Automatic Infusion Research Articles

Accuracy of gravity based automatic infusion system applied to chemoport for intravenous infusion.

191 Background: When a vesicant drug is administered to the peripheral vein, a gravity drip method rather than an peristaltic infusion pump is recommended. In addition, it is reported that the gravity based pump has less particle generation than the peristaltic pump that injects fluid through constant peristaltic movement. However, it is pointed out that the disadvantage of gravity based pump is that the rate of administration can easily change according to the change in the location of the injection site. We evaluate the accuracy of new gravity based pump (pressure-sensitive speed control fluid injection device, Accudrip made by Hanvit MD ) at various injection rates and hanging heights common to hospital settings. Methods: The accuracy and safety of the intravenous (IV) flow controller were evaluated for patients receiving IV chemotherapy in the oncology department. It was verified whether the accurate injection rate could be maintained even in various fluid heights, fluid amounts, and types of anticancer drugs that could affect the injection rate. Various anticancer drugs, including immune checkpoint inhibitor, were mixed with 250 ml/500 ml of normal saline and administered for 30 min/60 min, and glucose 500 ml/1000 ml was administered for 60 min/120 min to measure accuracy, each progressed 25 times. Medical staff were surveyed on the ease and limitations of medical practice for each peristaltic infusion pump and new gravity based pump. In addition, side effects occurring in patients during fluid administration were recorded. Results: The mean degree of error in the estimated end time of gravity based automatic infusion system was 3.09% (2.09 ~ 4.10). The error of the gravity based automatic infusion system was statistically significant depending on the patient age (p=.001) and the infusion time (p=.016), but the degree of error according to the type of fluids (p=.302) and fluid concentration (p=.844) was not statistically significant. Among the subjects of the study, nurses' satisfaction with the application of gravity based pump was 4.10 (±0.62) out of 5, and among the general characteristics of nurses, age ( p<.078), and working department (p<.91) did not show a statistically significant difference, but work experience ( p <.021) showed a statistically significant difference. Conclusions: The accuracy of Gravity based automatic infusion system was determined because the degree of error in the expected end time of infusion was not significant according to the infusion variable. In a survey of nurses who have used gravity based pump directly, it was found that the ease of use and satisfaction were similar to those of the conventional peristaltic pump. These findings will contribute greatly to the precise drug administration (over or under-administration) and minimization of adverse events in real-world hospital settings.

Successful treatment of diabetic ketoacidosis secondary to fulminant type 1 diabetes mellitus using a closed-loop artificial pancreas in a pediatric patient.

Diabetic ketoacidosis (DKA) is a life-threatening complication of pediatric diabetes mellitus (DM). A bedside closed-loop artificial pancreas (AP) (STG-55; NIKKISO, Tokyo, Japan) maintains the blood glucose (BG) levels within the target range via automatic infusion of insulin and glucose. We report the application of the closed-loop AP to safely control the BG levels of a pediatric patient with DKA. A 12-year-old child with an unremarkable medical history presented with fever and restlessness. The patient was diagnosed with DKA secondary to fulminant type 1 DM and was treated with insulin infusion. He presented with Glasgow Coma Scale of E2V3M4. Arterial blood gas analysis revealed metabolic acidosis and BG levels of 489mg/dL. His urine test was positive for ketones. Along with infusion therapy, automatic BG control using a closed-loop AP was initiated after ICU admission. This was adjusted to maintain BG levels within 100mg/dL/6h or less. After 24h in the ICU, the patient regained consciousness and recovered from the metabolic acidosis. His general condition improved, and he was prescribed a diet treatment. The treatment was shifted to continuous insulin infusion, and he was transferred to the general ward, and was discharged on the 33rd day of hospitalization. The closed-loop AP prevented repetitive blood extractions, achieved prompt glycemic control, and prevented cerebral edema in a pediatric patient with DKA. This is the first report of successful treatment of DKA using a bedside closed-loop AP.

