Infusion Flow Research Articles

Design and Development of An Integrated Monitoring System for Nebulizer and Infusion for Lung Disease Patients Based on IoT

This research develops an Internet of Things (IoT)-based monitoring system for nebulizers and infusion devices for patients with lung diseases, specifically Acute Respiratory Infections (ARI). The aim is to improve nursing efficiency and minimize the risk of complications due to delayed patient care by enabling remote monitoring and providing real-time information on the status of nebulizers and infusion devices via a website. The system is designed to stop the infusion fLow when the required amount is reached and to automatically turn off the nebulizer when there is no liquid. It uses an ESP32 microcontroller to control IR obstacle sensors, relays, and a servo motor for the infusion clamp, as well as an LCD display for digital information and feature displays. The system is also equipped with an alarm to indicate when the infusion liquid or nebulizer is depleted and a website to provide real-time status information to medical personnel. Testing shows that the system has a high accuracy of 98.7% and minimal error of approximately 1.82% in monitoring and controlling nebulizer and infusion fluids. In conclusion, the system successfully improves nursing efficiency and patient safety while reducing the workload of nurses through the automation of medical devices that were previously managed manually.

Stability Indicating LC–ESI-MS/MS Method Development and Validation for the Quantitation of Lurbinectedin in Biological Matrices.

The anticancer drug lurbinectedin was measured in plasma samples using a newly designed and validated LC-ESI-MS/MS method. The drug’s examination was conducted using ledipasvir as the internal standard. Following the liquid liquid extraction of 200 μL of plasma, the samples were separated using a ZorbaxSB (25 0mm x4.6 mm, 5 µm)C18 column. The mobile phase comprised of 0.1 %V/V formic acid and acetonitrile in the fraction of 10:90, and an infusion flow rate was 0.80mL/min. The analytes were eluted in 3.5 minutes total. Using a concentration range of 1.50 to 5000ng/mL of lurbinectedin and a correlation coefficient value of 0.9994, the method was validated in compliance with FDA standard standards. Assay accuracy ranged from 95.31% to 104.06% of the nominal values, and both intra- and inter-day precision results were within 4.32%. For the analyte at the LQC level, the matrix factor varies from 94.25% to 104.85% with a %CV of 4.61, whereas at the HQC level, it ranges from 94.62% to 103.88% with a %CV of 4.02. The results of the stability tests show that the approach is quite stable. Regular analysis in bioavailability, quality control, and bioequivalence investigations of biological matrices may be effectively performed using the established approach.

Optimizing Infusate Flow Patterns for Minimizing Vein Wall Trauma: An Exploratory Study with a Modified off-Axis Catheter Tip Opening.

Modifying the PIVC tip to direct infusates toward areas of highest hemodilution may reduce vein wall damage. This study compared flow patterns between a traditional PIVC with a central opening and one with an off-axis aperture. This was an exploratory observational analysis conducted at a tertiary care emergency department (ED) comparing flow patterns of two intravenous catheters: PIVC 1 (2.95 cm 20 gauge [Autoguard, Becton Dickinson]) and PIVC 2 (3.68 cm 20 gauge [Osprey, SkyDance Vascular]). Adult ED patients with PIVCs placed via traditional palpation/visualization method and with ultrasound capturing the flushing were eligible participants. Ultrasounds were reviewed to determine vein, catheter, and flow characteristics. The primary outcome was angle of the infusate leaving the catheter. Secondary outcomes included direction of catheter tip against vein wall, distance away from vein wall, vasospasm, and laminar/turbulent flow. Data from December 2023 included 28 catheters (10 PIVC 1, 18 PIVC 2). The average patient age was 53.7 years; 53.6% were female. Vein diameter/depth were similar: 0.35 cm/0.41 cm for PIVC 1 and 0.37 cm/0.47 cm for PIVC 2. The catheter tip pointed posteriorly towards the vein wall in 60% of PIVC 1 vs 11.1% in PIVC 2 (P=0.018). The angle of infusate flow away from the vein wall was 0.20° (SD 0.63) for PIVC 1 and 7.61° (SD 5.71) for PIVC 2 (P<0.001). Flow at 0° occurred in 90% of PIVC 1 vs 16.7% in PIVC 2 (P<0.001). In this exploratory investigation, a peripheral vascular access device with an off-axis tip aperture of demonstrated a sharper infusate flow angle away from the vein wall compared to a traditional central opening device. This redirection may reduce vein wall trauma and complications, though further research is needed to pair clinical outcomes with this technology.

