Foinard A, Décaudin B, Barthélémy C, Debaene B, Odou P
Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille 2 University, UDSL, EA GRIIOT, UFR Pharmacie, 59006 Lille, France.
Ann Fr Anesth Reanim. 2013 Sep;32(9):e107-12. doi: 10.1016/j.annfar.2013.06.017. Epub 2013 Aug 16.
Stopping and restarting carrier fluid flow and performing simultaneous drug infusions can lead to hazardous disturbances in drug delivery. The present study was designed to assess in vitro whether using a multi-lumen infusion access device could prevent noradrenaline disturbances.
In vitro laboratory work.
Two infusion devices were studied: a standard device with a four-port manifold and a 150cm extension line and a nine-lumen infusion device (Edelvaiss-Multiline(®)) with eight accesses connected to nine separate lumens in a single tube of 150cm: seven accesses connected to seven peripheral lumens and one for the carrier fluid access connected to two lumens. Two experimental protocols of noradrenaline infusion were made: (a) drug flow rate change and (b) stop-and-go carrier fluid flows. Two parameters were studied: drug mass flow rate and flow change efficiency (FCE) 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.
Variations in noradrenaline mass flow rate were more rapid with the Edelvaiss-Multiline(®) when the noradrenaline infusion rate was increased or decreased. FCE was significantly different from one infusion device to the other during both noradrenaline flow rate increase (standard vs. nine-lumen: 58% vs. 84%; P=0.008) and decrease (175% vs. 108%; P=0.008). Decreased drug delivery after stopping carrier fluid flow (standard vs. nine-lumen: 21% vs. 98%; P=0.008) and sudden temporary increases on resumption (253% vs. 103%; P=0.008) were reduced in magnitude and duration when using the Edelvaiss-Multiline(®) with a significant difference in FCE between the two infusion devices.
Using the nine-lumen infusion device reduces drug delivery disturbances during continuous intravenous infusion.
停止和重新启动载液流动以及同时进行药物输注可能会导致药物输送出现危险的干扰。本研究旨在体外评估使用多腔输液接入装置是否可以预防去甲肾上腺素干扰。
体外实验室研究。
研究了两种输液装置：一种是带有四端口歧管和150厘米延长线的标准装置，另一种是九腔输液装置（Edelvaiss-Multiline(®)），其八个接入端口连接到一根150厘米长单管中的九个独立管腔：七个接入端口连接到七个外周管腔，一个用于载液接入端口连接到两个管腔。制定了两种去甲肾上腺素输注的实验方案：（a）药物流速变化和（b）载液的启停流动。研究了两个参数：药物质量流速和流动变化效率（FCE），FCE通过实验质量流速曲线下面积与理论瞬时质量流速曲线下面积之比计算得出。
当去甲肾上腺素输注速率增加或降低时，使用Edelvaiss-Multiline(®)时去甲肾上腺素质量流速的变化更快。在去甲肾上腺素流速增加（标准装置与九腔装置：58%对84%；P = 0.008）和降低（175%对108%；P = 0.008）过程中，两种输液装置的FCE存在显著差异。停止载液流动后药物输送减少（标准装置与九腔装置：21%对98%；P = 0.008）以及恢复时突然出现的暂时增加（253%对103%；P = 0.008），在使用Edelvaiss-Multiline(®)时，其幅度和持续时间均减小，且两种输液装置之间的FCE存在显著差异。
使用九腔输液装置可减少持续静脉输注过程中的药物输送干扰。
