Abstract
Start-up delays of syringe pump assemblies can impede the timely commencement of an effective drug therapy when using microinfusions in hemodynamically unstable patients. The application of the venting principle has been proposed to eliminate start-up delays in syringe pump assemblies. However, effectively delivered infusion volumes using this strategy have so far not been measured. This invitro study used two experimental setups to measure the effect of the venting principle compared to a standard non-venting approach on delivered start-up infusion volumes at various timepoints, backflow volumes, flow inversion and zero drug delivery times by means of liquid flow measurements at flow rates of 0.5, 1.0 and 2.0 mL/h. Measured delivered initial start-up volumes were negative with all flow rates in the vented and non-vented setup. Maximum backflow volumes were 1.8 [95% CI 1.6 to 2.3] times larger in the vented setup compared to the non-vented setup (p < 0.0001). Conversely, times until flow inversion were 1.5 [95% CI 1.1 to 2.9] times shorter in the vented setup (p < 0.002). This led to comparable zero drug delivery times between the two setups (p = 0.294). Start-up times as defined by the achievement of at least 90% of steady state flow rate were achieved faster with the vented setup (p < 0.0001), but this was counteracted by the increased backflow volumes. The application of the venting principle to the start-up of microinfusions does not improve the timely delivery of drugs to the patient since the faster start-up times are counteracted by higher backflow volumes when opening the three-way stopcock.
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Disposable and capital infusion equipment used in this study were kindly provided by BD. The authors declare that no other support, funds, or grants were received for conducting the study and preparation of this manuscript.”
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All authors substantially contributed to conception and design of the study. Material preparation, data collection and analysis were performed by MW and PDWG. The first draft of the manuscript was written by MW and MKB. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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MW serves as a consultant for medical device industries and has received consultant honoraria from BD. MW is co-founder of Silberspross GmbH Zurich, Switzerland, an innovation company advancing safety of intravenous drug therapy holding a patent on a new infusion access port. All other authors have no relevant financial or non-financial interests to disclose.
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Weiss, M., Wendel-Garcia, P.D., Cannizzaro, V. et al. Evaluation of the venting principle to reduce start-up delays in syringe infusion pumps used for microinfusions. J Clin Monit Comput 38, 213–220 (2024). https://doi.org/10.1007/s10877-023-01068-4
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DOI: https://doi.org/10.1007/s10877-023-01068-4