Optimal Intravenous Administration Procedure for Efficient Delivery of Canine Adipose-Derived Mesenchymal Stem Cells

Mesenchymal stem cells (MSC) are currently being investigated for their therapeutic applications in a wide range of diseases. Although many studies examined peripheral venous administration of MSC, few have investigated the detailed intravenous administration procedures of MSC from their preparation until they enter the body. The current study therefore aimed to explore the most efficient infusion procedure for MSC delivery by preparing and infusing them under various conditions. Canine adipose-derived mesenchymal stem cells (cADSC) were infused using different infusion apparatuses, suspension solutions, allogenic serum supplementation, infusion time and rates, and cell densities, respectively. Live and dead cell counts were then assessed by manual measurements and flow cytometry. Efficiency of live- and dead-cell infusion and cell viability were calculated from the measured cell counts and compared under each condition. Efficiency of live-cell infusion differed significantly according to the infusion apparatus, infusion rate, and combination of cell density and serum supplementation. Cell viability after infusion differed significantly between the infusion apparatuses. The optimal infusion procedure resulting in the highest cell delivery and viability involved suspending cADSC in normal saline supplemented with 5% allogenic serum at a density of 5 × 105 cells/mL, and infusing them using an automatic infusion device for 15 min. This procedure is therefore recommended as the standard procedure for the intravenous administration of ADSC in terms of cell-delivery efficiency.

Dynamic Pressure Measurements During Vitrectomy in a Model of the Eye.

PurposeTo accurately evaluate pressure changes during vitrectomy in a rigid model of the vitreous chamber and to test the efficiency of the EVA phacovitrectomy system (Dutch Ophthalmic Research Center) in terms of compensation of intraocular pressure variations.MethodsWe tested 23-, 25-, and 27-gauge double-blade vitreous cutters in both vented global pressure control and automatic infusion compensation (AIC) modes in a vitreous chamber model, mimicking the real surgical procedure. Balanced salt solution and artificial vitreous, similar to the real vitreous body, were used. We tested both standard-flow (SF) and high-flow (HF) infusion systems, varying the infusion pressure between 20 and 40 mm Hg. In each experiment, flow rate was also measured.ResultsPressure drop was rapidly and efficiently compensated when 23- and 25-gauge cutters were used in AIC mode, with infusion pressures ranging between 30 and 55 mm Hg. The 27-gauge cutter was less efficient in compensating pressure variations. Pressure fluctuations related to the high-frequency motion of the cutter blade were small compared to the overall pressure variations. The use of the HF infusion system resulted in larger flow rates and lower pressure changes compared to the SF infusion system.ConclusionsDespite the rigid material of the model, the present pressure measurements are in line with previous studies performed on porcine eye. The use of AIC mode compensates intraoperative pressure drops efficiently, with both 23- and 25-gauge cutters. The HF infusion system is more efficient than the SF infusion system.Translational RelevanceThe AIC infusion mode efficiently compensates intraoperative pressure drops, in both 23- and 25-gauge experimental vitrectomy. The HF infusion system resulted in larger flow rate and lower pressure changes.

Intravenous Infusion Monitoring and Flow Control System Equipped with Automatic Air Bubble Detection

In clinical care, intravenous infusion is one of the best ways for continuous drug delivery or clinical therapy. In most medical institutions, the workload of nurses and patient care increases due to fluctuating populations. This causes an increase in the work intensity of medical personnel. If the infusion is not monitored properly, it will lead to a medical accident. The problem is also affected due to the lack of economical and automatic infusion monitoring devices. In this case, it is proposed to design an automatic infusion control instrumentation that can detect the presence of air bubbles in the infusion to prevent air bubbles from entering the body and detect the rate of infusion flow. The proposed device is equipped with Thin Film Transistor technology (TFT) which functions to display and enter information about the condition of the intravenous infusion and a buzzer as a reminder alarm when an undesirable condition occurs. System accuracy and precision are verified for all flow rates. The results of the drops per minute test show accuracy with an error percentage of less than 2% within 1 minute. The device can detect the presence of air bubbles at high speed for response times below 20 ms and reduce the possibility of air bubbles escaping in the infusion hose according to the system test results that have been carried out. In the evaluation using target 20 drops per minute the infusion flow rate changes stably according to the angular movement of the servo motor. So it is hoped that the proposed system can help officers to monitor the condition of infusion and reduce the work intensity of medical workers.

