Luer Lock Connector Research Articles

Erratum: Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock.

Erratum: Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock.

Validation of HepG2/C3A Cell Cultures in Cyclic Olefin Copolymer Based Microfluidic Bioreactors.

Organ-on-chip (OoC) technology is one of the most promising in vitro tools to replace the traditional animal experiment-based paradigms of risk assessment. However, the use of OoC in drug discovery and toxicity studies remain still limited by the low capacity for high-throughput production and the incompatibility with standard laboratory equipment. Moreover, polydimethylsiloxanes, the material of choice for OoC, has several drawbacks, particularly the high absorption of drugs and chemicals. In this work, we report the development of a microfluidic device, using a process adapted for mass production, to culture liver cell line in dynamic conditions. The device, made of cyclic olefin copolymers, was manufactured by injection moulding and integrates Luer lock connectors compatible with standard medical and laboratory instruments. Then, the COC device was used for culturing HepG2/C3a cells. The functionality and behaviour of cultures were assessed by albumin secretion, cell proliferation, viability and actin cytoskeleton development. The cells in COC device proliferated well and remained functional for 9 days of culture. Furthermore, HepG2/C3a cells in the COC biochips showed similar behaviour to cells in PDMS biochips. The present study provides a proof-of-concept for the use of COC biochip in liver cells culture and illustrate their potential to develop OoC.

Elastomeric Pump Infusion Failures Caused by Inadequate Luer Lock Connector Engagement to Needleless Connectors

Needleless connectors are used widely across all types of vascular access devices and provide safe, needleless administration of intravenous fluids and medications. An analysis of patients from an outpatient parenteral antimicrobial therapy program is presented in which elastomeric pumps had failed to flow due to incomplete tightening of Luer lock needleless connections. An alert was issued to community nursing staff responsible for daily elastomeric pump changes to ensure that needleless connectors were properly checked for full tightening. The frequency of failure of flow events before and after the alert was reviewed. Force and torque profiles required to activate the internal mechanism of connectors were measured in the 4 most frequently used needleless connectors in the outpatient parenteral antimicrobial therapy program. The degree of torque and force required to activate the different needleless connectors varied and was identified as a factor contributing to inadequate connection with the elastomeric pump and consequent failure of flow. Repeated feedback to nursing staff over the study period about the force and torque required for needleless connector flow activation resulted in a highly significant decrease in the rate of failure of flow events per elastomeric pump from a rate of 0.0147 events per elastomeric pump per year in the last 3 months of 2018 to 0.0003 in the first 6 months of 2020 (difference = 0.0144 [CI, 0.0097–0.02]; P < .0001).

Failure to Act: Tubing Misconnections in the United States.

Technology Today| March 15 2021 Failure to Act: Tubing Misconnections in the United States Debora Simmons, PhD, RN, CCNS, FAAN Debora Simmons, PhD, RN, CCNS, FAAN Debora Simmons is Assistant Professor, University of Texas Health Science Center at Houston, School of Biomedical Informatics, 10915 Cory, Manvel, TX 77578 (Debora.J.Simmons@uth.tmc.edu). Search for other works by this author on: This Site PubMed Google Scholar AACN Adv Crit Care (2021) 32 (1): 11–13. https://doi.org/10.4037/aacnacc2021920 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Cite Icon Cite Get Permissions Citation Debora Simmons; Failure to Act: Tubing Misconnections in the United States. AACN Adv Crit Care 15 March 2021; 32 (1): 11–13. doi: https://doi.org/10.4037/aacnacc2021920 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAACN Advanced Critical Care Search Advanced Search For over 20 years, clinicians have reported failures to connect the correct tubing to intravenous (IV), epidural, intracranial, intrathecal, gas, and other high-risk systems that resulted in death to the patient. Despite abundant evidence and consensus among organizations and agencies, tubing misconnections in the United States remain a pervasive risk to patient safety. Simply stated, the health care industry has been unable to remove a deadly and obvious threat to patients. Luer lock connectors are in every health care setting where therapies are delivered in the form of a fluid, feeding, gas, or device. Often called Luer connectors or small-bore connectors, they are the most convenient way to connect delivery systems in health care and are found at the end and/or beginning of tubing and syringe systems for delivery of IV, enteral, and respiratory therapies, gases (such as driving gases for equipment), drains,... ©2021 American Association of Critical-Care Nurses2021 You do not currently have access to this content.

