Author Of 1 Presentation
CONTINUOUS DRUG DELIVERY IS SIGNIFICANTLY AFFECTED BY CHANGES OF RELATIVE HEIGHT BETWEEN PATIENT AND SYRINGE DRIVER
Abstract
Background
Syringe drivers are the standard method of giving continuous infusions of important drugs to patients. Many of these drugs are critical for the maintenance of normal physiology. Anecdotal evidence abounds of severe patient instability on movements of syringe drivers.
Objectives
To define the variation in drug delivery seen in three syringe drivers, with changes in relative height between the syringe driver and the end of the giving set.
Methods
Three syringe drivers (Alaris CC, Braun, and Arcomed) were analysed for reliability of flow at 0.5, 1, 2, and 5ml/hr. A small air bubble was introduced in to the giving set, and the progression of this was documented before and after a vertical movement of the syringe driver by 25 or 50cm upwards or downwards.
Results
For all pumps, delivery was interrupted on movement of the pumps downwards, and a bolus was given with movement of the pump upwards. Delivery at lower pump speeds halted for longer than higher pump speeds. The maximum delivery interruption was 11.7 minutes. Boluses given on moving the pump up were calculated as the equivalent number of minutes needed to deliver the bolus at steady state. The maximum bolus given was 39 minutes. We were unable to eliminate the effect by slow movement of the pump.
Conclusion
Syringe drivers should not be moved vertically in relation to the patient. Patient critical drugs are interrupted for up to 11.7 minutes with relative downward movements, and significant boluses of drugs are given with relative upward movements.