Electronic Infusion Flow Regulator with Occlusion Detection

Infusion is one medical equipment that provides several fluids into the body through a needle into a vein to replace fluids or food substances lost from the body. The use of manual infusion to determine the number of drops given to the patient and the calculation manually. The purpose of this research is to design an automatic infusion flow control device equipped with occlusion detection. This module consists of an Arduino Mega 2560, DC motor (stepper NEMA 17), optocoupler module, 4x4 keypad, and TFT. Infusion drops are detected by the optocoupler sensor. The microcontroller will process the detection results and send a DC motor command to move according to the settings entered. The unit of flow rate used in the module is ml/min. After measuring using an IDA calibration device with the Fluke brand type IDA 4 plus on the occlusion parameter, the average time is 41 seconds and the results of the flow rate have the largest deviation of 0.15 ml/min at the time setting of 6 hours and the volume of 500. While the smallest deviation is 0.12 ml /min on setting time 4 hours and volume 500 ml. From the results of measurements that have been carried out, this module is expected to help nurses regulate the infusion. The results in the future this module can be developed again with the appearance of the flow rate results can be directly displayed without having to wait for the drops to stabilize.

Comparison of Postoperative Recovery after Manual and Target-Controlled Infusion of Remifentanil in Bariatric Surgery.

Background and Objectives: Early postoperative recovery after surgery is a key point for patients’ safety and comfort. Moreover, operating room turnover depends on recovery time. Our aim was to assess which method of remifentanil administration, manual (MI) or target-controlled infusion (TCI), could reduce patient time in recovery room. In this study, patients’ recovery times were registered and compared among the groups. Materials and Methods: We enrolled 31 morbidly obese patients in this prospective study. All of them had undergone bariatric surgery at the Hospital of Lithuanian University of Health Sciences Kauno Klinikos in 2020. Sevoflurane/remifentanil anaesthesia was performed for all patients. The patients were randomly assigned to the manual infusion (MI) (control group) or target-controlled infusion (TCI) group for the method of the administration of remifentanil. While the patients were waking up after the surgery, we recorded spontaneous breathing and airway reflexes recovery time, time of extubation, eye opening, recovery of orientation and beginning of the following oral command. For the TCI group, we also documented remifentanil concentrations in the blood (automatic infusion pump). Results: Patients did not differ in demographic values and duration of remifentanil infusion. We found that remifentanil consumption in the TCI group was lower, p = 0.02. Despite lower remifentanil consumption in the TCI group patients, they demonstrated longer total recovery time than the control group patiens: 14 (12–20) vs. 10 (6–16), p = 0.001. Conclusions: The study showed that, upon comparing the TCI method with MI, manual infusion produced better results in postoperative patient recovery. Additionally, higher doses of remifentanil were consumed using MI. In conclusion, the dosage recommended by highly qualified anaesthesiologists is favourable for morbidly obesity patients when compared to the TCI method.

Occupational exposure in a PET/CT facility using two different automatic infusion systems.

The aim of this study was to measure the occupational exposure using active personal dosimeters (APD) in the PET/CT department at different stages of the operation chain i.e. radiopharmaceutical arrival, activity preparation, dispensing, injection, patient positioning, discharge and compare the radiation exposure doses received using two automatic injection/infusion systems. This paper also reflects optimization processes that were performed to reduce occupational exposure. Measured APD data were analysed for medical physicists, radiology technologists and administrative staff from 2014 till 2018. For dispensing and injecting 18F-FDG, the automatic infusion/injection system IRIDE (Comecer, Italy) or the automatic fractionator ALTHEA (Comecer, Italy) with wireless injection system WIS (Comecer, Italy) were used. Radiation exposure optimization methods were applied during the data collection period (installation of the transport port, patient management, APD alarm threshold and etc.). Radiology technologists who perform injection procedures, regardless of the automatic infusion system, received the highest radiation exposure dose. The average doses to the radiology technologists per one study were 1.72±0.33 μSv and 1.16±0.11 μSv with ALTHEA/WIS and IRIDE system, respectively. The average dose for accompanying the patient to the PET/CT scanner and scan procedure was 0.52±0.07 μSv. For the medical physicists, the average dose was 0.29±0.09 µSv. The measured dose for administrative staff was 0.30±0.15 μSv. Occupational exposure can be effectively optimized by different means including staff monitoring with APD, implementation of radiation safety culture and the usage of automatic infusion systems.

