Arrangements of the intravenous parallel infusions with anti-reflux valves decreasing occlusion alarm delay

Abstract

Background: The methods of arrangement of combined intravenous parallel infusions using anti-reflux valve (ARV), with and without anti-syphon valve (ASV) that could decrease occlusion alarm delay were investigated.

Methods: Occlusion challenge tests were mainly performed as bench experiments of four kinds of multiple parallel infusions (10 ml/h and 50 ml/h infusions), which were connected at the proximal or distal portion of ARV, with or without ASV. Alarm threshold was set to 1000 mmHg. Occlusion alarm delays and the compliances of the infusion systems were compared among groups.

Results: Without ASV, compared to 10 ml/h infusion alone distal to anti-reflux valve, 50 ml/h infusion distal to anti-reflux valve reduced the mean alarm delay from 416 ± 7 s to 81 ± 3 s (P < 0.001). Compared to 50 ml/h infusion alone, combined 10 ml/h and 50 ml/h infusion distal to ARV prolonged the alarm delay from 81 ± 3 s to 133 ± 6 s (P < 0.001). However, combined infusions distal to ARV with ASV significantly reduced the alarm delay from 133 ± 6 s to 74 ± 5 s (P < 0.001), and also reduced the compliance of the infusion system from 2.31 ± 0.12 to 1.20 ± 0.08 µl/mmHg (P < 0.001).

Conclusions: The infusion setup of faster infusion rate, lower compliant system using ASV could effectively decrease occlusion alarm delay during multiple intravenous parallel infusions using ARV.

Keywords: Anesthetics; Equipment safety; Intravenous infusion.

Fig. 1

Four kinds of setups for the multiple parallel infusions of 10 ml/h and 50 ml/h using anti-reflux valve (ARV) with or without anti-syphon valve (ASV) for occlusion challenge test. The 10 ml/h infusion alone was connected distal to ARV (IR10), and the 50 ml/h infusion alone distal to ARV (IR50), and both 10 and 50 ml/h infusions distal to ARV (IR10&50), and both 10 and 50 ml/h infusions distal to ARV using ASV (IR10&50 + ASV). The gray portion indicates the portion anticipated to be closed after occlusion.

Fig. 2

Scatter plots of the relationship between the syringe driving pressure and the infused volume after occlusion of the multiple parallel infusions of 10 ml/h and 50 ml/h using anti-reflux valve (ARV). The 10 ml/h infusion alone was connected distal to ARV (black dot, ●), and the 50 ml/h infusion alone distal to ARV (black blank, ○), and both 10 and 50 ml/h infusions distal to ARV (gray dot, ●), and both 10 and 50 ml/h infusions distal to ARV using anti-siphon valve (gray blank, ○).