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两种不同PCA泵在儿科低流速情况下与泵杆位置相关的输注不准确易感性——一项实验研究

Susceptibility of two different PCA pumps to inaccurate delivery associated with pole position at low flow-rates in a pediatric setting - an experimental study.

作者信息

Riemer Judith E, Greber Nathalie C, Frühauf Melanie, Weiss Markus, Piegeler Tobias

机构信息

Department of Anesthesiology and Intensive Care, University of Leipzig Medical Center, Liebigstrasse 20, Leipzig, Germany.

Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.

出版信息

J Clin Monit Comput. 2025 Apr;39(2):469-479. doi: 10.1007/s10877-024-01233-3. Epub 2024 Oct 12.

Abstract

PURPOSE

Vertical displacement of infusion pumps used in patient-controlled analgesia can cause irregularities in drug delivery and is especially crucial at low flow rates, which are commonly used in pediatrics. There is only scarce data available regarding the extent of these inaccuracies. The current in vitro study therefore aimed at a comparison of the performance of two commonly used PCA pumps at different pole positions due to vertical displacement.

METHODS

The Syramed µSP6000 Chroma syringe infusion pump featuring a stepper motor drive was compared to the CADD-Solis pump utilizing a linear peristaltic pump system at two different flow rates (0.3 ml/h and 1 ml/h) and three different levels of height (0, + 50 and - 50 cm). Flow patterns and delivered volumes were measured after every change in position and infusion boluses, retrograde aspiration volumes and zero-drug delivery time were calculated.

RESULTS

The Syramed pump was more susceptible to vertical displacement than the CADD-Solis pump and showed overall greater inaccuracies in the delivered volumes as well as higher infusion boluses, retrograde aspiration volumes and zero-drug delivery time at both flow rates.

CONCLUSION

The observed differences between the pumps might be explained by the higher compliance of this syringe pump and the diverse working mechanisms. Overall, the CADD-Solis pump might be considered a preferable option for patient-controlled analgesia in children. It is nonetheless essential for medical staff to be aware of the effects of vertical displacement of PCA pumps and to minimize these displacements as much as possible.

摘要

目的

患者自控镇痛中使用的输液泵垂直位移会导致药物输送不规律,在儿科常用的低流速情况下尤为关键。关于这些不准确性的程度,现有数据非常有限。因此,当前的体外研究旨在比较两种常用PCA泵在因垂直位移而处于不同杆位时的性能。

方法

将采用步进电机驱动的Syramed µSP6000 Chroma注射器输液泵与采用线性蠕动泵系统的CADD-Solis泵在两种不同流速(0.3毫升/小时和1毫升/小时)以及三个不同高度水平(0、+50和 -50厘米)下进行比较。每次位置和输液推注变化后测量流速模式和输送体积,并计算逆行抽吸体积和零药物输送时间。

结果

Syramed泵比CADD-Solis泵更容易受到垂直位移的影响,并且在两种流速下,其输送体积的总体误差更大,输液推注量、逆行抽吸体积和零药物输送时间更高。

结论

泵之间观察到的差异可能是由于这种注射器泵的顺应性更高以及工作机制不同所致。总体而言,CADD-Solis泵可能被认为是儿童患者自控镇痛的更优选择。尽管如此,医护人员必须意识到PCA泵垂直位移的影响,并尽可能减少这些位移。

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