Design of high-precision micro-automatic control system based on Segmentation driven and closed-loop control

The high-precision micro-infusion automatic control system is an automatic infusion system that replaces manual infusion which solves the risk that the traditional infusion volume and speed cannot be controlled. By analyzing the system composition and configuration, it is determined that the system actuator belongs to the field of multi-body mechanics. After analysis of the system mechanics model, it is ensured that the mechanical performance of the designed system’s actuator meets the requirements. At the same time, the motor control method of subdivision drive and closed-loop control used in the design is described in detail, and the dynamic characteristics of the system are simulated and analyzed. High-precision and reliability control ensure that the medicine can enter the patient’s body uniformly, accurately and safely, and meet the design requirements.

Design of automatic infusion monitoring system based on Arduino

Intravenous Fluids Drops are very important for the process of healing or treatment for patients. The function of infusion is to replace the loss of fluids or nutrients in the body. In Indonesia, monitoring system of condition about infusion is still done manually, but for the cases such a large hospitals which is the number of patients is not balanced by medical personnel, it is becomes ineffective so that it can cause mistakes in monitoring. A very serious mistake can occur are too late in replacing the infusion. The solution to solve this problem is to make an automatic infusion monitoring system with an alarm warning. This research is experimental research. The measurement technique taken is direct and indirect measurement. Direct measurement data is mass of infusion and indirect measurment data is the number of infusion drops and the percentage of remaining intravenous fluid. The purpose of this research is to determine the design spesifications and peformance spesification of the instrument. The sensor used to measure infusion drops per minute is photogate and to measure the infusion volume is load cell. The display is use TFT LCD and using buzzer for alarm warning. The accuracy of infusion drops per minute system is 0, 97 with error 2, 15% and accuracy of infusion fluid percentage system is 0, 98 with error 1, 47%.

A rat model of acute kidney injury through systemic hypoperfusion evaluated by micro-US, color and PW-Doppler.

To create an animal model of acute renal ischemia induced by systemic hypoperfusion, controllable and reproducible to study, in real time, hemorrhagic shock changes with micro-imaging. Hemorrhagic shock was induced in rats activating a syringe pump setup to remove 1mL/min of blood, through the femoral artery catheter. The withdrawal was continued until the mean arterial pressure (MAP) dropped to 25-30mmHg. For the next 60min, the MAP was maintained at a constant pressure value, by automatic pump infusion and withdrawal. Micro-ultrasound imaging was performed using the Vevo 2100 system with the MS250 transducer (13-24MHz). Renal size, morphology and echogenicity were evaluated in B-mode. Renal blood flow was evaluated using color and PW-Doppler. After 1h of ischemia, B-mode images documented slight changes in kidney echogenicity. Color and PW-Doppler analysis showed a reduction in renal blood flow in kidneys during the hypoperfusion with a progressive and significant change from baseline values of resistive index (RI). At the histological evaluation, 60min of hypoperfusion resulted in ischemic changes in the kidneys. The results of this experimental study encourage the use of the described model to study acute renal ischemia trough severe hypoperfusion. The histological data confirmed that the model was able to produce injury in renal parenchyma. It can be used to assess acute ischemic damage not only in the kidney but also in other organs by using all available dedicated small animals imaging techniques.

Application of continuous iliac fascial interstitial obstruction in the placement of anaesthesia in the vertebral canal of the elderly femoral fractures and postoperative analgesia

