Prediction of flow capability in intravenous infusion systems: implications for fluid resuscitation. 1990

B K Philip, and J H Philip
Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.

The pressure-flow (P-F) relationship for intravenous infusion systems is nonlinear and may be expressed by the quadratic model P = RLF + RTF2. The flow parameters RL and RT may represent the resistance of laminar and turbulent flow, respectively. In this study pressure and flow were measured, and RL and RT were calculated for several infusion tubings, catheter, and system components. We then developed a technique to identify the relative effect of various devices on achieving the higher flows needed for fluid resuscitation. A typical infusion system was chosen, and the experimentally determined flow parameters RL and RT of its components were used in the quadratic P-F relationship at P = 300 mm Hg. Devices in the infusion system were ranked, using a subtractive algorithm, according to their relative impediment to flow as measured by contribution to the pressure drop. The order of devices removed or replaced, from largest to least pressure drop, was as follows: fluid warmer, 16-gauge catheter, check valve, 14-gauge catheter, standard-bore Y tubing, 12-gauge catheter, and standard-bore stopcock, leaving 10-gauge catheter + wide tubing. Devices with large RT, such as fluid warmers and check valves that produce large pressure drops, should generally be avoided during fluid resuscitation when high flows are needed. A similar ordering of device removal or substitution (largest to least pressure drop) was determined using the traditional but incorrect linear P-F model, P = RF, and the order of devices chosen for elimination was different.(ABSTRACT TRUNCATED AT 250 WORDS)

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
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D005440 Fluid Therapy Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS. Oral Rehydration Therapy,Rehydration,Rehydration, Oral,Oral Rehydration,Rehydration Therapy, Oral,Therapy, Fluid,Therapy, Oral Rehydration,Fluid Therapies,Oral Rehydration Therapies,Oral Rehydrations,Rehydration Therapies, Oral,Rehydrations,Rehydrations, Oral,Therapies, Fluid,Therapies, Oral Rehydration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016014 Linear Models Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. Linear Regression,Log-Linear Models,Models, Linear,Linear Model,Linear Regressions,Log Linear Models,Log-Linear Model,Model, Linear,Model, Log-Linear,Models, Log-Linear,Regression, Linear,Regressions, Linear

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