Flow rates of large animal fluid delivery systems used for high-volume crystalloid resuscitation. 2012

Rose D Nolen-Walston
Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA 19348, USA. rnolenw@vet.upenn.edu

OBJECTIVE Large animal species in states of shock can require particularly high flow rates for volume resuscitation and the ability to deliver adequate volumes rapidly may be a rate-limiting step. The objective of this study was to determine the maximum flow rates of common combinations of IV catheter, extension set, and fluid administration sets. METHODS University veterinary teaching hospital. METHODS In vitro experimental study. METHODS Maximum flow rates were measured using combinations of 4 IV catheters (3 14-Ga and a single 10-Ga), 2 IV catheter extension sets (small bore and large bore), and 2 types of fluid administration sets (standard 2-lead large animal coiled IV set and nonpressurized 4-lead arthroscopic irrigation set). The catheter, extension sets, and administration sets were arranged in 16 configurations, and flow rates measured in triplicate using tap water flowing into an open receptacle. RESULTS Flow rates ranged from 7.4 L/h with an over-the-wire 14-Ga catheter, small-bore extension, and coil set, to 51.2 L/h using a 10-Ga catheter, no extension, and arthroscopic irrigation set. There was an increase of 1.3-8.9% in flow rates between the large- versus small-bore extension sets. Crystalloid delivery in vivo to an adult horse was 21% slower (9.1 L/h versus 11.5 L/h) than the corresponding in vitro measurement. CONCLUSIONS Extremely high flow rates can be achieved in vitro using large-bore catheters and delivery systems, although the clinical necessity for rates >50 L/h has not been determined. The use of large-bore extension sets resulted in only a minimal increase in flow rate.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D007552 Isotonic Solutions Solutions having the same osmotic pressure as blood serum, or another solution with which they are compared. (From Grant & Hackh's Chemical Dictionary, 5th ed & Dorland, 28th ed) Solutions, Isotonic
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D006736 Horses Large, hoofed mammals of the family EQUIDAE. Horses are active day and night with most of the day spent seeking and consuming food. Feeding peaks occur in the early morning and late afternoon, and there are several daily periods of rest. Equus caballus,Equus przewalskii,Horse, Domestic,Domestic Horse,Domestic Horses,Horse,Horses, Domestic
D000077324 Crystalloid Solutions Isotonic solutions of mineral salts, such as RINGER'S LACTATE and SODIUM CHLORIDE (SALINE SOLUTION), used in FLUID THERAPY to rehydrate BLOOD VOLUME. Crystalloid Solution,Crystalloid,Solution, Crystalloid,Solutions, Crystalloid
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D016503 Drug Delivery Systems Systems for the delivery of drugs to target sites of pharmacological actions. Technologies employed include those concerning drug preparation, route of administration, site targeting, metabolism, and toxicity. Drug Targeting,Delivery System, Drug,Delivery Systems, Drug,Drug Delivery System,Drug Targetings,System, Drug Delivery,Systems, Drug Delivery,Targeting, Drug,Targetings, Drug

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