Development of a multiparametric (bio)sensing platform for continuous monitoring of stress metabolites

There is a growing need for real-time monitoring of metabolic products that could reflect cell damages over extended periods. In this paper, we report the design and development of an original multiparametric (bio)sensing platform that is tailored for the real-time monitoring of cell metabolites derived from cell cultures. Most attractive features of our developed electrochemical (bio)sensing platform are its easy manufacturing process, that enables seamless scale-up, modular and versatile approach, and low cost. In addition, the developed platform allows a multiparametric analysis instead of single-analyte analysis. Here we provide an overview of the sensors-based analysis of four main factors that can indicate a possible cell deterioration problem during cell-culture: pH, hydrogen peroxide, nitric oxide/nitrite and lactate. Herein, we are proposing a sensors platform based on thick-film coupled to microfluidic technology that can be integrated into any microfluidic system using Luer-lock connectors. This platform allows obtaining an accurate analysis of the secreting stress metabolites during cell/tissues culture.

Facial Rejuvenation with Concentrated Lipograft-A 12 Month Follow-Up Study.

Lipofilling is a popular technique to treat volume loss in aging patients. The isolated adipose tissue is composed of adipocytes and stromal vascular fraction cells, which include adipose-derived stem cells (ASC). We hypothesize that the patient’s wrinkle severity scale (WSS) and patient’s satisfaction on the global aesthetic improvement scale (GAIS) can be improved after using concentrated lipoaspirate. Fourteen patients (54 years ± 11.09 years) with volume loss in the midface area underwent waterjet-assisted liposuction (Human Med AG, Schwerin, Germany). Fat was centrifuged in an ACP Double Syringe (Arthrex GmbH, Munich, Germany) using Rotofix 32A centrifuge (Andreas Hettich, GmbH & Co.KG, Tuttlingen, Germany). Homogenization was performed using the double syringe and a 1.4 mm female–female luerlock connector. After a second centrifugation, patients received periorbital (PO) and nasolabial (NL) lipografting. ASC count was performed after enzymatical digestion. Vitality of cells was assessed using a resazurin assay. During long-term follow up (12 months, n = 10), we found a high patient’s satisfaction (GAIS 1+/−0.52) and a good improvement of the WSS during short- and long-term follow-up. The ASC count of processed lipoaspirate was 2.1-fold higher than of unprocessed lipoaspirate (p < 0.001). The difference of ASC in sedimented and simply centrifuged lipoaspirate was also significant (p < 0.05). Facial rejuvenation with concentrated fat graft offers good results concerning objective aesthetic outcome and patient’s satisfaction.

Microbial colonization of intravascular catheter connectors in hospitalized patients

Central line-associated bloodstream infections may be due to catheter connector colonization and intraluminal migration of pathogens. We assessed the colonization of the split septum catheter connector system, and subsequently the luer lock catheter connector system. This was a prospective, 2 phase, quality improvement study at a tertiary referral center. Each phase of the study was performed over 3 consecutive days in hospitalized patients receiving an active infusion; first with a split septum lever lock connector and second with a luer lock connector and alcohol port protector. The connectors were inoculated onto blood agar plates and incubated. Plates were assessed for microbial growth after 48-72 hours. In phase I, 98 (41.9%) of 234 split septum connectors yielded microbial growth. In phase II, 56 (23.1%) of 243 luer lock connectors yielded microbial growth. In phase II only, there was a significant increased rate of contamination in peripheral catheters compared with all other catheters, and the rate of contamination on the acute care wards was significantly higher when compared with the intensive care units. Bacterial colonization of the lever lock system was unacceptably high among all catheter types and hospital locations. Transition to luer lock catheter connectors and alcohol port protectors decreased the colonization; however, colonization still remained substantial. Causation of colonization cannot be determined with these results.