Objective To investigate the effect of continuous iliac fascia space block on the placement of body position and postoperative analgesia in patients with femoral fractures. Methods 60 patients with senile selective unilateral femoral fracture, aged 68-87 years old, weight 49-70kg, ASA grade II-III were selected, and they were randomly divided into iliac fascia block group (A group) and intravenous analgesia group (B group) according to the digital, 30 cases in each group.The two groups underwent lumbar epidural anesthesia, A group received continuous fascia iliaca compartment block 15 min before the the body position.B group was routinely given combination of lumbar and hard anesthesia.After operation, A group was connected with the automatic infusion pump continuous infusion of 0.2% ropivacaine 0.1mL·kg-1·h-1.B group received controlled intravenous analgesia, postoperative given loading dose of dezocine intravenous infusion of 5mg with automatic injection pump for dezocine 0.01mg·kg-1·h-1.When the patients entered the room (T0) and just after the placement of the body position (T1), the heart rate, diastolic blood pressure and systolic blood pressure were measured and recorded.At postoperative 2, 4, 6, 12, 24 and 48h, the VAS scores and pethidine usage during surgery, the adverse reaction were recorded. Results The heart rate, diastolic pressure and systolic pressure at T1 in A group had no significant change compared with T0 (all P>0.05). The heart rate, diastolic pressure and systolic pressure in the control group (B group) at T1 were significantly higher than at T0(t=5.302, 7.369, 5.629, all P<0.05). At T1, T2, T4, T6, T12, T24 and T48, the pain VAS scores in A group were lower than those in B group (t1=66.401, t2=7.719, t4=25.260, t6=13.170, t12=3.837, t24=3.081, t48=6.202.all P<0.05). The study group had no complications such as puncture hematoma, intoxication of local anesthetic and other complications. Conclusion Continuous iliofascial block can provide continuous analgesia for elderly patients with femoral fractures.It is safe and effective, and is easy to perform.It provides favorable conditions for later operative treatment. Key words: Iliac fascia space block; Femoral fracture; Elderly; Postoperative analgesia

A quantitative evaluation of multiple biokinetic models using an assembled water phantom: A feasibility study.

This study examined the feasibility of quantitatively evaluating multiple biokinetic models and established the validity of the different compartment models using an assembled water phantom. Most commercialized phantoms are made to survey the imaging system since this is essential to increase the diagnostic accuracy for quality assurance. In contrast, few customized phantoms are specifically made to represent multi-compartment biokinetic models. This is because the complicated calculations as defined to solve the biokinetic models and the time-consuming verifications of the obtained solutions are impeded greatly the progress over the past decade. Nevertheless, in this work, five biokinetic models were separately defined by five groups of simultaneous differential equations to obtain the time-dependent radioactive concentration changes inside the water phantom. The water phantom was assembled by seven acrylic boxes in four different sizes, and the boxes were linked to varying combinations of hoses to signify the multiple biokinetic models from the biomedical perspective. The boxes that were connected by hoses were then regarded as a closed water loop with only one infusion and drain. 129.1±24.2 MBq of Tc-99m labeled methylene diphosphonate (MDP) solution was thoroughly infused into the water boxes before gamma scanning; then the water was replaced with de-ionized water to simulate the biological removal rate among the boxes. The water was driven by an automatic infusion pump at 6.7 c.c./min, while the biological half-life of the four different-sized boxes (64, 144, 252, and 612 c.c.) was 4.8, 10.7, 18.8, and 45.5 min, respectively. The five models of derived time-dependent concentrations for the boxes were estimated either by a self-developed program run in MATLAB or by scanning via a gamma camera facility. Either agreement or disagreement between the practical scanning and the theoretical prediction in five models was thoroughly discussed. The derived biokinetic model represented the metabolic mechanism in the human body and helped to solidify the internal circulatory system into concert with numerical verification.

Adaptive pharmacokinetic and pharmacodynamic modelling to predict propofol effect using BIS-guided anesthesia

Background and objectivePropofol is widely used for hypnosis induction and maintenance of general anesthesia. Its effect can be assessed using the bispectral index (BIS). Many automatic infusion systems are based in pharmacokinetics (PK) and pharmacodynamics (PD) models to predict the response of the patient to the drug. However, all these models do not take into account intra and inter-patient variability. An adjusted intraoperative drug administration allows faster recovery and provides post-operative side-effect mitigation MethodsBIS evolution and surgery-recorded propofol infusion data of a group of 60 adult patients (30 males/30 females) with ASA I/II physical status were used to test a real time PK/PD compartmental model. This new algorithm tunes three model parameters (ce50, γ and ke0), minimizing a performance function online. ResultsThe error in the BIS signal predicted by the real time PK/PD model was smaller than the error measured with fixed parameter equations. This model shows that ce50, γ and ke0 change with time and patients, given a mean (95% confidence interval) of 3.89 (3.52–4.26)mg/l, 4.63 (4.13–5.13) and 0.36 (0.31–0.4)min−1, respectively. ConclusionsThe real time PK/PD model proposed provides a closer description of the patient real state at each sample time. This allows for greater control of the drug infusion, and thus the quantity of drug administered can be titrated to achieve the desired effect for the desired duration, and reduce unnecessary waste or post-operative effects.

