Syringe pump

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Syringe pump with the option of programming drug dosages (2013)

A syringe pump is a metering pump for the continuous parenteral administration of drugs. In clinical practice, the term perfusor (brand name of B. Braun Melsungen ) is often used synonymously. The first syringe pump was developed in 1951 under the name of the infusion apparatus after Dr. Hess developed. She only had one running speed.

Usage

Injections and infusions can be dosed precisely with a syringe pump , which is particularly important for long-term treatment. Many drugs have to be administered in such a way that the concentration of active substances in the blood remains as constant as possible (see also basal rate ). Even when using syringe pumps, certain fluctuations in the active substance level can occur if a constant flow is not guaranteed in the infusion system, for example due to changes in height compared to the patient, or if the pharmacokinetics change over the duration of the administration for physiological reasons . Another cause of such fluctuations can be the so-called stick-slip effect, in which the syringe empties 'stuttering' due to differences in the static and sliding friction between the cavity and the piston .

Syringe pumps are used in the rescue service and preferably in intensive care units. If in 1990 four or more devices per patient were considered sufficient for a cardiac surgery patient, in 2002 it was up to 15.

Specially programmed syringe pumps are also used for patient-controlled analgesia (PCA), for subcutaneous continuous insulin infusion (CSII) or for total intravenous anesthesia (TIVA).

functionality

Syringe pumps work with electricity and are therefore active medical products , are subject to the relevant legislation and must be subjected to regular safety checks . In addition, instruction is required in order to be able to operate the device.

Syringe pumps usually have an accumulator for patient transport or in the event of a power failure . It is driven by a stepper motor and a worm rod. Data on the accuracy of the delivery rate and the start-up behavior of the motors are measured by the manufacturer as so-called start-up and trumpet curves and are enclosed with the operating instructions. The testing of the delivery behavior takes place according to the rules of the standard EN 60601-2-24 . As a rule, the devices have two processors, a main processor and a second processor to monitor the first in order to drastically reduce the susceptibility to errors. The devices undergo a self-test when they are started. If problems are found here, an infusion will be prevented until the problem is corrected.

Depending on the device, optical and acoustic alarms can indicate malfunctions such as clogging (pressure increase) or (impending) emptying of the syringe or battery, but not the injection of air .

application

Common unit of infusion and syringe pumps (2013)

The desired drug solution is filled into a syringe suitable for the device , which is clamped according to the manufacturer's instructions. The associated infusion line is connected to the corresponding access ( port catheter , subcutaneous indwelling cannula, central venous catheter ) of the patient. After the delivery options (e.g. ml / h) have been entered, the syringe pump can be started. The device now pushes the syringe plunger and with it the drug solution into the patient's body within the entered (or calculated) time.

The most commonly used syringe volume is 50 ml. Certain models can also handle syringe volumes from 1 ml to 50 ml. The dosage on the syringe pump can usually be varied from 0.1 ml / h to 99.9 ml / h, special models can even dose down to 200 picoliters per hour. The accuracy of the injection rate is specified with ± 2% and depends on the geometry of the syringe used, which is why the syringe models recommended by the device manufacturer should be used. A one-time, rapid intravenous injection of a drug ( bolus administration ) is also possible with a selectable infusion rate (up to 1200 ml / h) with most syringe pump models. In addition to the usual single-channel syringe pumps, there are also double-barreled two-channel syringe pumps which combine two channels that can be controlled separately in one housing. Microprocessor-controlled devices can interface with a patient data management system , e.g. B. to the intensive information management system have. A syringe pump can be fixed to a vertical rod, for example an infusion stand , a ceiling supply unit or a standardized supply rail according to DIN EN 19054 .

Modern syringe pumps of the same design can be combined with infusion pumps to form units and logically networked, which only have a common mains power and data line when they require less space ( automated infusion system ).

In addition, it is possible to program drug databases with substance-specific areas for the delivery rate and to have a dose calculation carried out by entering patient-related data such as body weight. So that dosages z. B. in (µg / kg body weight ) / min realizable.

Medication

The most common drugs used in syringe pumps are:

various other drugs:

Web links

Commons : Syringe Pumps  - Collection of Images

Individual evidence

  1. ↑ Rüdiger Kramme (Ed.): Medical technology: procedures, systems, information processing . Springer Science & Business Media, Heidelberg 2007, ISBN 978-3-540-34102-4 , p. 561 ( limited preview in Google Book search).
  2. ^ Definition of Infusion , Pschyrembel.de; accessed on March 18, 2020
  3. ↑ a b c d Rolf Rossaint u. a. (Ed.): The anesthesiology: General and special anesthesiology, pain therapy and intensive medicine . 3. Edition. Springer, Berlin, Heidelberg 2012, ISBN 978-3-642-21125-6 , pp. 386 ( limited preview in Google Book Search).
  4. ↑ Friesdorf et al. (Ed.): Ergonomics in intensive care medicine . Bibliomed, Melsungen 1990, ISBN 3-921958-71-7 , pp. 179 .
  5. ↑ a b c d Studies on the ergonomics of medical devices - case study of syringe pumps. Federal Institute for Occupational Safety and Health, 2008, accessed on February 7, 2015 .
  6. ↑ a b TU Dresden: Device technology for infusion therapy 2008. P. 12 , accessed on February 7, 2015 .
  7. ↑ Rüdiger Kramme (Ed.): Medical technology: procedures, systems, information processing . Springer Science & Business Media, Heidelberg 2007, ISBN 978-3-540-34102-4 , p. 563 ( limited preview in Google Book search).
  8. ↑ Rüdiger Kramme (Ed.): Medical technology: procedures, systems, information processing . Springer Science & Business Media, Heidelberg 2007, ISBN 978-3-540-34102-4 , p. 566 ( limited preview in Google Book search).
  9. ↑ Rüdiger Kramme (Ed.): Medical technology: procedures, systems, information processing . Springer Science & Business Media, Heidelberg 2007, ISBN 978-3-540-34102-4 , p. 563 f . ( limited preview in Google Book search).
  10. ↑ Rüdiger Kramme (Ed.): Medical technology: procedures, systems, information processing . Springer Science & Business Media, Heidelberg 2007, ISBN 978-3-540-34102-4 , p. 562 ( limited preview in Google Book search).