Empirical Study on the Impact of Infusion Media on the Flow Rate of Infusion Pumps

To investigate the impact of different infusion media on the flow rate of infusion pumps. Ten infusion pumps were randomly selected and tested for infusion rates using deionized water, saline solution, glucose solution, and parenteral nutrition solution. The infusion flow rate was set at 30 mL/h, and the testing methodology conformed to the standards for the calibration and quality control of syringe pumps and infusion pumps. For infusion set A, the infusion rate was unaffected by the infusion media, remaining within the acceptable quality control standards. For infusion set B, when infused with deionized water, saline solution, and glucose solution, the infusion errors were within the quality control standards. However, when using parenteral nutrition solution as the infusion medium, the infusion error exceeded the acceptable quality control standards. Both the infusion set and the infusion medium can affect the flow rate of infusion pumps. It is crucial to calibrate the flow rate according to the specific infusion medium to reduce medical risks associated with infusion pumps during clinical use.

IoT-Driven Infusion Monitoring &amp; Management System

This research investigates the monitoring and management of an intravenous drip infusion system using the Internet of Things (IoT) and non- contact liquid level sensors, an Arduino circuit board, a GSM interface, and a cloud storage facility. The three sensors in the system are able to detect the presence of fluid without coming into contact with it. They can also send the data they collect to the cloud facility, where it can be used to access drip conditions and monitor fluid levels as well as control infusion flow when needed. This system can be considered an improvement over several systems on the market that are similarly intended to use optical sensors, TDR (Time domain reflectometry), and other types of sensors to monitor the IV drip flow. While it is true that each type of sensor has a combination of benefits and drawbacks, none of the other systems on the market can further regulate the drip flow like this one does. Since the sensors we've employed don't respond to fluids, the patients don't suffer any damage at all. This is now a crucial necessity in the biomedical industry since human reliance on IV drip infusions has led to a number of incidents, the most serious of which involved the patient suffering severe injuries from back blood flow in the nozzle. This system is made to guarantee that all safety precautions are taken and that the patient and attendant are in the best possible circumstances in order to minimize such incidents, accurately monitor and control fluid flow from drip to patients' veins, and prevent back blood flow. Keywords: Internet of Things, Intravenous drip infusion, Non‐contact Liquid Level Sensor, Thing speak, Esp-32, GSM.

The relationship between intraosseous catheter tip placement, flow rates, and infusion pressures in a high bone density cadaveric swine (Sus scrofa) model.

Intraosseous (IO) infusion is a life-preserving technique when intravenous access is unobtainable. Successful IO infusion requires sufficiently high flow rates to preserve life but at low enough pressures to avoid complications. However, IO catheter tips are often misplaced, and the relative flow rates and pressures between IO catheter tips placed in medullary, trabecular, and cortical bone are not well described, which has important implications for clinical practice. We developed the Zone Theory of IO Catheter Tip Placement based on bone density and proximity to the venous central sinus and then tested the influence of catheter tip placement locations on flow rates and pressures in a cadaveric swine model. Three cross-trained participants infused 500mL of crystalloid fluid into cadaveric swine humerus and sternum (N=210 trials total) using a push‒pull method with a 60 cm3 syringe. Computed tomography scans were scored by radiologists and categorized as zone 1 (medullary space), zone 2 (trabecular bone), or zone 3 (cortical bone) catheter tip placements. Differences between zones in flow rates, mean pressures, and peak pressures were assessed using analysis of variance and analysis of covariance to account for participant and site differences at the p<0.05 threshold. Zone 1 and zone 2 placements were essentially identical in flow rates, mean pressures, and peak pressures (each p>0.05). Zone 1 and zone 2 placements were significantly higher in flow rates and lower in pressures than zone 3 placements (each p<0.05 or less). Within the limitations of an unpressurized cadaveric swine model, the present findings suggest that IO catheter tip placements need not be perfect to acquire high flow rates at low pressures, only accurate enough to avoid the dense cortical bone of zone 3. Future research using in vivo animal and human models is needed to better define the clinical impact of IO catheter placement on infusion flow rates and pressures.