Microbial Colonization of Intravenous Luer Lock Connector During Active Infusions Among Hospitalized Patients

BackgroundCentral line associated bloodstream infections (CLABSI) result in patient morbidity and increased length of stay. While most CLABSI’s are due to extraluminal carriage of skin flora into the bloodstream, catheter hub colonization and intraluminal carriage remains a possible cause. We have previously evaluated a lever lock catheter in hospitalized patients, which had a 41.9% bacterial colonization rate. After replacing the lever lock system with a leur lock catheter system and passive port protector, we evaluated the colonization rate of this luer lock catheter system.MethodsA prospective 3 day study was performed evaluating the microbial colonization of the luer lock system in hospitalized patients with active infusions. Infusions were assessed, and if not deemed critical or an antimicrobial, paused while the catheter connector hub was used to inoculate a blood agar plate. After 48–72 hours the plates were evaluated for microbial growth.Results243 catheter connector hubs were cultured: 68 catheters were peripherally inserted central catheters, 60 were internal jugular venous lines, 93 were peripheral venous catheters, and 25 were others (femoral, subclavian, etc). 56 hubs (23.0%) yielded microbial growth. 176 of the hubs (71.5%) tested were in an ICU setting, and 70 (28.5%) were from an acute care ward. In comparing the luer lock system to the previously evaluated lever lock system, there was a reduced rate (P < .0001) of colonization. This reduction in the rate of colonization of the luer lock system was significant in the ICU (P < .0002). There was no difference seen in the colonization rate of the two systems in the acute care wards (P < .11).ConclusionThe luer lock system provided a significant reduction in colonization rates of catheters hubs, particularly in the ICU. However the observed 23% colonization rate remains unacceptably high. Causation of colonization is unable to be determined by this study. Given the potential for catheter hub colonization to increase the risk of CLABSI, the opportunity exists for further research.Disclosures All authors: No reported disclosures.

Observation of microbubbles during standard dialysis treatments.

BackgroundThe infusion of microbubbles as a side effect of haemodialysis was repeatedly demonstrated in recent publications, but the knowledge on the source of microbubbles and on microbubble formation is scarce.MethodsMicrobubbles in the range of 10–500 µm were measured by a non-invasive bubble counter based on a pulsed ultrasonic Doppler system in a non-interventional study of a single centre. Totally, 29 measurements were performed in standard treatments covering a broad range of patient and treatment conditions (types of blood access, treatment modes, blood flow rates and arterial pressures).ResultsSeveral possible sources of microbubbles could be identified such as an arterial luer lock connector at negative pressure and remnant bubbles from insufficient priming, but some sources of microbubbles remain unknown. Microbubbles were found in all treatments, haemodialysis (HD) and online haemodiafiltration. The lowest average microbubble rates (17 ± 16 microbubbles per minute) were observed in patients treated by online haemodiafiltration at medium blood flow rates and moderate arterial pressures and the highest average microbubble rates (117 ± 63 microbubbles per minute) at high blood flow rates (550 mL/min) and low arterial pressures (−210 mmHg). Generally, the microbubble rate correlated to both blood flow rate (correlation coefficient r = 0.45) and negative arterial pressure (r = 0.67).ConclusionsMicrobubbles are a general side effect of HD; origin and pathophysiologic consequences of this phenomenon are not well understood, and deserve further study.

PP-002 Evaluation of a medical device to improve the security of intraspinal administration of cytotoxic drugs

BackgroundIntraspinal administration errors are identified in the list of ‘never events’ of the French Health Authority (ANSM). New devices with different connectors incompatible with standard Luer-lock connectors (Univia syringe, Becton-Dickinson)...

Bradycardia during laparoscopic surgery due to high flow rate of CO2insufflation

Bradycardia during laparoscopic surgery due to high flow rate of CO₂insufflation

Dangerous Connections: Healthcare Community Tackles Tubing Risks

Dangerous Connections: Healthcare Community Tackles Tubing Risks

Artificial erection in Peyronie's disease surgery

Figure 1 Loose body in knee joint sited into either corporal body through the glans (Figs 1 and 2), taking care not to injure the penile urethra. Following adequate placement, the cannula is secured to the foreskin with a suture and a non-return valve with a Luer lock connector is attached (Fig 3). The penis is inflated using 50ml of normal saline. The syringe can then be detached, refilled and reattached without dismantling the cannula mechanism.

