Weiss Markus, Wendel-Garcia Pedro David, Cannizzaro Vincenzo, Kleine-Brueggeney Maren
Department of Anesthesia, University Children's Hospital, Zurich, Switzerland.
Department of Intensive Care, University Hospital, Zurich, Switzerland.
Paediatr Anaesth. 2025 Feb;35(2):118-124. doi: 10.1111/pan.15031. Epub 2024 Nov 7.
Connecting an infusion line to a closed stopcock results in pressurization of fluid within the syringe infusion pump assembly leading to flow irregularities when opening the stopcock and activating the pump.
It was the purpose of this study to assess the extent of pressurization under different conditions and its impact on start-up fluid delivery.
Intraluminal pressures and start-up fluid delivery at 1 mL/h flow rate were assessed with connection of the infusion line 1 min (delayed connection) or immediately after purging (immediate connection) using two different infusion lines made from polyvinylchloride (PVC) or polyethylene (PE).
Delayed connection resulted in an increase of intraluminal pressures from zero to 5.1 [4.5 to 5.7] mmHg with the PVC line and from zero to 47.1 [44.8 to 49.3] mmHg with the PE line (mean difference 42.0 [95% CI 39.3-44.7] mmHg; p < .0001). Immediate connection resulted in an increase of intraluminal pressures from zero to 44.3 [41.8-46.8] mmHg with the PVC line and from zero to 61.3 [57.2-65.4] mmHg with the PE line (mean difference 17.0 [95% CI 11.8-22.2] mmHg; p < .0001). The increase in intraluminal pressures was significantly higher with PE lines for both delayed and immediate connection when compared to the PVC lines (mean difference 29.5 [95% CI 19.3-39.7] mmHg; p < .0001). Related fluid volumes delivered at 10 s and 360 s after starting the pump ranged from -252% to 1321% (10 s) of expected infusion volumes and from 59% to 129% (360 s), respectively.
Both, timing of infusion line connection after purging and infusion line characteristics considerably affect intraluminal pressures and start-up fluid delivery when connecting a new syringe infusion pump assembly to a closed stopcock. Consecutive alterations in drug administration can have considerable hemodynamic consequences when dealing with catecholamine infusions in critically ill patients.
将输液管路连接至封闭的旋塞阀会导致注射器输液泵组件内的液体增压，从而在打开旋塞阀并启动泵时导致流量不规则。
本研究旨在评估不同条件下的增压程度及其对启动时液体输送的影响。
使用由聚氯乙烯（PVC）或聚乙烯（PE）制成的两种不同输液管路，在输液管路连接1分钟（延迟连接）或冲洗后立即连接（立即连接）的情况下，评估管腔内压力以及流速为1mL/h时的启动液体输送情况。
延迟连接导致PVC管路的管腔内压力从零增加到5.1[4.5至5.7]mmHg，PE管路的管腔内压力从零增加到47.1[44.8至49.3]mmHg（平均差值42.0[95%CI 39.3 - 44.7]mmHg；p <.0001）。立即连接导致PVC管路的管腔内压力从零增加到44.3[41.8 - 46.8]mmHg，PE管路的管腔内压力从零增加到61.3[57.2 - 65.4]mmHg（平均差值17.0[95%CI 11.8 - 22.2]mmHg；p <.0001）。与PVC管路相比，延迟连接和立即连接时，PE管路的管腔内压力增加均显著更高（平均差值29.5[95%CI 19.3 - 39.7]mmHg；p <.0001）。启动泵后10秒和360秒时输送的相关液体量分别为预期输液量的 - 252%至1321%（10秒）和59%至129%（360秒）。
在将新的注射器输液泵组件连接至封闭的旋塞阀时，冲洗后输液管路连接的时机以及输液管路的特性均会显著影响管腔内压力和启动时的液体输送。在危重症患者中处理儿茶酚胺输注时，连续的药物给药改变可能会产生相当大的血流动力学后果。