Design of a switched robust control scheme for drug delivery in blood pressure regulation

A control algorithm based on switching robust controllers is presented for a Linear Parameter Varying (LPV) time-delay system modeling automatic infusion of vasodilator drug to regulate postsurgical hypertension. The system is scheduled along a measurable signal trajectory. The prospective controllers are robustly designed at various operating points forming a finite set of robust controllers and then a hysteresis switching is performed between neighboring robust controllers for a larger operating range of the LPV system. The stability of the switching LPV system for the entire operating range is ensured by providing a sufficient condition in terms of bound on the scheduling signal variation using the concept of dwell time. Simulation results are provided to verify the performance of the designed control scheme.

A New Type of Design for Automatic Medicine Renewing and Final Alarming Intravenous Infusion Device

This paper introduces the structure and working principle of a new type of automatic medicine renewing and final alarming intravenous infusion device. The control system and the choosing of stepping motor are also discussed. Experiments show that this device can open and close the infusion tubes effectively so the medicine can be renewed automatically, and sound the alarm finally. With this device, the unattended infusion can be realized, the medical labor intensity can be effectively reduced, the clinical safety and work efficiency can be improved.

Occupational Radiation Dosimetry Assessment Using an Automated Infusion Device for Positron-Emitting Radiotracers

Handling and administration of radiopharmaceuticals are a key contributor to staff radiation dose. Shielded automated infusion devices potentially standardize and reduce radiation exposure during procedures. However, loading the devices adds incremental radiation exposure, which may mitigate dose savings. We measured radiation doses from the loading and use of an automated infusion device and compared these with those from manual injection of (18)F radiotracers. Adult patients were administered (18)F-FDG or (18)F-FLT before 3-dimensional PET whole-body or brain imaging, respectively. Radioactivity amounts from manual injections performed with protective syringe shields and vial holders were measured by a standard dose calibrator before and after injection. Automated infusions were performed using the shielded infusion device. Staff wore electronic dosimeters at the wrist and trunk. Electronic dosimeters were also worn while multidose (18)F-FDG vials were loaded and unloaded. For each task, background radiation was determined and subtracted from the electronic dosimeter values. Twenty-seven manually injected unit doses yielded a mean administered dose to patients of 480.7 ± 66.2 MBq (12.99 ± 1.79 mCi), compared with 431.9 ± 22.7 MBq (11.67 ± 0.61 mCi) in 34 automated injections. The mean difference was statistically significant. To control for this difference, results were expressed as a standardized dose per unit of activity. With the automated infusion device, the mean extremity dose per injection was 0.003 ± 0.002 μSv/MBq, compared with 0.026 ± 0.017 μSv/MBq with manual injections. Mean body dose per procedure with automated infusion was 0.001 μSv/MBq, versus 0.011 μSv/MBq with manual injection (P < 0.001). The changing of bulk (18)F-FDG vials in 37 procedures added a mean dose per vial change of 0.89 ± 1.3 μSv to the extremities and 0.47 ± 2.0 μSv to the body. The use of a shielded automatic infusion device in a clinical PET setting resulted in an approximately 10-fold decrease in staff extremity and body doses during the administration of (18)F-labeled radiopharmaceuticals. Loading and unloading bulk vials of radiotracer did not significantly offset these dose savings.

P-0273 Hepatic Metastasis and Reccurence of Colorectal Cancer Assesment by 18FDG PET/CT