Effect of nociception level-directed analgesic management on opioid usage in robot-assisted laparoscopic radical prostatectomy: a single-center, single-blinded, randomized controlled trial.

To assess the importance of appropriate opioid administration methods according to nociceptive monitoring. We conducted a randomized controlled trial involving 54 patients who underwent robot-assisted laparoscopic radical prostatectomy at our hospital. Patients were randomly allocated to either receive nociception level (NOL)-directed intraoperative opioid management with a minimum flow of remifentanil (NOL group) or conventional intraoperative analgesic management (control group). The primary outcome was the mean intraoperative remifentanil infusion flow rate (intraoperative remifentanil usage [μg]/ideal body weight [kg]/operation time [min]). The main secondary outcomes were plasma concentrations of three perioperative inflammatory biomarkers (interleukin-6, C-reactive protein [CRP], and cortisol levels) and postoperative pain (Numeric Rating Scale [NRS]) scores 2h postoperatively and on postoperative days 1, 2, 3, and 7. Compared with standard analgesia management, NOL-directed analgesic management reduced remifentanil consumption by 20% ( - 0.038; 95% confidence interval, - 0.059 to - 0.017; p = 0.0007). NOL-directed management did not lead to an increase in IL-6, CRP, or cortisol levels compared with conventional analgesic management. Furthermore, this protocol led to improvements in the NRS scores at rest 2h postoperatively and upon movement up to postoperative day 3. NOL-directed analgesic management reduced remifentanil consumption by 20% and the NRS scores at rest 2h postoperatively and upon movement up to postoperative day 3 without an increase in inflammatory marker levels. Japan Registry of Clinical Trials, JRCTs052220034.

Rigid ureteroscopic lithotripsy with a pressure-controlling ureteral access sheath for complex steinstrasse

ObjectiveTo evaluate the safety and efficacy of rigid ureteroscopic lithotripsy with a pressure-controlling ureteral access sheath (PC-UAS) for complex steinstrasse.MethodsThirty-one consecutive patients (male: 18; female: 13) with steinstrasse were enrolled, six of whom had concurrent kidney stones. The mean cumulative stone size was 2.7 ± 1.3 cm. The patients were treated with rigid ureteroscopic lithotripsy using a PC-UAS. The cavity pressure parameters were set as follows: control value at -15 mmHg to -2 mmHg, warning value at 20 mmHg, and limit value at 30 mmHg. The infusion flow rate was set at 150–200 ml/min. A holmium laser (550 μm) was used to powderize the stone at 2.0–2.5 J/pulse with a frequency of 20–30 pulses/s. Analyses included cavity pressure, operative time, stone-free rates, and complications.ResultsAmong the 31 patients, 29 were successfully treated with PC-UAS, with nine requiring adjunctive flexible ureteroscopy for stone migration to the kidney. Two procedures were converted to percutaneous nephrolithotomies due to failure of sheath placement. The cavity pressure of all 29 patients was well-maintained below 20 mmHg, with clear vision. The mean operative time was 48.2 ± 17.7 min. No complications, such as ureteral perforation, mucosal avulsion, or hemorrhage, occurred. Two cases of Clavien-Dindo grade I complications occurred. No major complications (Clavien-Dindo grade II–V) occurred. The mean postoperative hospitalization time was 1.7 days. The stone-free rates 1 day and 1 month after surgery were 93.1% and 96.6%, respectively. One patient with residual stones underwent extracorporeal shockwaves.ConclusionsRigid ureteroscopic lithotripsy with PC-UAS can effectively control the cavity pressure, shorten the operation time, and improve the efficiency of broken stones, thus reducing the complication rate.

