Kamata Mineto, Walia Hina, Hakim Mumin, Tumin Dmitry, Tobias Joseph D
1Department of Anesthesia, Saitama Children's Medical Center, Saitama, Japan. 2Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH. 3Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH. 4Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH.
Pediatr Crit Care Med. 2017 May;18(5):e224-e228. doi: 10.1097/PCC.0000000000001151.
The current study prospectively evaluates the administration of fluid through commonly used vascular cannulas of various length and diameter.
Observational, in vitro experiment.
Not applicable.
No human subjects.
None.
Fluid (500 mL) was administered via gravity flow and with pressure assistance (pressure bag set at 300 mm Hg) through various vascular cannulas including peripheral IV catheters (22 gauge, 1 inch; 20 gauge, 1.16 and 1.88 inch; and 18 gauge, 1.16 and 1.88 inch), 3-Fr central line lumens (lengths 50, 80, and 120 mm), and a 4-Fr, 10 cm Micropuncture catheter (Cook Medical, Bloomington, IN). During gravity flow, drain time decreased by approximately 50% when moving from a 22 to 20 to 18 gauge cannula and increased by approximately 20% as the catheter length increased from 50 to 80 to 120 cm. Flow rates were highest with the Micropuncture catheter, which achieved a drain time of 2.7 minutes for the 500 mL bag when infused with pressure assistance.
In general, the delivery of crystalloid solutions through commonly used vascular cannulas was fastest with larger diameter and shorter length cannulas. Pressure-assisted flow was able to partially compensate for the increased resistance with smaller and longer catheters. The unique design of the tip of the Micropuncture catheter compensated for the increased length and allowed for rapid fluid delivery. This design may compensate for the increased length when longer catheters are needed for ultrasound-guided placement.
本研究前瞻性评估通过各种长度和直径的常用血管插管进行液体输注的情况。
观察性体外实验。
不适用。
无人类受试者。
无。
通过重力流以及压力辅助(压力袋设置为300毫米汞柱),经各种血管插管输注500毫升液体,这些插管包括外周静脉导管(22号,1英寸;20号,1.16英寸和1.88英寸;18号,1.16英寸和1.88英寸)、3F中心静脉管腔(长度50、80和120毫米)以及一根4F、10厘米的微穿刺导管(库克医疗公司,印第安纳州布卢明顿)。在重力流情况下,从22号插管更换为20号再到18号插管时,排空时间大约减少50%,而随着导管长度从50厘米增加到80厘米再到120厘米,排空时间大约增加20%。微穿刺导管的流速最高,在压力辅助输注时,500毫升袋装液体的排空时间为2.7分钟。
一般来说,通过常用血管插管输注晶体溶液时,直径较大且长度较短的插管速度最快。压力辅助流能够部分补偿较小和较长导管增加的阻力。微穿刺导管尖端的独特设计弥补了长度增加的影响,并实现了快速液体输注。当超声引导放置需要更长导管时,这种设计可能弥补长度增加的问题。