An evaluation of the Rapid Infusion System

Rothen, H. U.; Lauber, Rolf; Mosimann, Marc

doi:10.1111/j.1365-2044.1992.tb02333.x

Cited by 18 publications

(7 citation statements)

References 20 publications

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“…In adult patients, options for rapid fluid resuscitation include rapid infuser devices and pressure bag support [6-8]. While these modalities are available for use in pediatric resuscitation, in our experience, syringes are most commonly used for this purpose, likely due to their relative availability and health care providers’ comfort using them.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting pediatric isotonic fluid resuscitation efficiency: a randomized controlled trial evaluating the impact of syringe size

et al. 2013

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BackgroundGoal-directed therapy guidelines for pediatric septic shock resuscitation recommend fluid delivery at speeds in excess of that possible through use of regular fluid infusion pumps. In our experience, syringes are commonly used by health care providers (HCPs) to achieve rapid fluid resuscitation in a pediatric fluid resuscitation scenario. At present, it is unclear which syringe size health care providers should use when performing fluid resuscitation to achieve maximal fluid resuscitation efficiency. The objective of this study was therefore to determine if an optimal syringe size exists for conducting manual pediatric fluid resuscitation.MethodsThis 48-participant parallel group randomized controlled trial included 4 study arms (10, 20, 30, 60 mL syringe size groups). Eligible participants were HCPs from McMaster Children’s Hospital, Hamilton, Canada blinded to the purpose of the trial. Consenting participants were randomized using a third party technique. Following a standardization procedure, participants administered 900 mL (60 mL/kg) of isotonic saline to a simulated 15 kg child using prefilled provided syringes of the allocated size in rapid sequence. Primary outcome was total time to administer the 900 mL and this data was collected through video review by two blinded outcome assessors. Sample size was predetermined based upon a primary outcome analysis using one-way ANOVA.Results12 participants were randomized to each group (n=48) and all completed trial protocol to analysis. Analysis was conducted according to intention to treat principles. A significant difference in fluid resuscitation time (in seconds) was found between syringe size group means: 10 mL, 563s [95% CI 521; 606]; 20 mL, 506s [95% CI 64; 548]; 30 mL, 454s [95% CI 412; 596]; 60 mL, 455s [95% CI 413; 497] (p<0.001).ConclusionsThe syringe size used when performing manual pediatric fluid resuscitation has a significant impact on fluid resuscitation speed, in a setting where fluid filled syringes are continuously available. Greatest efficiency was achieved with 30 or 60 mL syringes.Trial registrationClinicalTrials.gov, NCT01494116

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Section: Introductionmentioning

confidence: 99%

Factors affecting pediatric isotonic fluid resuscitation efficiency: a randomized controlled trial evaluating the impact of syringe size

et al. 2013

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“…Clinically, venous resistance has far greater impact on rates of flow than the characteristics of the equipment delivering fluids 7,8 . In addition, automated pressurization devices may increase flow by 200–300%, 9,10 thus negating the minor reduction in flow rate of any of these needleless devices. Hence, while our in vitro study demonstrated reductions in flow rates with the InterLink system and large diameter catheters, this is unlikely to have clinical significance.…”

Section: Discussionmentioning

confidence: 99%

The effect of the InterLink® cannula on fluid flow rates and haemolysis

Saw

Arendts

2001

Emergency Medicine

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Objective: To examine the effect of the InterLink cannula system (Becton Dickinson, New Jersey, NY, USA) on intravenous fluid flow rates and red blood cell haemolysis. Methods: An in vitro study was performed with crystalloid and packed red blood cells run through intravenous catheters of various sizes, with and without the InterLink cannula. Data recorded and analysed included fluid flow rates and plasma free haemoglobin concentration. Results: The InterLink cannula significantly reduced flow of crystalloid through a 14G catheter (reduction of median flow rate by 0.72 L/h, 12.3%, P < 0.001). There was a reduction of flow of packed red blood cells through a 14G catheter (0.11 L/h) but this was not statistically significant. There was no significant reduction of flow through smaller catheters and no significant effect on red blood cell haemolysis. Conclusions: The InterLink cannula reduced flow rates through large diameter intravenous catheters. Because of other factors affecting fluid infusion in vivo this is of minor clinical significance. No increased haemolysis of red blood cells occured with the InterLink cannula.

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“…3). The first of these devices, the Rapid Infusion System (RIS) (Haemonetics Corp., Braintree, MA), was developed in the 1980s for use during liver transplantation but is no longer commercially available [72]. It was capable of flow rates as high as 1200 mL/min by means of an electronically controlled roller pump, with safety mechanisms to detect air and limit infusion pressure.…”

Section: Rapid Infusersmentioning

confidence: 99%

When Minutes Matter: Rapid Infusion in Emergency Care

Piehl

Park

2021

Curr Emerg Hosp Med Rep

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Purpose of Review This review provides historical context and an update on recent advancements in volume resuscitation for circulatory shock. Emergency department providers who manage critically ill patients with undifferentiated shock will benefit from the insights of early pioneers and an overview of newer techniques which can be used to optimize resuscitation in the first minutes of care. Recent Findings Rapid infusion of fluids and blood products can be a life-saving intervention in the management of circulatory and hemorrhagic shock. Recent controversy over the role of fluid resuscitation in sepsis and trauma management has obscured the importance of early and rapid infusion of sufficient volume to restore circulation and improve organ perfusion. Evidence from high-quality studies demonstrates that rapid and early resuscitation improves patient outcomes. Summary Current practice standards, guidelines, and available literature support the rapid reversal of shock as a key priority in the treatment of hypotension from traumatic and non-traumatic conditions. An improved understanding of the physiologic rationale of rapid infusion and the timing, volume, and methods of fluid delivery will help clinicians improve care for critically ill patients presenting with shock. Clinical Case A 23-year-old male presents to the emergency department (ED) after striking a tree while riding an all-terrain vehicle. On arrival at the scene, first responders found an unconscious patient with an open skull fracture and a Glasgow coma scale score of 3. Bag-valve-mask (BVM) ventilation was initiated, and a semi-rigid cervical collar was placed prior to transport to your ED for stabilization while awaiting air transport to the nearest trauma center. You are the attending emergency medicine physician at a community ED staffed by two attending physicians, two physicians assistants, and six nurses covering 22 beds. On ED arrival, the patient has no spontaneous respiratory effort, and vital signs are as follows: pulse of 140 bpm, blood pressure of 65/30 mmHg, and oxygen saturation 85% while receiving BVM ventilation with 100% oxygen. He is bleeding profusely through a gauze dressing applied to the exposed dura. The prehospital team was unable to establish intravenous access. What are the management priorities for this patient in shock, and how should his hypotension best be addressed?

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An evaluation of the Rapid Infusion System

Abstract: Summary

Cited by 18 publications

References 20 publications

Factors affecting pediatric isotonic fluid resuscitation efficiency: a randomized controlled trial evaluating the impact of syringe size

Factors affecting pediatric isotonic fluid resuscitation efficiency: a randomized controlled trial evaluating the impact of syringe size

The effect of the InterLink® cannula on fluid flow rates and haemolysis

When Minutes Matter: Rapid Infusion in Emergency Care

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