Flexible Ureteroscopy with a Tip-Flexible Pressure-Controlling Ureteral Access Sheath for Renal Stones in Children

Introduction: The aim of this study was to evaluate the safety and efficacy of flexible ureteroscopy using a tip-flexible pressure-controlling ureteral access sheath (TFPC-UAS) for renal stones in children. Methods: Consecutive patients aged 5–18 years with renal stones of diameter 1–3 cm were enrolled between January 2022 and November 2023 at Ganzhou People’s Hospital. The patients were treated with flexible ureteroscopy using the TFPC-UAS. The renal pelvic pressure (RPP) parameters were set as follows: control value at −10 mm Hg to 5 mm Hg, warning value at 20 mm Hg, and limit value at 30 mm Hg. The infusion flow rate was set to 100–120 mL/min. A holmium laser (276 μm) was used to fragment the stone at 2.0–2.5 J/pulse with a frequency of 20–30 pulses/s. The cases were analyzed for RPP, operative time, stone-free rate, and complications. Results: A total of 21 consecutive patients were included. Two patients were switched to percutaneous nephrolithotomy owing to sheath placement failure. The RPP was −4.6 ± 2.1 mm Hg. The mean operative time was 56.5 ± 17.1 min. The postoperative hospitalization time was 1.5 ± 0.3 days. The stone-free rates at 1 day and 1 month after surgery were 81.0% and 85.7%, respectively. Residual stones in 2 patients were cleared after extracorporeal shockwave lithotripsy. Three cases of Clavien I complications and one case of Clavien II complications occurred. No major complications (Clavien grade III–V) were observed. Conclusions: Flexible ureteroscopy with a TFPC-UAS is safe and effective for renal stones in children.

Experimental study of a new technique for minimally invasive percutaneous nephrolithotomy: intelligent pressure-controlled minimally invasive percutaneous nephrolithotomy

BackgroundTo test the reliability and safety of a newly invented technique for minimally invasive percutaneous nephrolithotomy, intelligent pressure-controlled minimally invasive percutaneous nephrolithotomy (IPC-MPCNL).MethodsEighteen kidneys of nine female pigs were randomly divided into three groups. Those in Groups A and B underwent IPC-MPCNL through the new system composed of a pressure-measuring MPCNL suctioning sheath and an irrigation and suctioning platform with pressure feedback control. The infusion flow rate was 500 ml/min in Group A and 750 ml/min in Group B. Those in Group C underwent MPCNL at an infusion flow rate of 500 ml/min. The renal pelvic pressure (RPP) monitored by a ureteral catheter and that monitored by the pressure-measuring sheath in Groups A and B were compared. The RPP in Group C was monitored by a ureteral catheter.ResultsThe RPP measured by the pressure-measuring sheath and that measured by the ureteral catheter in Group A was − 5.59 ± 1.95 mmHg and 4.46 ± 2.08 mmHg, respectively. The RPP measured by the pressure-measuring sheath and that measured by the ureteral catheter in Group B was − 4.00 ± 2.01 mmHg and 5.92 ± 2.05 mmHg, respectively. Hence, the RPPs measured by the pressure-measuring sheath in Groups A and B were consistent with those measured by the ureteral catheter. The RPP in Group C was 27.75 ± 5.98 mmHg (large fluctuations).ConclusionsIPC-MPCNL can be used to accurately monitor the RPP and maintain it within a preset safe range via suction. The new technique and the new system are safe and reliable.

Оценка клинической эффективности нового способа адаптивного управления инфузией при факоэмульсификации

Reduction of the adverse effects of intraoperative intraocular pressure fluctuation referred to as post-occlusion surge on the intraocular structures is an important task for ensuring phacoemulsification safety. In this regard, the method to control infusion during phacoemulsification based on controlling the infusion and aspiration flow rates in combination with monitoring of vacuum parameters was developed. The study was aimed to provide comparative assessment of clinical and functional characteristics of the eye in patients after phacoemulsification using the new and already existing adaptive infusion control methods. A total of 38 patients aged 66.4 ± 7.8 years (15 males and 23 females) in the index group (Optimed Profi system with the use of new method) and 35 patients aged 68.7 ± 7.5 years (16 males and 19 females) in the control group (Centurion Vision System with Active Fluidics) underwent surgery due to cataract. The patients underwent comprehensive eye examination before surgery and on days 1, 7, 30, months 3, 6 after surgery. The smaller loss of corneal endothelial cells on months 3 and 6 after surgery was observed in patients of the index group with grade III and IV cataract (p &lt; 0.05). Comparison of macular microcirculation parameters revealed the reduced FAZ area by month 6 of postoperative follow-up in the index group, along with the increased total vascular density of the deep vasculature (p &lt; 0.001). A significant decrease in the total density of the superficial and deep vascular plexuses by month 6 of postoperative follow-up was observed in the control group (p &lt; 0.05). The use of new adaptive infusion control method contributes to effective phacoemulsification of cataracts of varying density with the lower percentage of the corneal endothelial cells lost in the late postoperative period.

