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Performance of modern syringe infusion pump assemblies at low infusion rates in the perioperative setting.
British Journal of Anaesthesia ( IF 9.1 ) Pub Date : 2019-12-19 , DOI: 10.1016/j.bja.2019.10.007 Martina Baeckert 1 , Martin Batliner 2 , Beate Grass 3 , Philipp K Buehler 1 , Marianne Schmid Daners 2 , Mirko Meboldt 2 , Markus Weiss 1
British Journal of Anaesthesia ( IF 9.1 ) Pub Date : 2019-12-19 , DOI: 10.1016/j.bja.2019.10.007 Martina Baeckert 1 , Martin Batliner 2 , Beate Grass 3 , Philipp K Buehler 1 , Marianne Schmid Daners 2 , Mirko Meboldt 2 , Markus Weiss 1
Affiliation
BACKGROUND
Syringe infusion pumps are used for the precise continuous administration of intravenous drugs. Their compliance and mechanical deficiencies have been found to cause considerable start-up delays, flow irregularities during vertical displacement, as well extensive delays of occlusion alarms at low infusion rates. The aim of this study was to evaluate the performance of several modern syringe infusion pumps at low infusion rates and the impact on drug concentration.
METHODS
Seven currently marketed syringe infusion pump assemblies were assessed in an in vitro study during start-up, vertical displacement manoeuvres, and infusion line occlusion at a set flow rate of 1 ml h-1. The measured data were used as input for a pharmacokinetic simulation modelling plasma concentration during a standard neonatal continuous epinephrine infusion.
RESULTS
The mean time from starting the infusion pump to steady-state flow varied from 89 to 1622 s. The zero-drug delivery time after lowering the pump ranged from 145 to 335 s. In all assemblies tested, occlusion alarm delays and measured flow irregularities during vertical displacement manoeuvres resulted in relevant deviations in plasma epinephrine concentration (>25%) as calculated by the pharmacokinetic simulation model.
CONCLUSION
Problems with the performance of syringe infusion pump assemblies can have considerable impact on plasma drug concentration when highly concentrated short-acting cardiovascular drugs are administered at low flow rates. The problems, which affected all assemblies tested, are mainly related to the functional principle of syringe infusion pumps and will only partially be solved by incremental improvements of existing equipment.
中文翻译：
在围手术期低输注速率下，现代注射器输液泵组件的性能。
背景技术注射器输液泵用于精确连续地静脉内给药药物。已经发现它们的柔顺性和机械缺陷会导致相当大的启动延迟，垂直位移过程中的流量不规则，以及在低输注速度时闭塞警报的大量延迟。这项研究的目的是评估几种现代注射器输注泵在低输注速率下的性能以及对药物浓度的影响。方法在设定为1 ml h-1的流速下，在启动，垂直位移操作和输液管路阻塞期间的体外研究中，对七个当前市售的注射器输液泵组件进行了评估。在标准新生儿连续肾上腺素输注过程中，将测得的数据用作建模血浆浓度的药代动力学模拟的输入。结果从启动输液泵到稳态流量的平均时间为89到1622 s。降低泵后的零药物输送时间为145至335 s。在所有测试的组件中，如通过药代动力学模拟模型计算出的，在垂直位移操作期间发生堵塞警报延迟和测得的流量不规则性会导致血浆肾上腺素浓度的相关偏差（> 25％）。结论当以低流速施用高浓度的短效心血管药物时，针筒输液泵组件的性能问题可能会对血浆药物浓度产生相当大的影响。这些问题影响了所有测试的组件，
更新日期：2019-12-19
中文翻译：
在围手术期低输注速率下，现代注射器输液泵组件的性能。
背景技术注射器输液泵用于精确连续地静脉内给药药物。已经发现它们的柔顺性和机械缺陷会导致相当大的启动延迟，垂直位移过程中的流量不规则，以及在低输注速度时闭塞警报的大量延迟。这项研究的目的是评估几种现代注射器输注泵在低输注速率下的性能以及对药物浓度的影响。方法在设定为1 ml h-1的流速下，在启动，垂直位移操作和输液管路阻塞期间的体外研究中，对七个当前市售的注射器输液泵组件进行了评估。在标准新生儿连续肾上腺素输注过程中，将测得的数据用作建模血浆浓度的药代动力学模拟的输入。结果从启动输液泵到稳态流量的平均时间为89到1622 s。降低泵后的零药物输送时间为145至335 s。在所有测试的组件中，如通过药代动力学模拟模型计算出的，在垂直位移操作期间发生堵塞警报延迟和测得的流量不规则性会导致血浆肾上腺素浓度的相关偏差（> 25％）。结论当以低流速施用高浓度的短效心血管药物时，针筒输液泵组件的性能问题可能会对血浆药物浓度产生相当大的影响。这些问题影响了所有测试的组件，
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