Université Lille Nord de France, Lille, France.
Anesth Analg. 2010 Dec;111(6):1427-31. doi: 10.1213/ANE.0b013e3181f66ee3.
The ability of an infusion set to deliver a specific amount of drug to the patient can be directly related to the presence of an antireflux valve and dead-space volume. In this study we quantified separately the impact of these 2 components on drug delivery.
Various infusion sets were assessed differing in length, in dead-space volume, and with or without an antireflux valve. Noradrenaline was infused with a syringe pump simultaneously with a carrier flow. Effluent drug concentration was measured using ultraviolet spectrophotometry. Flow change efficiency (FCE) was calculated from the ratio of the area under the experimental mass flow rate curve to the area under the theoretical instantaneous mass flow rate curve.
The FCE for infusion sets with or without antireflux valves were significantly different 10 to 15 minutes after the start of an infusion at flow rates of 7 mL/h for noradrenaline and 35 mL/h to 70 mL/h for the carrier fluid. They were not different with a carrier flow of 115 mL/h.
These findings suggest that antireflux valves have a significant impact on FCE when the ratio of drug flow rate to carrier fluid flow rate is high. Infusion sets with very low dead-space volume connectors yield better FCE. There is a nonlinear relationship between dead-space volume and FCE 5 to 10 minutes after the onset of drug infusion.
Care providers must consider dead-space volume and the presence of an antireflux valve when choosing their infusion sets.
输注器将特定剂量的药物输送给患者的能力可以直接与反流阀和死腔体积的存在相关。在这项研究中，我们分别量化了这两个组件对药物输送的影响。
评估了不同长度、不同死腔体积、有或没有反流阀的各种输注器。同时，用注射器泵输注去甲肾上腺素，并带有载体流。使用紫外分光光度法测量流出药物浓度。通过比较实验质量流速曲线下的面积与理论瞬时质量流速曲线下的面积，计算流量变化效率（FCE）。
在去甲肾上腺素流速为 7 毫升/小时和载体流速为 35 毫升/小时至 70 毫升/小时的情况下，输注器带或不带反流阀的 FCE 在输注开始后 10 至 15 分钟时差异显著。当载体流速为 115 毫升/小时时，它们没有差异。
这些发现表明，当药物流速与载体流体流速之比较高时，反流阀对 FCE 有显著影响。具有非常低死腔体积连接器的输注器产生更好的 FCE。在药物输注开始后 5 至 10 分钟，死腔体积与 FCE 之间存在非线性关系。
护理人员在选择输注器时必须考虑死腔体积和反流阀的存在。
