A simulation study on the performance and safety of various infusion devices in clinically possible vibration situations

Abstract

Introduction: Infusion devices are frequently used when transferring critically ill patients using various measures including moving cart, ambulance, or helicopter. However, the performance of various infusion devices has not been explored under these circumstances. Objectives/Aims: We aimed to evaluate the performance of the infusion devices under clinically possible vibration conditions. Methods: Experiments were conducted using four different types of pumps; two conventional syringe pumps (Injectomat MC Agilia, Fresenius Kabi) and one conventional infusion pump (Volumed VP 7000, Arcomed), and a new-generation cylinder pump (H-100, Meinntech) which is a convertible infusion and syringe pump. The flow rate was measured using the infusion pump analyser (IDA 4 Plus, Fluke biomedical) on the stable table for 1 hour with 1ml/h and 5ml/h. Experiments were repeated in the mild vibration (2m/s2), which is vibration in the patients moving cart or ambulance, and in moderate vibration (6m/s2), which is vibration in the helicopter transport. Vibration level of the vibrating table was measured using a vibrating meter (VM-6360). In addition, experiment with accidental bolus in extreme vibration situations was done. Results: In the resting state without vibration and the mild vibration condition, all the pumps showed comparable results within clinically acceptable error range. However, in moderate vibration condition, it was observed that an inadvertent bolus dose of the drug was injected accidentally in both conventional syringe pumps. In the case of the infusion pump, overall less amount was injected than the specified amount. For a new generation cylinder pump, it was possible to prevent accidental bolus injection in vibration and inject the desired amount. Conclusion: In mimicking clinical vibration situations, most of infusion devices worked well. However, the conventional infusion pump was infused less than the desired amount, and the conventional syringe pump was infused unintentionally in a strong vibration, which required a careful attention.