INFLUENCE OF INFUSION-PUMP OPERATION AND FLOW-RATE ON HEMODYNAMIC STABILITY DURING EPINEPHRINE INFUSION

被引:42
|
作者
KLEM, SA
FARRINGTON, JM
LEFF, RD
机构
[1] UNIV KANSAS,MED CTR,DEPT PEDIAT,KANSAS CITY,KS 66103
[2] UNIV KANSAS,MED CTR,DEPT PHARM,KANSAS CITY,KS 66103
关键词
INFUSION PUMPS; EPINEPHRINE; METHOHEXITAL; BLOOD PRESSURE; DRUG DELIVERY SYSTEMS; INFUSIONS; INTRAVENOUS; HEMODYNAMICS; CATECHOLAMINES; CARDIAC EMERGENCIES; CRITICAL ILLNESS;
D O I
10.1097/00003246-199308000-00023
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To determine whether variations in the flow rate of epinephrine solutions administered via commonly available infusion pumps lead to significant variations in blood pressure (BP) in vivo. Design: Prospective, randomized, crossover study with factorial design, using infusion pumps with four different operating mechanisms (pulsatile diaphragm, linear piston/syringe, cyclic piston-valve, and linear peristaltic) and three drug delivery rates (1, 5, and 10 mL/hr). Subjects: Two healthy, mixed-breed dogs (12 to 16 kg). Interventions: Dogs were made hypotensive with methohexital bolus and continuous infusion. BP was restored to normal with constant-dose epinephrine infusion via two pumps at each rate. Measurements: Femoral mean arterial pressure (MAP) was recorded every 10 secs. Pump-flow continuity was quantitated in vitro using a digital gravimetric technique. Variations in MAP and flow continuity were expressed by the coefficient of variation; analysis of variance was used for comparisons. Results: The mean coefficients of variations for MAP varied from 3.8 +/- 3.1% (linear piston/syringe) to 6.1 +/- 6.6% (linear peristaltic), and from 3.4 +/- 2.2% (10 mL/hr) to 7.9 +/- 6.6% (1 mL/hr). The coefficients of variation for in vitro flow continuity ranged from 9 +/- 8% (linear piston-syringe) to 250 +/- 162% (pulsatile diaphragm), and from 35 +/- 44% (10 mL/hr) to 138 +/- 196% (1 mL/hr). Both the type of pump and infusion rate significantly (p < .001) influenced variation in drug delivery rate. The 1 mL/hr infusion rate significantly (p <.01) influenced MAP variation. Cyclic fluctuations in MAP of less-than-or-equal-to 30 mm Hg were observed using the pulsatile diaphragm pump at 1 mL/hr. Conclusion: Factors inherent in the operating mechanisms of infusion pumps may result in clinically important hemodynamic fluctuations when administering a concentrated short-acting vasoactive medication at slow infusion rates.
引用
收藏
页码:1213 / 1217
页数:5
相关论文
共 50 条
  • [1] INFUSION-PUMP OPERATION, FLOW-RATE, AND HEMODYNAMIC STABILITY DURING EPINEPHRINE INFUSION
    CRISP, CB
    LOVY, D
    SLATE, J
    [J]. CRITICAL CARE MEDICINE, 1994, 22 (08) : 1339 - 1340
  • [2] INFUSION-PUMP OPERATION, FLOW-RATE, AND HEMODYNAMIC STABILITY DURING EPINEPHRINE INFUSION - REPLY
    KLEM, SA
    LEFF, RD
    FARRINGTON, JM
    [J]. CRITICAL CARE MEDICINE, 1994, 22 (08) : 1340 - 1340
  • [3] INFLUENCE OF INFUSION RATE AND IV PUMP OPERATION ON HEMODYNAMIC STABILITY DURING EPINEPHRINE INFUSION
    KLEM, SA
    FARRINGTON, JM
    LEFF, RD
    [J]. PEDIATRIC RESEARCH, 1991, 29 (04) : A30 - A30
  • [4] STABILITY OF CEFTRIAXONE SODIUM IN INFUSION-PUMP SYRINGES
    BAILEY, LC
    TANG, KT
    MEDWICK, T
    [J]. AMERICAN JOURNAL OF HOSPITAL PHARMACY, 1993, 50 (10): : 2092 - 2094
  • [5] STABILITY OF GANCICLOVIR SODIUM IN AN INFUSION-PUMP SYRINGE
    MULYE, NV
    TURCO, SJ
    SPEAKER, TJ
    [J]. AMERICAN JOURNAL OF HOSPITAL PHARMACY, 1994, 51 (10): : 1348 - 1349
  • [6] STABILITY OF BUPIVACAINE HYDROCHLORIDE, EPINEPHRINE HYDROCHLORIDE, AND FENTANYL CITRATE IN PORTABLE INFUSION-PUMP RESERVOIRS
    ALLEN, LV
    STILES, ML
    WANG, DP
    TU, YH
    [J]. AMERICAN JOURNAL OF HOSPITAL PHARMACY, 1993, 50 (04): : 714 - 715
  • [7] EFFECT OF INFUSION PUMP AND DRUG DELIVERY RATE FLUCTUATIONS ON HEMODYNAMIC STABILITY IN DOGS RECEIVING EPINEPHRINE
    KLEM, SA
    FARRINGTON, JM
    LEFF, RD
    [J]. CLINICAL RESEARCH, 1990, 38 (03): : A897 - A897
  • [8] CONTINUOUS DELIVERY OF DRUGS BY INFUSION-PUMP - PRESENTATION OF AN INFUSION RATE COMPUTING PROGRAM
    CARAMELLA, JP
    CLAUDE, E
    [J]. ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION, 1994, 13 (06): : 902 - 903
  • [9] STABILITY OF ONDANSETRON HYDROCHLORIDE IN PORTABLE INFUSION-PUMP RESERVOIRS
    STILES, ML
    ALLEN, LV
    FOX, JL
    [J]. AMERICAN JOURNAL OF HOSPITAL PHARMACY, 1992, 49 (06): : 1471 - 1473
  • [10] ELECTRONIC FLOW-RATE CONTROLLER FOR A PORTABLE INSULIN INFUSION PUMP
    FERGUSON, RT
    ZINMAN, B
    MARLISS, EB
    ALBISSER, AM
    [J]. DIABETES CARE, 1980, 3 (02) : 332 - 337