Nolen-Walston Rose D
Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA 19348, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Dec;22(6):661-5. doi: 10.1111/j.1476-4431.2012.00817.x.
Large animal species in states of shock can require particularly high flow rates for volume resuscitation and the ability to deliver adequate volumes rapidly may be a rate-limiting step. The objective of this study was to determine the maximum flow rates of common combinations of IV catheter, extension set, and fluid administration sets.
University veterinary teaching hospital.
In vitro experimental study.
Maximum flow rates were measured using combinations of 4 IV catheters (3 14-Ga and a single 10-Ga), 2 IV catheter extension sets (small bore and large bore), and 2 types of fluid administration sets (standard 2-lead large animal coiled IV set and nonpressurized 4-lead arthroscopic irrigation set). The catheter, extension sets, and administration sets were arranged in 16 configurations, and flow rates measured in triplicate using tap water flowing into an open receptacle.
Flow rates ranged from 7.4 L/h with an over-the-wire 14-Ga catheter, small-bore extension, and coil set, to 51.2 L/h using a 10-Ga catheter, no extension, and arthroscopic irrigation set. There was an increase of 1.3-8.9% in flow rates between the large- versus small-bore extension sets. Crystalloid delivery in vivo to an adult horse was 21% slower (9.1 L/h versus 11.5 L/h) than the corresponding in vitro measurement.
Extremely high flow rates can be achieved in vitro using large-bore catheters and delivery systems, although the clinical necessity for rates >50 L/h has not been determined. The use of large-bore extension sets resulted in only a minimal increase in flow rate.
处于休克状态的大型动物在进行容量复苏时可能需要特别高的流速,而快速输送足够容量的能力可能是一个限速步骤。本研究的目的是确定静脉导管、延长管和输液器常见组合的最大流速。
大学兽医教学医院。
体外实验研究。
使用4种静脉导管(3根14号和1根10号)、2种静脉导管延长管(细管腔和粗管腔)和2种输液器(标准的双通路大型动物螺旋静脉输液器和无压力的四通路关节镜冲洗器)的组合测量最大流速。将导管、延长管和输液器按16种配置排列,使用流入开口容器的自来水进行三次重复测量流速。
流速范围为使用导丝引导的14号导管、细管腔延长管和螺旋输液器时的7.4升/小时,至使用10号导管、无延长管和关节镜冲洗器时的51.2升/小时。粗管腔延长管和细管腔延长管之间的流速增加了1.3%-8.9%。晶体液在成年马体内的输送速度比相应的体外测量值慢21%(9.1升/小时对11.5升/小时)。
使用大口径导管和输送系统可在体外实现极高的流速,尽管尚未确定流速>50升/小时的临床必要性。使用大口径延长管仅使流速略有增加。