Universidad de Chile, Santiago de Chile, Chile.
Pediatr Crit Care Med. 2010 Mar;11(2):282-6. doi: 10.1097/PCC.0b013e3181c31848.
To evaluate the impact of syringe size on start-up delay and the time to reach 50% and 90% of target flow rates, using two commercially available syringe infusion pumps at infusion rates of < or =1 mL/hr.
Two syringes (Terumo) of different size (10-mL and 50-mL), using two syringe infusion pumps (Pump A, Terumo Terufusion Infusion Pump TE-331; and Pump B, Braun Perfusor Compact S) were studied. Effective fluid delivery was measured at 0.4 mL/hr, 0.8 mL/hr, and 1.0 mL/hr for the initial 60 mins, using the gravimetric method. Instant flow was calculated as volume difference for every 1-min interval per minute. Start-up delay was defined as time in minutes of 0 flow from the start of infusion. Syringe placement, bubble removal, infusion line priming, and positioning were standardized for all measurements, using new syringes and infusion lines. Each experiment was repeated six times. Statistical analysis was performed, using a nonparametric test (Mann-Whitney U test).
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Using the 50-mL syringe, the start-up delay was consistently higher and the time to reach 50% and 90% of target flow were significantly longer, independent of which syringe infusion pump was used. At every flow rate studied, the pumps did not reach the target flow rate before 60 mins with the 50-mL syringe. With the 10-mL syringe, target flow rate was achieved before 20 mins for both pumps.
Our findings demonstrate a clinically relevant impact of syringe size on syringe infusion pump performance at low flow rates. The time to reach 50% and 90% of target flow are significantly longer, using the 50-mL syringe compared with the 10-mL syringe, and the time to reach 50% of target flow is independent of the longer start-up delay. Based on our findings, we speculate that smaller syringe sizes and higher infusion rates are preferable for continuous drug infusions, particularly when prompt establishment of the drug effect is critical.
评估在输注速率为 < 或 =1 毫升/小时时，使用两种市售注射器输注泵，注射器大小对启动延迟以及达到目标流速的 50%和 90%所需时间的影响。
使用两种不同大小的注射器（Terumo，10 毫升和 50 毫升）和两种注射器输注泵（A 泵，Terumo Terufusion 输液泵 TE-331；B 泵，Braun Perfusor Compact S）进行研究。在最初的 60 分钟内，使用重量法在 0.4 毫升/小时、0.8 毫升/小时和 1.0 毫升/小时的输注速率下测量有效液体输送。瞬时流速被计算为每分钟每 1 分钟间隔的体积差。启动延迟定义为从输注开始到 0 流量的分钟数。为所有测量值标准化了注射器放置、气泡去除、输液管路预充和定位，使用新的注射器和输液管路。每个实验重复六次。使用非参数检验（Mann-Whitney U 检验）进行统计分析。
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使用 50 毫升注射器，启动延迟始终较高，达到目标流速的 50%和 90%所需的时间明显更长，与使用哪种注射器输注泵无关。在研究的每个流速下，50 毫升注射器在 60 分钟前都未达到目标流速。使用 10 毫升注射器，两台泵在 20 分钟内都达到了目标流速。
我们的研究结果表明，注射器大小对低流速下注射器输注泵性能具有临床相关影响。与 10 毫升注射器相比，使用 50 毫升注射器达到目标流速的 50%和 90%所需的时间明显更长，达到目标流速的 50%所需的时间与较长的启动延迟无关。根据我们的发现，我们推测，在需要快速建立药物作用的情况下，较小的注射器尺寸和较高的输注速率更适合连续药物输注。
