Changing flow accuracy and continuity lead to serious clinical consequences

2023-03-09

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Infusion pumps delivering small quantities of fluids and doses of medications are tailored to the patients in a wide range of care settings. From 1 liter or more in an hour to 1-2 drops per hour, the flow rates can range from 0.1 to 999 ml/hr - creating a full 10,000-fold difference from the lowest to the highest settings [1]. Looking at the dosage diluted in normal saline, the difference is even larger that every drop matters to achieve the target medication outcomes.

 

The problem of flow accuracy and continuity is especially prominent for infusion therapy at low rates, like dopamine hydrochloride to light-weight neonates and norepinephrine in the ICU and ED that can be as low as single-digit micrograms/minute. With the small dose diluted in 50 mL of normal saline, every slight change in flow can lead to serious clinical consequences.

  • >10,000-fold difference from the lowest to the highest dose rate settings
  • Infusion of Dopamine Hydrochloride for newborn intensive care can be as low as 2 micrograms/kg/minute

 

Even with correct infusion programming, the highly sensitive flow accuracy can still be affected by multiple factors including:

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  • Pump stability and accuracy: Actual flow output is known to differ from target flow, especially when looking at live flow during dynamic adjustments. Over time, additional flow bias may accumulate, leading to significant clinical consequences.
  • The tubing choices and materials: the tubing sizes and stiffness, the material of the plunger head and the length of the extension tubing line can all affect the compliance of the infusion system, especially on the long-term flow rate deviations [2].
  • Human errors in moving the syringe/pumps: syringe loading and movement putting additional pressure onto the pumps may result in unintentional drug boluses.
Safe and Accurate Flow from Beginning to End:
Intelligent Solutions of BeneFusion i/u series
Smart accurate™ high precision calibration technology
Incorporating a high-precision sensor to continually monitor drug infusion rate and send real-time feedbacks to pump, BeneFusion iVP and uVP enables timely correction of flow rate deviations to guarantee a high accuracy and continuity of the flow rate.

• Help simplify the pump tube brand choice process and improve infusion efficiency
• Resolve accuracy deviation concerns caused by tube fatigue and wrong tube brand choice, ensuring excellent accuracy and stability of long-term infusion
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BolusGUARD™ automatic clutch technology
Detection of a seated syringe triggers the internal clutching system immediately to lock the handle, preventing accidental bolus injections with serious clinical consequences.

• Guarantee a safe and effcient syringe loading, especially in the emergencies
• Maintain a steady infusion rate even when accidentally falling or moving
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Reference
[1] Eskew JA, Jacobi J, Buss WF, Warhurst HM, DeBord CL. Using innovative technologies to set new safety standards for the infusion of intravenous medication. Hosp Pharm 2002;37:1179-1189
[2] Lee E K, Hong K Y, Kim Y, et al. Effects of infusion tubing line lengths and syringe sizes on infusion system compliance: An experimental study using a syringe-type infusion pump at low flow rate[J]. 2022.