Plus-Hex CLINICAL
Different approaches to cytarabine CRI preparation
Approach 1
Administered at 1 ml / hour over a 24-hour period( 5 ml cytarabine total)
• Total of 24 ml: 5 ml cytarabine plus 19 ml saline.
• Draw up into a UV-light-protected syringe and flush through a UV-light-protected extension line.
• Place in a syringe driver at 1 ml / hour for administration over 24 hours.
• Attach 10 ml of saline to a UV-light-protected extension line to flush the remaining cytarabine through. Run at 1 ml / hour until all the extension line is flushed through( approximately 1.5 ml).
• An appropriate saline bag and giving sets and / or extension lines
• Absorbent pads with waterproof lining( e. g. incontinence sheets)
• Alcohol wipes × 2
• Syringe driver or infusion pump
• 10 ml saline flush × 2
• Cytotoxic labels
• Large drug labels
• Light protection in the form of an opaque plastic bag to drape over the fluid bag( if using a syringe, use a UV-light-protected syringe).
Approach 2
Administered at a maintenance rate of 2 ml / kg / hour over a 24-hour period( 5 ml cytarabine total, 20 kg dog)
• Maintenance rate( 2 ml / kg / hour) over 24 hours = 2 × 20 × 24 = 960 ml.
• Total of 960 ml: 955 ml saline plus 5 ml cytarabine.
• Take a fresh 1,000 ml bag of saline and remove 45 ml. Add 5 ml cytarabine to the remaining 955 ml in the bag to make 960 ml. Gently mix the contents of the bag.
• Attach a UV-light-protected giving set and run the fluid through. Administer at 2 ml / kg for 24 hours.
• When the saline bag is empty, insert 25 ml saline to flush through the remaining cytarabine in the giving set.
Figure 3. Materials for a cytarabine CRI.
It is advisable to collect all the necessary materials before obtaining the cytarabine( Figure 3):
• PPE – gown, gloves, eye protection, respiratory mask and shoe protectors
• CSTD syringes of all sizes and needle-free connectors
Top tip
Collect all materials for a cytarabine CRI set-up and place them in a bag with a laminated list of contents. Include different-sized syringes for different doses. Refill once used, using the laminated sheet as a guide to the required contents.
• A vial spike for the cytarabine
Volume 40( 4) • August 2025
47