[abstract] INTRAVENOUS INFUSION PUMP PERFORMANCE UNDER MONOPLACE HYPERBARIC CHAMBER CONDITIONS

Abstract

BACKGROUND: Patients receive intravenous infusions during hyperbaric oxygen treatments in the monoplace chamber. However, clinically important pump performance may vary by brand of pump and between pumps of the same brand. MATERIALS AND METHODS: We compared the saline infusion accuracy of the Baxter Flo-Gard?6201(Baxter?IV Set) and IVAC?530 pumps (Alaris? IV set) using the Maxxim? and Sechrist? pass-through sets at infusion rates of 1, 5, and 10ml/hr. We tested: 1) infusion accuracy during a 10-minute compression to 203kPa (2.0atm abs) and a 15-minute compression to 304kPa (3.0atm abs); 2) infusion rates once pressures were achieved to determine the interval to flow rate stabilization (+20percent) up to 20 minutes; 3) infusion rate accuracy at constant chamber pressure of 203kPa (2.0atm abs) and 304kPa (3.0atms abs) for 30- and 60-minutes. RESULTS: 1) Compression Measurements: percent of Expected Volume Delivered, 10 min to 2.0 ATA 15 min to 3.0 ATA, Passthrough Tubing Flow Rate (ml/hr) Baxter? IVAC? Baxter? IVAC? Maxxim? 1 6percent 20percent 0percent 13percent, 5 12percent 80percent 8percent 71percent, 10 60percent 78percent 56percent 86percent, Sechrist? 1 0percent 20percent 0percent 13percent, 5 0percent 80percent 0percent 68percent, 10 36percent 74percent 32percent 74percent, 2) Of 24 tests: 7 not stable at 20 minutes, 7 stable immediately, 6 and 1 stable by 10 and 20 minutes respectively. Generally, Sechrist tubing trials took longer to stabilize. 3) Baxter@1ml/hr=0-4percent; 5ml/hr=12-86percent; 10ml/hr=52-88percent; IVAC@1ml/hr=7-100percent; 5ml/hr=75-99percent; 10ml/hr=80-95percent; Performance varied between pumps with the IVAC/Maxxim combination performing best. Generally, Sechrist tubing negatively affected performance. The lowest flow rate performance was reduced by greater chamber pressure. CONCLUSIONS: Clinicians should be aware of variation in pump performance between brands and pumps of the same brand. Tubing distensibility may explain our findings. At lower flow rates and higher chamber pressures, both pumps and pass-through sets performed inferiorly. We suggest, monitoring patients closely when administering low infusion rate medications.