Ureteroscopic lithotripsy with pressure-measuring ureteral access sheath for large ureteral stones

Introduction To evaluate the safety and efficacy of ureteroscopic lithotripsy with pressure-measuring ureteral access sheath (PM-UAS) for large ureteral stones. Material and methods A total of 258 consecutive patients with large ureteral stones ≥15 mm was enrolled. They were treated by ureteroscopic lithotripsy with PM-UAS in the oblique supine lithotomy position. The technology can precisely monitor and automatically control cavity pressure. The cavity pressure control value was set at –15 mmHg∼–5 mmHg. The cavity pressure limit value was set at 30 mmHg. Infusion flow rate was set at 100–200 ml/min. Postoperative data such as stone-free rate and complications were analyzed. Results PM-UAS was successfully implanted in 225 patients at one stage. Eighteen cases of patients who had failed the first surgery were successfully treated with a second operation. Fifty-one cases with stones migrating up to the kidney were converted to flexible lithotripsy. The other 15 cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis. The operative time was 49.5 ± 11.2 min. The stone-free rates after one month and three months were 87.2% (212/243) and 94.2% (229/243), respectively. Complications from grade I to II were observed in 25(10.3%) patients. No other complications from grade III to V were noted Conclusion The ureteroscopic lithotripsy with PM-UAS is safe and efficacious for large ureteral stones.

The impact assessment of automated drip infusion control using weighing scale and pinch method on subjects

A novel approach in infusion flow control technology under development is based on liquid weight and pinch valve control to stop and control the flow for better management. The main part of this device consists of a load cell, a microcontroller, and a pinch valve. In this method, a pinch valve controls the rate of infusion drops as prescribed to the patient, so that nurses do not have to keep on checking the infusion flow rate. The device detects the infusion flow from the measured liquid weight, which is mathematically converted to volume. A pinch valve, via a pinch-release method, controls the amount of fluid via the pinch duration. In this study, the effective duration of valve opening and the sensations of the fluid flow by the patients are also studied. The study, which involves fourteen healthy subjects, shows that a valve opening of a maximum of 70 ms is still considered comfortable. Some subjects indicate discomfort with pinch opening longer than 70ms. A valve opening of less than 70ms shows no significant impact on the increase of outflow volume with a pinch-release period of 3000ms. The increase in outflow volume is quite linear concerning the pinch valve opening period. With this method, the prescription is more accurate and will lessen the impact of medical waste for better environmental impact..

A self-powered spiral droplet triboelectric sensor for real-time monitoring of patient infusion in nursing wards.

Monitoring of intravenous infusion together with an alarm system is significant for safety and automation operation in the process of clinical drug delivery for major medical institutions. However, there is still a lack of multifunctional sensors to monitor the whole infusion process, such as flow rate, drip rate, and temperature. Herein, we propose a self-powered droplet triboelectric sensor (SDTS) based on the principle of liquid-solid triboelectrification to monitor both intravenous infusion flow and infusion type. Such SDTS devices use two materials with different electrically charged properties to directly generate an electrical signal without any additional power supply, which is conducive to the formation of a large-scale detection system and for enhancing the convenience of medical treatment. The SDTS placed in a disposable infusion set has high potential application in clinical practice and is low cost and easy to prepare. Specifically, we demonstrate the feasibility of the detection of the current infusion flow rate and identification of the infusion medicine type according to the triboelectric signals, providing a new solution for real-time monitoring of patient infusion in nursing wards.

