Guiffant Gérard, Durussel Jean Jacques, Merckx Jacques, Flaud Patrice, Vigier Jean Pierre, Mousset Patrice
MSC-UMR 7057, Université Paris Diderot, Paris, France.
J Vasc Access. 2012 Jan-Mar;13(1):75-8. doi: 10.5301/JVA.2011.8487.
To compare, under controlled conditions similar to practical situations, the efficacy of pulsed and continuous infusion for flushing IVADs. For both of them different flow rates, flushing volumes, and times were tested.
The PU catheter lumens were filled with a mixture of fibronectin and bovine albumin to simulate physiologic protein depot. Flushing was performed with normal saline. An adapted pump controlled the flow rates. Efficacy was measured by the amount of albumin recovered from the lumen of the tested devices. Flow rate, volumes, and times tested were based upon values reported and/or measured in nursing practices. We compared: (A) single 10 mL bolus and 6 flushing times, (B) continuous infusion of 500 mL in 24 hours, (C) 10 successive boluses 1 mL flushed in 0.5 s each and 6 different time intervals between each bolus. Statistics were performed using the Mann and Whitney U test.
In group A, the maximum percentage of recovered protein (79.1% was achieved with the 10 mL bolus flushed in 2.5. In group B, 77% of protein was recovered at 24h. In group C: maximum efficacy (90 +/- 3%) was obtained when the time interval between 2 boluses was 0.4 s.
We conclude that hydrodynamics has a determinant effect on the efficacy and that the adjunction of an intermittent component in the flow increases it. Flow type and the time interval between 2 boluses are the 2 critical variables.
在类似于实际情况的可控条件下，比较脉冲式输注和连续输注用于冲洗静脉输液辅助装置（IVADs）的效果。对这两种输注方式，分别测试了不同的流速、冲洗量和时间。
聚氨酯（PU）导管内腔填充纤连蛋白和牛血清白蛋白的混合物，以模拟生理性蛋白质储存库。用生理盐水进行冲洗。采用适配的泵控制流速。通过从受试装置内腔回收的白蛋白量来衡量效果。所测试的流速、冲洗量和时间基于护理实践中报告和/或测量的值。我们比较了：（A）单次10 mL推注和6次冲洗时间，（B）24小时内连续输注500 mL，（C）10次连续1 mL推注，每次推注在0.5秒内完成，且每次推注之间有6种不同的时间间隔。采用曼恩 - 惠特尼U检验进行统计学分析。
在A组中，2.5秒内推注10 mL时，回收蛋白质的最大百分比达到79.1%。在B组中，24小时时回收了77%的蛋白质。在C组中：当两次推注之间的时间间隔为0.4秒时，获得了最大功效（90±3%）。
我们得出结论，流体动力学对效果有决定性影响，并且在流动中加入间歇性成分可提高效果。流动类型和两次推注之间 的时间间隔是两个关键变量。
