Al Balushi Aisha, Smart David
National Hyperbaric Medicine Centre, Royal Hospital, Muscat, Sultanate of Oman.
Department of Diving and Hyperbaric Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Diving Hyperb Med. 2023 Mar 31;53(1):42-50. doi: 10.28920/dhm53.1.42-50.
Critically ill patients require continuation of their care when receiving hyperbaric oxygen treatment. This care may be facilitated via portable electrically powered devices such as intravenous (IV) infusion pumps and syringe drivers, which may create risks in the absence of a comprehensive safety evaluation. We reviewed published safety data for IV infusion pumps and powered syringe drivers in hyperbaric environments and compared the evaluation processes to key requirements documented in safety standards and guidelines.
A systematic literature review was undertaken to identify English language papers published in the last 15 years, describing the safety evaluations of IV pumps and/or syringe drivers for use in hyperbaric environments. Papers were critically assessed in relation to the requirements of international standards and safety recommendations.
Eight studies of IV infusion devices were identified. There were deficiencies in the published safety evaluations of IV pumps for hyperbaric use. Despite a simple, published process for evaluating new devices, and available guidelines for fire safety, only two devices had comprehensive safety assessments. Most studies focused only on whether the device functioned normally under pressure and did not consider implosion/explosion risk, fire safety, toxicity, oxygen compatibility or risk of pressure damage.
Intravenous infusion (and other electrically powered) devices require comprehensive assessment before use under hyperbaric conditions. This would be enhanced by a publicly accessible database hosting the risk assessments. Facilities should conduct their own assessments specific to their environment and practices.
重症患者在接受高压氧治疗时需要持续护理。这种护理可通过便携式电动设备来辅助,如静脉输液泵和注射器驱动装置,在缺乏全面安全评估的情况下,这些设备可能会带来风险。我们回顾了高压环境下静脉输液泵和电动注射器驱动装置已发表的安全数据,并将评估过程与安全标准和指南中记录的关键要求进行了比较。
进行了一项系统的文献综述,以确定过去15年发表的英文论文,这些论文描述了用于高压环境的静脉输液泵和/或注射器驱动装置的安全评估。根据国际标准的要求和安全建议对论文进行了严格评估。
确定了八项关于静脉输液设备的研究。已发表的用于高压环境的静脉输液泵安全评估存在缺陷。尽管有一个简单的、已发表的新设备评估流程以及消防安全指南,但只有两种设备进行了全面的安全评估。大多数研究仅关注设备在压力下是否正常运行,而未考虑内爆/爆炸风险、消防安全、毒性、氧气兼容性或压力损坏风险。
静脉输液(以及其他电动)设备在高压条件下使用前需要进行全面评估。通过一个可公开访问的承载风险评估的数据库可以加强这一点。各医疗机构应针对其环境和操作进行自身评估。