Landow L, Shahnarian A
Department of Anesthesiology, University of Massachusetts Medical Center, Worcester 01655.
Crit Care Med. 1990 May;18(5):540-3. doi: 10.1097/00003246-199005000-00016.
We tested the hypothesis that large-bore iv tubing sets provide greater in vitro flow rates than conventional sets currently utilized for the administration of normal saline. The study was conducted in two parts. First, flow rates were measured using a conventional iv tubing set under gravity and 300 mm Hg of pressure, and four large-bore iv tubing sets under gravity. Additional measurements were made after attaching various catheters and sheaths ranging in size from 14 ga to 9 Fr. Five trials were conducted for each combination. Second, we measured the amount of time taken in a mock drill by 28 randomly chosen anesthesiology residents and staff to load a unit of packed RBC into a pressure infusor bag, inflate to 300 mm Hg, and deflate to ambient pressure. Data were analyzed for individual tubing sets as a whole and individual catheter-tubing set combinations, using the Mann-Whitney U test with Bonferroni adjustment. Statistically significant (p less than .03) differences in flow rates were noted between the conventional set under gravity compared with both the pressurized conventional set and the large-bore tubing sets under gravity. There was no statistical difference in flow rates between pressurized conventional iv sets and large-bore iv sets. Mean time necessary for the 28 anesthesiology staff and residents to pressurize and deflate a conventional tubing set was 65 sec/bag of packed RBC. We conclude that a considerable amount of time can be saved by utilizing large-bore iv tubing sets instead of conventional pressurized sets during massive volume resuscitation. Clinical trials are indicated to corroborate these results.
大口径静脉输液管组在体外的流速比目前用于输注生理盐水的传统输液管组更快。该研究分两部分进行。首先，使用传统静脉输液管组在重力作用下以及300毫米汞柱压力下测量流速，同时使用四套大口径静脉输液管组在重力作用下测量流速。在连接从14号到9法式不同尺寸的各种导管和护套后进行了额外测量。每种组合进行了五次试验。其次，我们测量了28名随机挑选的麻醉科住院医师和工作人员在模拟演练中，将一单位浓缩红细胞装入压力输液袋、充压至300毫米汞柱然后放气至常压所需的时间。使用经Bonferroni校正的Mann-Whitney U检验，对整个单个输液管组以及单个导管-输液管组组合的数据进行了分析。在重力作用下的传统输液管组与加压传统输液管组以及重力作用下的大口径输液管组之间，流速存在统计学显著差异（p小于0.03）。加压传统静脉输液管组和大口径静脉输液管组之间的流速没有统计学差异。28名麻醉科工作人员和住院医师对传统输液管组进行加压和放气所需的平均时间为每袋浓缩红细胞65秒。我们得出结论，在大量液体复苏期间，使用大口径静脉输液管组而非传统加压输液管组可节省大量时间。需要进行临床试验来证实这些结果。
