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评估市售过滤器在去除静脉输液系统中空气微栓子方面的效果。

Assessing the Efficacy of Commercially Available Filters in Removing Air Micro-Emboli in Intravenous Infusion Systems.

作者信息

Lee Subin, Bulsara Ketan R

机构信息

UConn School of Medicine; and UConn Health Division of Neurosurgery, Farmington, Connecticut.

出版信息

J Extra Corpor Technol. 2020 Jun;52(2):118-125. doi: 10.1182/ject-1900037.

Abstract

The presence of gaseous air emboli in the vasculature has the potential to cause significant morbidity and mortality. Once viewed as a rare complication of high-risk surgeries, air embolism is now also being associated with even minor and routine procedures such as peripheral venous catheterization. With increasing recognition, various preventive measures have emerged, the most important of which is the use of air-eliminating filters. However, studies on these devices are currently lacking. Therefore, in this present study, we aimed to evaluate the effectiveness of two commercially available filters in removing air within intravenous (IV) lines. An IV infusion system was created, designed to resemble standard conditions used in real clinical practice. Testing was completed using a .9% NaCl solution at room temperature with a flow rate set at 75 mL/h and involving three different filter orientations. The test bed was configured to inject air every 2 minutes with volumes ranging between 5 and 600 μL. The two filter models tested were GVS .2-μM and Braun SUPOR membrane air-eliminating filters. Data was collected at pre-filter and post-filter sites. The Braun SUPOR membrane filter (B Braun, Bethlehem, PA) reduced air micro-emboli by 100.0% ( < .0001) both by volume and count compared with -.6 ± 3.5% by volume and -.8 ± 1.5% by count for the control. The reduction seen with the GVS .2-μM filter was 99.8 ± .2% ( < .0001) by volume and 86.2 ± 21.1% ( < .0001) by count compared with the control. There was no statistically significant difference in the removal efficacy between the two filter models. As the use of air-eliminating filters becomes a common standard of care, establishing the validity of the commercially available filter models is important to minimize the risk of vascular air embolism.

摘要

血管系统中存在气态空气栓子有可能导致严重的发病和死亡。空气栓塞曾经被视为高风险手术的罕见并发症,现在也与诸如外周静脉置管等甚至轻微和常规的操作相关联。随着认识的增加,出现了各种预防措施,其中最重要的是使用排气过滤器。然而,目前缺乏关于这些装置的研究。因此,在本研究中,我们旨在评估两种市售过滤器在去除静脉(IV)管路内空气方面的有效性。创建了一个IV输液系统,其设计类似于实际临床实践中使用的标准条件。在室温下使用0.9%的NaCl溶液进行测试,流速设定为75 mL/h,涉及三种不同的过滤器方向。测试台配置为每2分钟注入一次空气,体积范围在5至600 μL之间。测试的两种过滤器型号是GVS 0.2-μm和贝朗SUPOR膜排气过滤器。在过滤器前和过滤器后部位收集数据。与对照组相比,贝朗SUPOR膜过滤器(B Braun,宾夕法尼亚州伯利恒)在体积和数量上均将空气微栓子减少了100.0%(P <.0001),而对照组在体积上减少了-0.6±3.5%,在数量上减少了-0.8±1.5%。与对照组相比,GVS 0.2-μm过滤器在体积上减少了99.8±0.2%(P <.0001),在数量上减少了86.2±21.1%(P <.0001)。两种过滤器型号在去除效果上没有统计学显著差异。随着排气过滤器的使用成为一种常见的护理标准,确定市售过滤器型号的有效性对于将血管空气栓塞的风险降至最低很重要。

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