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Open Access

Role of biocompatible IV infusion pumps in hemodynamic instability

  • D MouraJr1,
  • M Oliveira1,
  • A GibertoniJr1,
  • L Silva1,
  • A Ferreira1,
  • M Cendoroglo1 and
  • E Knobel1
Critical Care20015(Suppl 3):P24

https://doi.org/10.1186/cc1357

Published: 26 June 2001

Keywords

NorepinephrineNitroprussidePeak FlowperistalticIV PumpSyringe Pump

Biocompatibility is defined as the ability of a material or equipment to perform without inducing a clinically significant response. We started using an IV infusion pump calibrator (BIOTECH) in 1999 for quality control. Very soon we observed that some peristalticIV pumps presented with a phasic variation of flow, although the average flow was well calibrated (and used to be categorized as so). Theoretically, this could have a clinically significant impact in the delivery of vasoactive drugs with fast and short action, such as nitroprusside or norepinephrine. We tested three different brands of pumps, two peristaltic (A, n = 10; and B, n = 13) and one syringe pump (C, n = 5) at a flow of 50 ml/min for 20 min. The average flow was 48.5 ± 3.4 ml/min, 51.6 ± 0.4 ml/min and 52.6 ± 2.0 ml/min, respectively (P < 0.001). We measured the highest and the lowest peak flow in each graph and calculated the maximum percent variation ([max-min]/average flow): 26 ± 7%, 28 ± 7% and 9 ± 3%, respectively (P < 0.001). During the 20 min of observation, the number of phases (plus and minus peaks) was 13.2 ± 2.5, 8.9 ± 4.5 and 16.8 ± 3.0, respectively (P = 0.002). Therefore, pump typeB had the highest variation with phases that lasted longer. The most extreme case was a typeB pump, which showed a 32% variation in flow (from 62 to 46 ml/min) with plateaus lasting for up to 4 min and 27 s. In conclusion, IV infusion pumps may have phasic flow variations with long-lasting plateaus that could have an impact on the delivery of vasoactive drugs, possibly worsening hemodynamic instability.

Authors’ Affiliations

(1)
Centro de Terapia Intensiva do Hospital Israelita Albert Einstein, São Paulo, Brazil

Copyright

© The Author(s) 2001

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