Tourniquet Systems Pose Challenges

Q: We constantly have work orders on our tourniquet systems in the operating room. Do you have any suggestions on how we can reduce work orders?A:. We have struggled with this at our hospital and have developed a system that reduces downtime and surgeon frustration with tourniquet systems. These systems have become much more high tech than they were 10 to 15 years ago. In the past, the system was a cuff connected to a pressure regulator. When the pressure reached a preset pressure, the valve closed and held the cuff at the pressure it was set at until the valve was manually released. The good news is not much has changed, although there are more bells and whistles, along with some added safety features, that make these devices seem more sophisticated than earlier versions.The five basic components of most tourniquet systems—inflatable cuff, pressure display, compressed gas source, pressure regulator, and connection tubing—can lead to numerous issues. A variety of devices now use an electrical pump which compresses ambient air. If the device does not have this technology, then most likely it needs to be connected externally to some compressed gas source such as nitrogen. Regardless of the source of compressed gas, the goal is to deliver a carefully regulated amount of pressure to the tourniquet cuff. The pressure display is an extremely simple device that digitally or pneumatically displays the pressure at the tourniquet cuff. Some devices today can supply and read two cuffs at time, in which case there would be a dual display. Whichever type your facility has, the goal is to know exactly what the cuff pressure is set for and what the pressure actually is. The control board is found on “microprocessor controlled” tourniquet systems. It is nothing more than a board that everything plugs into, sits on, or goes through. And it does that so there is a control point or a “chief” to make sure all tasks are completed. The pressure regulator's sole purpose is to adjust and control the pressure in the cuff. Older devices, which were not “computerized,” were comprised of valves that mechanically responded to pressure. Most devices today are microprocessor controlled. They can be microprocessor controlled because the pressure regulator and pump are combined into one instrument. This microprocessor-controlled regulator is a very finite instrument, which can detect very small changes in pressure and respond to those changes accordingly, adding or releasing pressure from the cuff.Modern tourniquets also offer many safety features. Some of these features include interlocks that cause the cuff to stay pressurized should the power inadvertently be switched off or if the unit is put in “stand by.” Some devices warn users that the tubing is kinked or occluded, preventing the instrument from displaying and resulting in invalid pressure. Alarms are also included on some tourniquets that alert the user to leaks in tubing or the cuffs.Some pieces of a tourniquet which are most often overlooked, and always need attention, are the connection tubing and the inflatable cuff. Most tubing either utilizes a Positive Locking Connector or a Luer-lock connector. It does not matter what connector is utilized, the connection must be a tight fit to prevent leaks.Some devices automatically calibrate themselves every time they are turned on. Other units must have a certain hose connected to calibrate them.Regardless of which technique is used, it is very important that the specific hose for that unit is always used because this will affect the calibration and in return affect the pressure in the cuff, ultimately leading to blood leaking. In my experience, blood leaking is very annoying to a surgeon who is trying to perform a specific surgery.Cuffs may not be considered a biomed issue, but I work under the premise that building a bridge with staff always results in a positive outcome. In my shop, cuffs are a biomed issue. The right cuff for the right procedure is as important as the right tool for the right job. Familiarize yourself with cuff sizes and when and where they are used. Most sales representatives are eager to explain this to you. Make sure the right cuffs are available and serviceable. Check that cuff to ensure the Velcro is good and not filled with lint. Make sure the o-ring on the cuff is flexible and moves easily. Replace it immediately if it doesn't move easily or is cracked. These little 10-cent o-rings will cause a lot of issues if they are not serviceable.Here are some simple things a biomed can do to maintain this equipment:When our facility adopted this process, our work orders on tourniquets dropped exponentially. And here is the best part, surgeon confidence with our particular device and manufacturer increased.

Embolie gazeuse sur cathéter central chez un nouveau-né prématuré, méfiez-vous de votre montage de perfusion !

A fatal pulmonary air embolism, confirmed by an oriented necropsy, is described in a 25-day-old premature and small-for-gestational-age neonate. The embolism was suspected after air bubbles were detected in the infusion line. The air bubbles originated from a male Luer-lock to male Luer-lock connector, which was part of a specific assembly of the perfusion line. A solution to this problem is thereby proposed. We recommend caution in using complex infusion line assemblies because such complications are probably underestimated.

