J Patient Saf. 2021 Jan 1;17(1):e15-e19. doi: 10.1097/PTS.0000000000000645.
Syringe drivers are the principle method of giving small-volume continuous infusions of important drugs to patients. Many of these drugs are critical for the maintenance of normal physiology. Anecdotal evidence abounds of severe patient instability on movement of syringe drivers during infusion. We aimed to define the variation in drug delivery seen in three syringe drivers, with changes in relative height between the syringe driver and the end of the giving set.
Three syringe drivers (Alaris CC [Becton Dickinson], Perfusor Space [B Braun], and Synamed μSP6000 [Arcomed]) were analyzed for reliability of flow at 0.5, 1, 2, and 5 mL/h.
This is an in vitro investigation.
A small air bubble was introduced into the giving set, and the progression of this was documented before and after a vertical movement of the syringe driver by 25 or 50 cm upward or downward relative to the delivery port.
For all pumps, delivery was interrupted on movement of the pumps downward, and a bolus was given with movement of the pump upward. Delivery halted at lower pump speeds for longer than higher pump speeds. The maximum delivery interruption was 11.8 minutes. Boluses given on moving the pump up were calculated as the equivalent number of minutes needed to deliver the bolus volume at steady state. The maximum bolus given was equivalent to 15.8 minutes of delivery. We were unable to eliminate the effects seen by very slow, steady movement of the pumps up or down. Static height differences made no difference to delivery.
Syringe drivers should not be moved vertically in relation to the patient. Critical drug delivery is interrupted for up to 12 minutes with relative downward movements, and significant boluses of drugs are given with relative upward movements. As far as possible, elimination of relative height movements is advised, and extreme caution is necessary if any movements are unavoidable.
注射器驱动器是向患者给予小体积连续输注重要药物的主要方法。这些药物中有许多对于维持正常生理机能至关重要。大量传闻证据表明，在输注过程中移动注射器驱动器会导致患者严重不稳定。我们旨在定义在注射器驱动器和给药装置末端之间的相对高度发生变化时，三种注射器驱动器中观察到的药物输送变化。
分析了三种注射器驱动器（Becton Dickinson 的 Alaris CC、B Braun 的 Perfusor Space 和 Arcomed 的 Synamed μSP6000）在 0.5、1、2 和 5 mL/h 的流速下的可靠性。
这是一项体外研究。
在给药装置中引入一个小气泡，并在注射器驱动器相对于输送端口向上或向下移动 25 或 50 cm 前后记录气泡的推进情况。
对于所有的泵，当泵向下移动时，输送会中断，当泵向上移动时会给予一个脉冲。在较低的泵速下，输送停止的时间比在较高的泵速下更长。最大输送中断时间为 11.8 分钟。在向上移动泵时给予的脉冲量被计算为以稳态输送脉冲体积所需的等效分钟数。给予的最大脉冲量相当于 15.8 分钟的输送量。我们无法消除泵非常缓慢、稳定地上下移动所产生的影响。静态高度差异对输送没有影响。
注射器驱动器不应相对于患者垂直移动。相对向下移动会中断关键药物输送长达 12 分钟，相对向上移动会给予大量药物脉冲。应尽可能消除相对高度的移动，如果不可避免，应特别小心。
