the standard, perhaps eventually phasing out the traditional IV within the next five years.
Based on research first developed on — and still widely used on — animals, Hylenex works by injecting a human DNA-derived enzyme called hyaluronidase. This enzyme creates a pathway to blood vessels in need of fluids and other medicines commonly injected through an IV. It can be injected into any part of the skin.
The skin-penetrating enzyme, which was discovered in animals in the 1940s, is the same enzyme in bee stings, snakebites and semen. Hylenex now contains only one billionth of a gram of the amount of enzyme contained in those substances.
But the animal enzyme proved highly allergenic when tested on humans. The traditional IV came onto the medical scene in the 1960s, and hyaluronidase testing on humans was halted in the 1990s.
It wasn’t until 2005 that the human gene producing the enzyme was discovered.
“This will really save people from being human pincushions,” Kuensting said. “Most parents and kids have had a wild response.”
Karen Flood counts herself among those parents.
“I told the nurses about what happened to Jackson before and we didn’t even try an IV,” she said. “It just seemed — why would anyone want an IV if you have another opportunity?”
It took 30 seconds to give Jackson the fluids he needed. He sat in his mother’s lap while nurses stuck a Hylenex needle into the skin near his shoulder blade. The tube of fluids was taped to his back, and he went to sleep. He woke up to a juice box and a happy mother.
© YellowBrix 2008
casassy62688
about 1 year ago
288 comments
Wow, I know the medical field makes advances everyday, but that is just cool! Especially if you think about all of things that sould contraindicate a traditional IV. Some examples being dehydration, higher risk for infection, the IV going subqu (which can be very painful), not having a steady vein to hold an IV, etc) so this is great!
Done
about 1 year ago
362 comments
More info needed- found this interesting-
Hylenex
Indications & Dosagefont sizeAAAINDICATIONS
HYLENEX recombinant is indicated as an adjuvant to increase the absorption and dispersion of other injected drugs; for hypodermoclysis; and as an adjunct in subcutaneous urography for improving resorption of radiopaque agents.
DOSAGE AND ADMINISTRATION
HYLENEX recombinant (hyaluronidase human injection) should be administered only as discussed below, since its effects relative to absorption and dispersion of other drugs are not produced when it is administered intravenously.
Absorption and Dispersion of Injected Drugs
Absorption and dispersion of other injected drugs may be enhanced by adding 50-300 U, most typically 150 U hyaluronidase, to the injection solution.
It is recommended that appropriate references be consulted regarding physical or chemical incompatibilities before adding HYLENEX recombinant to a solution containing another drug.
Hypodermoclysis
Insert needle with aseptic precautions. With tip lying free and movable between skin and muscle, begin clysis; fluid should start in readily without pain or lump. Then inject HYLENEX recombinant into rubber tubing close to needle.
An alternate method is to inject HYLENEX recombinant under skin prior to clysis. 150 U will facilitate absorption of 1,000 mL or more of solution. As with all parenteral fluid therapy, observe effect closely, with the same precautions for restoring fluid and electrolyte balance as in intravenous injections. The dose, the rate of injection, and the type of solution (saline, glucose, Ringers, etc.) must be adjusted carefully to the individual patient. When solutions devoid of inorganic electrolytes are given by hypodermoclysis, hypovolemia may occur. This may be prevented by using solutions containing adequate amounts of inorganic electrolytes and/or controlling the volume and speed of administration.
HYLENEX recombinant may be added to small volumes of solution (up to 200 mL), such as small clysis for infants or solutions of drugs for subcutaneous injection. For infants and children less than 3 years old, the volume of a single clysis should be limited to 200 mL; and in premature infants or during the neonatal period, the daily dosage should not exceed 25 mL/kg of body weight; the rate of administration should not be greater than 2 mL per minute. For older patients, the rate and volume of administration should not exceed those employed for intravenous infusion.
Subcutaneous Urography
The subcutaneous route of administration of urographic contrast media is indicated when intravenous administration cannot be successfully accomplished, particularly in infants and small children. With the patient prone, 75 U of HYLENEX recombinant is injected subcutaneously over each scapula, followed by injection of the contrast medium at the same sites.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.
HOW SUPPLIED
HYLENEX recombinant (hyaluronidase human injection) is supplied sterile as 150 USP units of nonpreserved recombinant human hyaluronidase per mL in a single-use 2 mL glass vial with a gray rubber stopper and aluminum flip-off seal.
1 mL Single Dose Vial available in boxes of 1 (NDC 60977-319-02)
1 mL Single Dose Vial available in boxes of 10 (NDC 60977-319-01)
Not Recommended for IV Use.
Store unopened in a refrigerator at 2° to 8°C (36° to 46°F).
DO NOT FREEZE.
Marketed by: Baxter Healthcare Corporation Deerfield, IL 60015 USA
Manufactured for: Halozyme Therapeutics, Inc. San Diego, CA 92121 By Baxter Pharmaceutical Solutions LLc Bloomington, IN 47403
HYLENEX recombinant is a trademark of Baxter International, Inc. or its subsidiaries.
For Product Inquiry 1 800 ANA DRUG (1-800-262-3784) MLT-01xxx/4.0_dk
Fda rev date 12/02/05.