ABSTRACT Introduction Liver is the most frequent long distance metastasis site of digestive cancer. Early and accurate detection of hepatic metastasis as well as of tumoral recurrence is an important objective, especially in colorectal cancer, due to the improved 5 year surveillance rates after metastasectomy compared to nonsurgical therapy. Aim: to assess the use of 18FDG PET/CT (18 fluorodeoxyglucose positron emission tomography and computed tomography) in the detection of hepatic metastasis and recurrence of colorectal cancer. Methods Our study took place in the Emergency Clinical County Hospital (Oradea, Romania) in collaboration with PET POZITRON Diagnostic Center (Oradea, Romania). We studied 48 patients (38 men and 10 women, aged 48-74 years) who were previously treated by surgery for colorectal cancer. The FDG-PET/CT examination was made with the Siemens Biograph 16 unit (Germany) at 1 hour after the automatic infusion of FDG, at doses previously adjusted to individual parameters of each patient. Afterwards the recurrence and/or metastasis diagnosis was confirmed by colonoscopy, histology or other imaging techniques. At the same time, CEA (carcinoembryonic antigen) was measured. The statistical analysis was made with the help of SPSS application (Statistical Package for the Social Sciences). Results The time interval between the surgical intervention and PET/CT evaluation varied between 6 months to 8 years, with a mean value of 2.6 years. Out of the 48 studied patients recurrence and/or metastasis were diagnosed in 36 (75%) patients, including 8(16.7%) recurrences, 26 (54.2%) metastasis and 2 (4.1%) recurrence with metastasis. The diagnosis sensibility of identifying recurrent colorectal cancer and hepatic metastasis was 93% and its specificity was 84%. Treatment plans were changed in 8 (16.7%) patients after PET/CT evaluation. Localised metastasis were detected in the liver and lungs of 2 (4.2%) patients who were referred to surgery instead of chemotherapy. 4 patients (8.3%) had disseminated metastasis and were referred to chemotherapy. 2 (4.2%) patients with high levels of CEA and indication of iv chemotherapy in which conventional imaging showed no lesions, had at PET/CT evaluation, the following aspects: 1 patient had a recurrence and was resent to surgery and the other one, had lung and bone metastasis being thus referred to radio and chemotherapy. In our study group besides hepatic metastasis we also found metastasis in: lung (9/36, 25%), abdominal cavity and mesentery (8/36, 22%), retroperitoneal (7/36, 19%). Other secondary localizations included bone, lymph nodes, peritoneum and brain but the preferred metastasis foci were liver and lung. In some patients, beside conventional imaging examinations, PET/CT offered restaging of the disease. Conclusion 18FDG PET/CT examination can detect with high sensibility and specificity tumoral recurrences and/or hepatic metastasis. At the same time, in patients with surgically treated colorectal cancer it can identify lesions with abnormal metabolic levels, incipient occult metastasis and can orientate therapeutic measures.

Stabilité et compatibilité du paracétamol, du kétoprofène et de l’amoxicilline administrés avec un perfuseur de sécurité

Objectives Intravenous infusion takes an important place in the current therapy in hospitals and pharmaceutical firms keep improving their infusion medical devices, particularly with the development of an intravenous administration set with an automatic infusion stop. The aim of our study consists in an evaluation of the stability of acetaminophen, ketoprofen and amoxicillin during infusion and stasis of drugs for several hours in the dropper chamber and in the tube of this device. Study design Analytical study. Materials and methods Ten milligram per millilitre acetaminophen (acetaminophen 1 and acetaminophen 2), 1 mg/mL ketoprofen and 20 mg/mL amoxicillin were prepared and infused individually and successively with the intravenous administration set under ambient light and temperature. Collected samples of each drug during the infusion and after 24 hours of stasis in the medical device were monitored by a visual inspection, pH and osmolality assessment and chromatographic analysis of each drug with a validated stability-indicating method. Results Repeated individual perfusions of 10 mg/mL acetaminophen 1 or 1 mg/mL ketoprofen are possible through a fail-safe intravenous administration set, while repeated individual amoxicillin infusions are not because of the unstability of this drug. There is also no problem to infuse successively acetaminophen and ketoprofen through this medical device because these drugs are stable. However, we underlined an incompatibility between acetaminophen 2 and ketoprofen, which advises against the use of intravenous administration set for successive infusions of these two drugs. Conclusion Despite the technical innovation of a fail-safe intravenous administration set, we have to stay aware of mixture consequences in intravenous infusion field.

Development of an Intellectualized Wireless Infusion Control/Monitoring System

One kind of automatic wireless infusion control/monitoring system based on micro controller unit(MCU) and nRF401 had been designed and implemented to overcome the shortages in the processing of venous transfusion care. The system used AT89C52 single-chip computer as machine’s core, the realization of communication between a master computer and a slave computer with nRF401. Doctors could get the information through the wireless transmission to control and monitor the process of transfusion in time. According to RS232 communication protocol, the system implements the communication between one computer and multi-computer by adopting AT89C51 single chip microcomputer. This system has many advantages, such as low cost, high precision, small volume, convenience, low power consumption, good extendibility and so on.