Focus on nanoscience and nanotechnology

Focus on nanoscience and nanotechnology

Use of a large bore syringe creates significantly fewer high intensity transient signals (HITS) into a cardiopulmonary bypass system than a small bore syringe

High intensity transient signals (HITS) have been reported to occur following perfusionist intervention during cardiac surgery. This study investigates the relationship of the syringe bore, injection rate, and HITS created. Syringes (10 mL) with a male luer-lock connection (Large Bore) and Abboject 'jet syringes' with a 20 GA needle and male luer-lock connector (Small Bore) were filled with 10 mL of 0.9 N saline. A perfusionist was randomly assigned a set of four similar syringes followed by the other syringe bore. Each of the four syringes was injected into an in vitro saline-primed cardiopulmonary bypass (CPB) system over 5, 10, 15, or 20 sec. Sixteen randomizations of small and large bore syringes were completed at the four injection times (128 injections). HITS in the CPB arterial line were detected with transcranial Doppler (TCD) probes, were recorded for the 2 min following the injection, and were counted independently off-line by two reviewers. The use of a large bore syringe compared to a small bore syringe created significantly fewer HITS (29 +/- 6 versus 145 +/- 17 [mean +/- SEM], p<0.001) introduced into the CPB arterial line. Injection over a longer time produced significantly fewer HITS than shorter injection times (p<0.001). Significantly fewer HITS are introduced into the CPB system by using standard syringes and slower injection time.

Failure of a Luer lock

I wish to report the failure of a Luer lock intravenous delivery system. During anaesthesia for a mastectomy, an intravenous fluid administration system was employed using, in part, an Avon wide bore extension set (Avon Medical, SIMS Portex Limited, Hythe, UK) connected via a Codan ‘R-Lock’ one way valve (Codan Ltd, Wokingham, UK) to an intravenous cannula. The Luer lock between the extension tubing and one-way valve was tightened using normal force. Upon opening the regulator, fluid was seen dripping from the junction between these components. Morphine had been administered into a 3-way tap upstream from the extension tubing and the amount of morphine delivered to the patient was therefore unclear. I recreated this system with fresh equipment of the same make and the leak was seen again. Although tightening the Luer lock using considerable excess force could contain the leak, I believe this represents a potential hazard. Comparing the Luer lock threads on the R-Lock one-way valve, a BD Connecta Plus 3 three-way tap (Becton Dickinson Infusion Therapy AB, Helsingborg, Sweden), a Universal luer lock cap (Universal Hospitals Supplies Ltd, London, UK) and the upstream end of the Avon wide bore extension set, revealed different patterns and thickness of thread (see Fig. 1). It is likely that, given this wide variation in design, incompatibility of the kind I have described will occur with other combinations of components. Differing designs of Luer lock. Clockwise from top left: Universal luer lock cap, BD Connecta Plus 3 three-way tap, Codan ‘R-Lock’ one-way valve, Avon wide bore extension set. There is already concern about the design of Luer lock systems for intravenous administration, particularly with regard to the security of the lock [1]. There is also the wider problem of the ubiquitous nature of the Luer design (for example, its use for neuraxial access systems and gas sampling devices) [2]. The fact that decades after its introduction, standardisation of the Luer lock has not been achieved does not offer hope for a solution to the wider problem. Thank you for bringing this matter to our attention and for giving us the opportunity to comment. The female Luer lock used on Avon wide bore extension sets is designed and manufactured to meet the requirements of British Standard BSEN1707 : 1997 (Conical fittings with a 6% (Luer) taper for syringes, needles and certain other medical equipment. Lock fittings). This standard specifies both the dimensions and performance requirements for Luer Lock connectors and is harmonised with International Standard ISO594. Compliance with this standard should ensure the compatibility of equipment manufactured by different companies. However, the standard does allow a degree of flexibility in design and this results in the different configurations seen in Dr Fletcher's photographs. The problems that Dr Fletcher encountered may relate to an isolated fault with either of the connecting parts. We have no adverse complaints or quality history relating to the Avon component and therefore we are unable to define the exact root cause of the reported problems. A. LingProduct Manager Smiths Medical Hythe CT21 5BN, UK E-mail: complaints@smiths-medical.com

Specific resistance of Veress needles, disposable and reusable trocars is limiting CO2 gas flow performance in pelviscopy and laparoscopy

