Introduction: In the literature, the change of a syringe pump is described as a dangerous situation, especially in the case of vasoactive drug administration. Methods: Different variables have been studied (central venous pressure, pump displacement in relation to the patient position, utilization of a stopcock, or a neutral displacement needle-free connector between the syringe and the infusion tubing) to understand their influence on medication administration in terms of backflow or bolus creation when changing the syringe. Results: We performed 576 measurements with different combinations. With respect to all the observations, in comparison with “time zero,” we found the following differences expressed in microliters: 0 (±1) at the plunger opening; 0 (±3) at the syringe extraction from the pump; 0 (±7) at the syringe disconnection from the infusion tubing; 0 (±11) at the syringe reconnection to the infusion tubing; 1 (±7) at the syringe insertion in the pump; 3 (±23) at the plunger closing; 8 (±33) at the stabilization at the maneuver end. Conclusion: The syringe change can be a very critical moment given different influencing variables. Syringe pump position, displaced higher than the patient level, always generates a medication bolus that is higher at the lowering of the central venous pressure value. The presence of a neutral displacement needle-free connector reduces the incidence of boluses. When the pump is placed at the patient level, the presence of neutral displacement needle-free connector reduces the establishment of boluses, even in a central venous pressure of −5 mmHg simulations.

Elli, S., Mattiussi, E., Bambi, S., Tupputi, S., San Fratello, S., De Nunzio, A., et al. (2020). Changing the syringe pump: A challenging procedure in critically ill patients. JOURNAL OF VASCULAR ACCESS, 21(6), 868-874 [10.1177/1129729820909024].

Changing the syringe pump: A challenging procedure in critically ill patients

Elli, Stefano
Primo
;
Fumagalli, Roberto;Lucchini, Alberto
Ultimo
2020

Abstract

Introduction: In the literature, the change of a syringe pump is described as a dangerous situation, especially in the case of vasoactive drug administration. Methods: Different variables have been studied (central venous pressure, pump displacement in relation to the patient position, utilization of a stopcock, or a neutral displacement needle-free connector between the syringe and the infusion tubing) to understand their influence on medication administration in terms of backflow or bolus creation when changing the syringe. Results: We performed 576 measurements with different combinations. With respect to all the observations, in comparison with “time zero,” we found the following differences expressed in microliters: 0 (±1) at the plunger opening; 0 (±3) at the syringe extraction from the pump; 0 (±7) at the syringe disconnection from the infusion tubing; 0 (±11) at the syringe reconnection to the infusion tubing; 1 (±7) at the syringe insertion in the pump; 3 (±23) at the plunger closing; 8 (±33) at the stabilization at the maneuver end. Conclusion: The syringe change can be a very critical moment given different influencing variables. Syringe pump position, displaced higher than the patient level, always generates a medication bolus that is higher at the lowering of the central venous pressure value. The presence of a neutral displacement needle-free connector reduces the incidence of boluses. When the pump is placed at the patient level, the presence of neutral displacement needle-free connector reduces the establishment of boluses, even in a central venous pressure of −5 mmHg simulations.
Articolo in rivista - Articolo scientifico
Backflow; bolus; changeover; infusion; inotrope infusion; needle-free connector; syringe pump vasoactive drug pumping; vasoactive drug administration;
Backflow; bolus; changeover; infusion; inotrope infusion; needle-free connector; syringe pump vasoactive drug pumping; vasoactive drug administration
English
4-mar-2020
2020
21
6
868
874
none
Elli, S., Mattiussi, E., Bambi, S., Tupputi, S., San Fratello, S., De Nunzio, A., et al. (2020). Changing the syringe pump: A challenging procedure in critically ill patients. JOURNAL OF VASCULAR ACCESS, 21(6), 868-874 [10.1177/1129729820909024].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/264248
Citazioni
  • Scopus 9
  • ???jsp.display-item.citation.isi??? 9
Social impact