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Flow irregularities from syringe infusion pumps caused by syringe stiction


Peduzzi, Neris; Batliner, Martin; Grass, Beate; Buehler, Philipp K; Schmid Daners, Marianne; Meboldt, Mirko; Weiss, Markus (2020). Flow irregularities from syringe infusion pumps caused by syringe stiction. Paediatric Anaesthesia, 30(8):885-891.

Abstract

Objective: The current study aimed to evaluate the extent of the slide-stick phenomenon in differently designed infusion syringes at various infusion rates and filling positions.

Methods: Fluid delivery from three 50-mL infusion syringe brands (BD; Codan; Fresenius) was investigated using a flow sensor at flow rates of 0.5, 1.0, or 5.0 mL h-1 , with the syringes filled with either 10, 30, or 50 mL of distilled water. Two identical models (A/B) of the same infusion pump model were used. The effect of flow rate variations on the plasma concentration of a continuous epinephrine infusion in a 3 kg neonate receiving a continuous infusion of 0.1 μg kg min-1 epinephrine was studied using a pharmacokinetic simulation model.

Results: Considerable variations in calculated plasma epinephrine concentration were detected between flow rates of 5 and 0.5 or 1 mL h-1 for all syringe types and filling volumes. The median deviation of plasma concentration for the 5 mL h-1 flow rate varied depending on assembly from 1.3% (Codan) to 1.8% (Fresenius). This was more pronounced for lower flow rates, where at 1 mL h-1 the deviation varied from 3.3% (BD) to 4.8% (Fresenius) and at 0.5 mL h-1 from 4.9% (BD) to 5.4% (Fresenius). Differences between filling volumes (within syringe type and flow rate) did not appear to have relevant influence on variations in calculated plasma epinephrine concentration.

Conclusion: Infusion set rate rather than syringe brand or filling volume was a major predictor for syringe stiction-related amount of variation in the calculated plasma epinephrine concentration.

Abstract

Objective: The current study aimed to evaluate the extent of the slide-stick phenomenon in differently designed infusion syringes at various infusion rates and filling positions.

Methods: Fluid delivery from three 50-mL infusion syringe brands (BD; Codan; Fresenius) was investigated using a flow sensor at flow rates of 0.5, 1.0, or 5.0 mL h-1 , with the syringes filled with either 10, 30, or 50 mL of distilled water. Two identical models (A/B) of the same infusion pump model were used. The effect of flow rate variations on the plasma concentration of a continuous epinephrine infusion in a 3 kg neonate receiving a continuous infusion of 0.1 μg kg min-1 epinephrine was studied using a pharmacokinetic simulation model.

Results: Considerable variations in calculated plasma epinephrine concentration were detected between flow rates of 5 and 0.5 or 1 mL h-1 for all syringe types and filling volumes. The median deviation of plasma concentration for the 5 mL h-1 flow rate varied depending on assembly from 1.3% (Codan) to 1.8% (Fresenius). This was more pronounced for lower flow rates, where at 1 mL h-1 the deviation varied from 3.3% (BD) to 4.8% (Fresenius) and at 0.5 mL h-1 from 4.9% (BD) to 5.4% (Fresenius). Differences between filling volumes (within syringe type and flow rate) did not appear to have relevant influence on variations in calculated plasma epinephrine concentration.

Conclusion: Infusion set rate rather than syringe brand or filling volume was a major predictor for syringe stiction-related amount of variation in the calculated plasma epinephrine concentration.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Intensive Care Medicine
04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Pediatrics, Perinatology and Child Health
Health Sciences > Anesthesiology and Pain Medicine
Uncontrolled Keywords:Anesthesiology and Pain Medicine, Pediatrics, Perinatology, and Child Health
Language:English
Date:1 August 2020
Deposited On:21 Oct 2020 10:08
Last Modified:07 Dec 2020 09:13
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1155-5645
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/pan.13926
PubMed ID:32443169

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