MEASUREMENT OF INFUSION FLOW RATE USING A DROPLET SENSOR BASED ON ARDUINO UNO

A research has been conducted to help the medical staff in the hospital. The purpose of this study is to calculate and regulate the infusion flow rate of the infusion into the patient's body. This research uses an experimental method. The liquid released from the infusion is converted into droplets, which are then detected by the LM393 optocoupler sensor, which consists of three sensors arranged around the detection area by emitting infrared light through a transmitter to detect the shadow of the droplet so that the signal is received by the receiver of the optocoupler sensor. Which is processed with the Arduino Uno microcontroller. The Arduino Uno provides the results received from the sensor and coded using the Arduino IDE software to be displayed on a 16x2-character Liquid Crystal Display (LCD). The sample used in this study was Sodium Chloride (NaCl). The calibration tools performed were droplet sensor test, servo motor test, and Real Time Clock (RTC) DS3231 module test. The results of the detection in the droplet sensor configuration showed a high degree of accuracy, with an error value of 2.414%. so that this research can be implemented in the detection and appropriate management of infusion flow rates. The current testing being carried out is still on a laboratory scale. However, in the future, this system can be developed to monitor infusions in real-time over a longer period of time and using more complex data processing functions.

Incapacité des logiciels d’aide à la prescription hospitaliers à sécuriser l’utilisation des solutions concentrées de potassium injectable

To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued by French healthcare agencies. We sent a questionnaire to the members of the Association pour le Digital et l'Information en Pharmacie. More than three quarters of the 84 responses received involving 23 CPOE systems indicate that it is possible to: prescribe an ampoule of concentrated potassium chloride 10% 10mL intravenously without any diluents (80%); prescribe 4g of KCl in a bag of 500mL of NaCl 0,9% (98%); prescribe a solution that contains 6 grams of KCl per liter (94%); prescribe the administration of an injectable ampoule orally by means of a free text comment (83%). Nearly half of the responses indicate that it is possible to prescribe: concentrated KCl ampoules as administration solvent (50%); an injectable vial to be administered by oral route (52%). At least 23 hospital CPOE systems are unable to secure the prescriptions of injectable KCl. This finding lifts the veil on an unthought, namely the role of CPOE systems in securing high-risk medications. In order to solve this problem, it should be mandatory that health information technology vendors pay particular attention to these drugs. With regard to injectable KCl, the utilisation of a dilution vehicle, maximum concentration and maximum infusion flow rate are the first four constraints to be satisfied.

Determination of spinal tracer dispersion after intrathecal injection in a deformable CNS model.

Background: Traditionally, there is a widely held belief that drug dispersion after intrathecal (IT) delivery is confined locally near the injection site. We posit that high-volume infusions can overcome this perceived limitation of IT administration. Methods: To test our hypothesis, subject-specific deformable phantom models of the human central nervous system were manufactured so that tracer infusion could be realistically replicated in vitro over the entire physiological range of pulsating cerebrospinal fluid (CSF) amplitudes and frequencies. The distribution of IT injected tracers was studied systematically with high-speed optical methods to determine its dependence on injection parameters (infusion volume, flow rate, and catheter configurations) and natural CSF oscillations in a deformable model of the central nervous system (CNS). Results: Optical imaging analysis of high-volume infusion experiments showed that tracers spread quickly throughout the spinal subarachnoid space, reaching the cervical region in less than 10min. The experimentally observed biodispersion is much slower than suggested by the Taylor-Aris dispersion theory. Our experiments indicate that micro-mixing patterns induced by oscillatory CSF flow around microanatomical features such as nerve roots significantly accelerate solute transport. Strong micro-mixing effects due to anatomical features in the spinal subarachnoid space were found to be active in intrathecal drug administration but were not considered in prior dispersion theories. Their omission explains why prior models developed in the engineering community are poor predictors for IT delivery. Conclusion: Our experiments support the feasibility of targeting large sections of the neuroaxis or brain utilizing high-volume IT injection protocols. The experimental tracer dispersion profiles acquired with an anatomically accurate, deformable, and closed in vitro human CNS analog informed a new predictive model of tracer dispersion as a function of physiological CSF pulsations and adjustable infusion parameters. The ability to predict spatiotemporal dispersion patterns is an essential prerequisite for exploring new indications of IT drug delivery that targets specific regions in the CNS or the brain.

