Comparison of Dosing Accuracy Between the ENFit LDT and a Neonatal-Specific ISO-Compliant Enteral Syringe

Abstract

OBJECTIVE To evaluate the dosing accuracy of 2 female enteral syringe types for use in neonates. METHODS This was an in vitro study evaluating dosing accuracy of ENFit with low dose tip (LDT) and Nutrisafe2 (NS2) syringes. Acceptable dosing variance (DV) was +/− 10%. Outcomes included tests exceeding 10% DV and DV by syringe size, dispensing source, and intended dosing volume. RESULTS A total of 300 tests were performed (LDT = 150, NS2 = 150) with 3 syringe sizes (0.5, 1, 3 or 2.5 mL). Compared with NS2, LDT had significantly more tests with unacceptable DV (48% vs 4.7%, p < 0.0001) and higher absolute DV (11.9% vs 3.5%, p < 0.001). Dosing variance was inversely proportional to syringe size, where the smallest syringes were least accurate (0.5 mL LDT 16.1% vs 4.6%, p < 0.001). The largest syringes had acceptable DV (3 mL LDT 8.8% vs 2.5 mL NS2 3.3%, p < 0.001). Bulk bottle with adapters demonstrated a higher DV with LDT compared with NS2 (13.3% vs 3.9%, p < 0.001). Medication cups without adapters were associated with acceptable DV for both LDT and NS2 (9.7% vs 2.9%, p < 0.001). CONCLUSIONS The Nutrisafe2 syringe has greater dosing accuracy as compared with ENFit LDT syringe. Smaller syringes are associated with greater dosing inaccuracy, but this effect was within acceptable DV for the NS2 syringe. Bulk bottle adapters did not improve the accuracy of the LDT. More clinical evaluations are needed to determine if the ENFit can be safely used in the neonatal population.