We aimed to investigate flow rates through modern intravenous access devices using an in vitro system” Khoyratty et al (2016).
Abstract:
STUDY OBJECTIVE: Fluid administration using intravenous (IV) access devices is required in many settings. There are a lack of quantitative data comparing traditional cannulas and modern access devices. We aimed to investigate flow rates through modern intravenous access devices using an in vitro system.
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DESIGN: This is an experimental study.
SETTING AND MEASUREMENTS: Rates of flow of intravenous fluids (crystalloid and colloid) were measured through various access devices using a uroflowmeter. Standardized conditions and repeat measurements ensured validity. Fluid was administered with or without the addition of a pressure bag and needle-free valve.
MAIN RESULTS: Increasing the size of cannulas improved flow. Fourteen-gauge cannulas had significantly higher mean flow rates compared to 14G central venous lines in all conditions (136% higher with no pressure bag/valve; 95% CI, +130% to +152%; P < .001). Both the emergency infusion device and rapid infusion catheter produced significantly increased mean flows compared to a 14G cannula (12% higher for emergency infusion catheter; 95% CI, +7% to +15%; P = .008, and 15% higher for rapid infusion catheter; 95% CI, +12% to +21%; P = .004). The needle-free valve significantly impaired flow on 16G and wider IV access devices (36% lower with no pressure bag using 14G cannula; 95% CI, -29% to -46%; P = .003), but flow reductions in narrower IV access were insignificant. Pressure bags significantly improved flow in all devices, in all combinations.
CONCLUSIONS: Flow rates in IV devices can be maximized by pressure bag use and removal of needle-free valves. The rapid infusion catheter and emergency infusion catheter allow some increase in flow over a 14G cannula. Familiarity with varying flow rates across IV access devices could better inform clinical decisions.
Reference:
Khoyratty, S.I., Gajendragadkar, P.R., Polisetty, K., Ward, S., Skinner, T. and Gajendragadkar, P.R. (2016) Flow rates through intravenous access devices: an in vitro study. Journal of Clinical Anesthesia. 31, p.101-5.
doi: 10.1016/j.jclinane.2016.01.048.
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