Automated Infusion Monitoring Device Using Arduino-Based IoT (Internet of Things)

Efforts to improve healthcare services in the medical world are being made by implementing rapidly evolving Computer and Information Technology. In the medical field, particularly in infusion procedures, this is the most commonly used device. The function of infusion is to administer fluids or medication into the body through an intravenous route at a constant rate for a specific period. Infusion is performed for patients who urgently need medication or require a continuous and slow administration of fluids due to dehydration. However, during implementation in the field, issues may arise due to a lack of medical personnel and nursing errors, especially considering the ongoing Covid-19 conditions. An automated infusion monitoring device is one of the solutions created to ease the nursing process by monitoring and regulating the infusion flow rate through a monitor that displays real-time fluid volume in the nurse's area. The author employs an Arduino Mega 2560 as the data reader, a Load Cell sensor to measure the weight of the fluid in the infusion, a Servo to control the infusion flow rate, and an ESP module to connect to the server

Intravenous Fluid Resuscitation Capabilities in Simulated Reduced Gravity.

BACKGROUND: Critical care for exploration space missions may require intravenous (IV) fluid resuscitation therapy. Resource constraints may limit availability of standard, Earth-based infusion technologies. The effect of variable acceleration on infusion flow rates using simple fluid resuscitation supplies was investigated.METHODS: Infusions of water or blood analog (40% glycerol) from a 1 L IV bag were performed using pressure bag augmentation at 0, 150, or 300 mmHg. The solution bag rested on an adjustable mount, configured to different heights to simulate relevant gravitational accelerations (1 G, Martian G, lunar G, and 0 G). The bag emptied through an IV line with a 14- or 20-gauge angiocath into a 3-mmHg venous pressure reservoir. Flow rates were measured using an in-line flow probe. Three determinations were made for each test condition.RESULTS: Temporal flow rate data for all test conditions displayed one-phase exponential decay. At 300 mmHg pressurization, maximum infusion rates ranged from 92-222 mL ⋅ min-1 for water and from 21-49 mL ⋅ min-1 for blood analog. All reduced gravity conditions had significantly longer infusion times in comparison to 1 G for both test solutions.DISCUSSION: Reduced acceleration significantly altered flow rates and infusion times for fluid resuscitation. Fluid resuscitation protocols specify a desired volume to infuse for a target time (e.g., 20-30 mL ⋅ min-1 for a 75-kg adult). This data demonstrates that this protocol parameter can be achieved with infusion pressure bag augmentation alone and provides information for the refinement of fluid resuscitation protocols for exploration space missions.Pantalos GM, Heidel JS, Jain IM, Warner SE, Barefoot TL, Baker RO, Hailey M. Intravenous fluid resuscitation capabilities in simulated reduced gravity. Aerosp Med Hum Perform. 2023; 94(8):596-603.

Effect of central venous pressure on fluid delivery during start-up of syringe infusion pumps for microinfusion.

Intravenous administration of highly concentrated and potent drugs at low flow rates is common practice, particularly in critically ill children. Drug delivery during infusion start-up can be considerably delayed by intrinsic factors of syringe infusion pump assemblies. The impact of central venous pressures on the course of start-up fluid delivery of such microinfusions remains unknown. Infusion volumes delivered after activation of the start button in a conventional 50 mL syringe infusion pump assembly equilibrated (representing classical in vitro testing) and not equilibrated (representing real clinical conditions) to central venous pressure levels of 0, 10 and 20 mmHg at a set infusion flow rate of 1 mL/h were measured using a fluidic flow sensor. The experimental setup mimicking real life conditions demonstrated considerable differences in fluid delivery during pump start-up depending on central venous pressure. A central venous pressure of 0 mmHg resulted in massive fluid delivery at infusion start-up, while central venous pressure levels of 10 and 20 mmHg resulted in retrograde flows with related mean (95% CI) zero-drug delivery times of 3.22 (2.98-3.46) min and 4.51 (4.33-4.69) min, respectively (p < .0001). Depending on central venous pressure level, connection and starting a new syringe pump can result in significant antegrade or retrograde fluid volumes. In clinical practice, this can lead to hemodynamic instability and hence requires clinical alertness. Further research and methods to improve start-up performance in syringe infusion pump systems are desirable.