Xu Zeping, Jin Lingyan, Smith Byron, Bai Yiping, Luo Haoxiang, Strombergsson Lars Axel, Fei Min, Jiang Yandong
Department of Anesthesiology, Jiangsu Cancer Hospital, Nanjing, China.
Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Drive, 4648 TVC, Nashville, TN, 37232-5614, USA.
J Clin Monit Comput. 2018 Dec;32(6):1041-1047. doi: 10.1007/s10877-018-0114-7. Epub 2018 Feb 17.
Efficient air removal from a vascular access line is a key step to prevent air embolism. Existing devices, especially for rapid infusers, are far from optimum. In this study, we developed a novel device, vascular access line air removal device (VALARD), and compared its efficiency of air removal and pause time of forward bulk flow with a commonly used device, the Belmont pump. Part I experiment, saline was infused at a forward bulk flow rate of 250, 500, and 750 mL/min. Meanwhile, air was introduced into the infusion line at a rate of 5, 10, and 15 mL/min for each bulk flow rate. Air bubbles > 10 µL downstream from either the VALARD or the Belmont pump and the fraction of pause time of the forward bulk flow were determined. Part II experiment, 120 mL of air was rapidly introduced into the VALARD at a bulk flow rate of about 500 mL/min. Air bubbles > 10 µL downstream from the VALARD, fraction of pause time of the forward bulk flow, and the transit time of the 120 mL of air at the working chamber were recorded. The VALARD: no air bubbles > 10 µL were detected during any tested combination of air injection and bulk flow rates without pause of forward flow. The Belmont pump: air bubbles > 10 µL were detected in 60% of the tests with pause of the forward flow. The VALARD eliminates air efficiently without pause of the forward bulk flow. Further clinical trials are needed to compare the VALARD with other devices and to assess its efficiency, safety, and user friendliness.
从血管通路中有效排出空气是预防空气栓塞的关键步骤。现有的设备，尤其是快速输液器，远非最佳。在本研究中，我们开发了一种新型设备——血管通路空气去除装置（VALARD），并将其空气去除效率和正向大流暂停时间与常用设备贝尔蒙特泵进行了比较。实验一，以250、500和750毫升/分钟的正向大流速率输注生理盐水。同时，对于每个大流速率，以5、10和15毫升/分钟的速率将空气引入输液管路。测定VALARD或贝尔蒙特泵下游大于10微升的气泡以及正向大流的暂停时间比例。实验二，以约500毫升/分钟的大流速率将120毫升空气快速引入VALARD。记录VALARD下游大于10微升的气泡、正向大流的暂停时间比例以及120毫升空气在工作室的通过时间。VALARD：在任何测试的空气注入和大流速率组合中，均未检测到大于10微升的气泡，且正向流无暂停。贝尔蒙特泵：在60%的测试中检测到大于10微升的气泡，正向流有暂停。VALARD能有效去除空气，且正向大流无暂停。需要进一步的临床试验来将VALARD与其他设备进行比较，并评估其效率、安全性和用户友好性。