SummaryAn efficient insufflation technique is essential for laparoscopy. Up to now physicians have had to rely on their experience and intuition when putting together an insufflation system. Comparable, objective data about the insufflation properties of all insufflation components used has not been available. In this study, details of the insufflation properties of disposable and reusable Veress needles and trocars and Luer lock connectors and the particular meaning of flow resistance for function and efficiency of the entire insufflation system have been measured and compared. In an independent laboratory study, a computer-based data acquisition measurement model was developed. Specific pressure dependent flow and resistance curves of insufflation components from manufacturers such as Auto Suture, Dexide, Ethicon, HiTec, Olympus, Origin, Richard-Allan, Volzer, Wiest, Wolf and Storz were evaluated by measurement of physical parameters pressure, CO2 gas flow and resistance. Through the introduction of reference values, different insufflation properties for all studied components were characterised for the first time and can be compared. Despite similar type of construction, remarkable differences of CO2 gas flow were found in Veress needles (0.85–2.38 L mim−1, disposable (3.91–9.61 L mim−1) and reusable trocars (5.27–21.07 L min−1) at reference pressure of 12 mmHg, if used for insufflation only. It further decreased after insertion of a 10 mm optic for disposable (1.53–7.08 L min−1) and reusable trocars (1.22–14.03 L min−1). All insufflation components have different flow properties, due to the space left for insufflation. The largest resistance is usually the diameter size at the insufflation supply (1.5–4.3 mm). In general, disposable trocars are not useful for high flow insufflation (> 10 L mim−1) at PRef = 12 mmHg). Only two reusable trocars studied deliver high flow with a 10 mm optic inserted (HiTec 1013, Olympus A 5359). Resistance, especially of disposable trocars, needs to be improved by enlarging the insufflation diameter. Resistance-optimised insufflation components are more efficient, faster and could save time and money. Users need to demand resistance-improved products from manufacturers, who should publish reference values about specific flow and resistance properties of their products.

Simple Transfer of Cryoprecipitate

Barbara J. Roberts, M.D., Assistant Professor of Anesthesiology, Director, Transplantation Anesthesia Service.Nilda E. Salaman, M.D., Assistant Professor of Anesthesiology, Department of Anesthesiology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060.To the Editor:--Orthotopic liver transplantation (OLT) is an effective treatment for end-stage liver disease. The procedure is fraught with the risk of massive intraoperative blood loss and severe coagulopathy requiring the anesthesiologist's efficient use of time to correct the acute blood loss, coagulopathy, and hemodynamic and metabolic derangements that are present. Several devices facilitate the rapid administration of warm fluids and blood products. Cryoprecipitate usually is given separate from the rapid infusion system (RIS) to prevent dilution of the cryoprecipitate in the reservoir of the RIS, which may be filled with a mixture of crystalloid, packed erythrocytes, and fresh frozen plasma.Our regional American Red Cross provides the blood bank with cryoprecipitate with an approximate volume of 10–15 ml in a 300-ml bag. Transfusing multiple bags (i.e., 5–10 units) of cryoprecipitate one after another is labor-intensive and inefficient. Also, one may risk a needlestick injury and its sequelae when attempting to aspirate the contents of multiple bags into one large syringe.We describe a device for effectively transferring cryoprecipitate for bolus infusion. After appropriately identifying each bag of cryoprecipitate, one bag is retained as a reservoir, and subsequent bags are used for transfer of their small volume of cryoprecipitate into the 300-ml reservoir bag. This is achieved through a large-bore blood priming catheter. Using two sterile Blood Bag Spike "Quickie Prime" 1/4 x 1/16 x 3-inch catheters (Surgimedics, Woodlands, TX) connected by one sterile 1/4 x 1/4-inch straight luer lock connector (Cobe Cardiovascular, Arvada, CO), we composed a rapid transfer catheter (Figure 1) that facilitates the pooling of cryoprecipitate into one infusion bag. The components are sterile, and the luer lock port allows a needleless syringe aspiration to obtain residual cryoprecipitate from the transfer bag. We emphasize that it is important to observe the use of sterile technique throughout the pooling process and that the cryoprecipitate transfer device should be used for only one set of pooled products (i.e., 5–10 units). Once pooled, the cryoprecipitate can be transfused using a standard blood infusion set.We believe that pooling the cryoprecipitate units into a reservoir bag using our device provides an efficient method for transfer and administration, simplifying the effort of cryoprecipitate administration to the patient and decreasing the risk of needlestick injury to the anesthesiologist. This device also can be used in procedures when severe coagulopathy may require the administration of multiple units of cryoprecipitate.Barbara J. Roberts, M.D., Assistant Professor of Anesthesiology, Director, Transplantation Anesthesia Service.Nilda E. Salaman, M.D., Assistant Professor of Anesthesiology, Department of Anesthesiology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060.