Flow irregularities from syringe infusion pumps caused by syringe stiction

"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" Peduzzi et al (2020).

Abstract:

Objective: The current study aimed to evaluate the extent of the slide-stick phenomenon in differently designed infusion syringesat 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 mLh-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 μgkgmin-1 epinephrine was studied using a pharmacokinetic simulation model.

Results: Considerable variationsin calculated plasma epinephrine concentration were detected between flow rates of 5 and 0.5 or 1 mLh-1 for all syringe types and filling volumes. The median deviation of plasma concentration for the 5 mLh-1 flow rate varieddepending onassembly from 1.3% (Codan) to 1.8% (Fresenius). This was more pronounced for lower flow rates, where at 1 mLh-1 the deviation variedfrom 3.3% (BD) to 4.8% (Fresenius) and at 0.5 mLh-1 from 4.9% (BD) to 5.4% (Fresenius). Differences between filling volumes (within syringe type and flow rate) did not appear to haverelevant 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.

Reference:

Peduzzi, N., Batliner, M., Grass, B., Buehler, P. K., Schmid Daners, M., Meboldt, M., and Weiss, M. (2020) Flow irregularities from syringe infusion pumps caused by syringe stiction. Paediatric Anaesthesia. May 22nd. doi:10.1111/pan.13926. (epub ahead of print).

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