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<p>Minimising variance in continuous infusion of short half-life drugs is crucial in maintaining haemodynamic stability whilst transporting critically ill children. We aimed to determine whether syringe pump displacement, orientation, vibration, pump flow rate, plunger speed, and plunger pressure influence performance during transport.</p><p>We performed six iterative in-vitro experiments in an ambulance using BBraun Space Perfusor pumps. Delivery of the infusion was measured by tracking an air bubble in the delivery line. 50 mL syringes in six pumps at different displacements, and orientations, were simultaneously investigated. We studied a gimbal mounted pump (eliminating vibration), and differing syringe sizes at constant flow rate, plunger speed, or plunger pressure. Finally we investigated whether a virtual net zero displacement was similar to a pump with true near zero displacement. The experiments were repeated in triplicate. Resultant serum drug concentration variations were modelled.</p><p>Displacement along the line of G-forces cause high levels of variation. Lateral orientation was optimal (<i>p</i> &lt; 0.05). The gimbal improved delivery significantly with 50 mL syringes, but not with 20 mL syringes. Plunger speed (not flow rate or plunger pressure) is the critical factor in improving consistency. Net zero displacement was similar to trying to achieve minimal displacement. Modelled serum concentration variation improved from 96 to 216% of steady state (standard positioning), to 103 - 123% (best positioning).</p><p>Our study supports the use of 20 mL syringes, positioned laterally, with near zero or net zero displacement, and a high plunger speed for transport infusions of short half-life drugs to minimise drug delivery variability and therefore increase patient stability.</p>

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Minimising syringe pump delivery instability under G-Force stress in ambulance transports

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月13日

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  • Molly Smith,
  • Gabrielle Dyson,
  • Harry Rhodes,
  • Andrew Wignell,
  • Dusan Raffaj,
  • Patrick Davies

摘要

Minimising variance in continuous infusion of short half-life drugs is crucial in maintaining haemodynamic stability whilst transporting critically ill children. We aimed to determine whether syringe pump displacement, orientation, vibration, pump flow rate, plunger speed, and plunger pressure influence performance during transport.

We performed six iterative in-vitro experiments in an ambulance using BBraun Space Perfusor pumps. Delivery of the infusion was measured by tracking an air bubble in the delivery line. 50 mL syringes in six pumps at different displacements, and orientations, were simultaneously investigated. We studied a gimbal mounted pump (eliminating vibration), and differing syringe sizes at constant flow rate, plunger speed, or plunger pressure. Finally we investigated whether a virtual net zero displacement was similar to a pump with true near zero displacement. The experiments were repeated in triplicate. Resultant serum drug concentration variations were modelled.

Displacement along the line of G-forces cause high levels of variation. Lateral orientation was optimal (p < 0.05). The gimbal improved delivery significantly with 50 mL syringes, but not with 20 mL syringes. Plunger speed (not flow rate or plunger pressure) is the critical factor in improving consistency. Net zero displacement was similar to trying to achieve minimal displacement. Modelled serum concentration variation improved from 96 to 216% of steady state (standard positioning), to 103 - 123% (best positioning).

Our study supports the use of 20 mL syringes, positioned laterally, with near zero or net zero displacement, and a high plunger speed for transport infusions of short half-life drugs to minimise drug delivery variability and therefore increase patient stability.