Delivery of erythropoietin with a needleless injection system during hemodialysis maintains plasma levels

Recent Occupational Safety and Health Administration guidelines require the implementation of needleless systems in dialysis units in the state of California. It is not known whether needleless systems deliver medication as well as traditional low dead-space needle/syringes. The purpose of this study was to compare the delivery of recombinant human erythropoietin (rHuEpo) by a needleless system (Medic Plastic Anti-Stick Needle/Connector, Medisystems, Seattle, WA) with delivery using a traditional low dead-space needle/syringe. We also studied the Medisystems High Flow venous chamber with integral injection site that is designed to prevent the formation of a separate serum layer within which rHuEpo may become trapped. There was no significant difference in the mean serum rHuEpo concentration achieved by either the needleless system, or traditional low dead-space needle/syringe, whether using the venous chamber's integral injection site or the postvenous chamber in-line injection site. This study demonstrates for the first time that a needleless system of delivery can reliably achieve serum rHuEpo comparable to traditional low dead-space needle/syringes.