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///2015 Abstract Details
2015 Abstract Details2019-08-02T16:54:43-05:00

Pressures Differences Generated by a CADD-Solis Programmed Intermittent Bolus Pump at Infusion Rates of 100, 175, and 300 cc/hr

Abstract Number: S-20
Abstract Type: Original Research

Elizabeth MS Lange MD1 ; Thomas T Klumpner MD2; Paul C Fitzgerald BSN, MS3; Cynthia A Wong MD4; Paloma Toledo MD, MPH5

Introduction: Epidural infusion pumps capable of delivering timed boluses of local anesthetic with PCEA recently became commercially available. Several infusion rates are available for delivering the timed bolus, and the optimal bolus rate is unknown. Previous studies have examined pressure waveforms produced by epidural infusion pumps at infusion rates of 5, 10, 15, 50 and 99mL/hr (1, 2); however, infusion rates as high as 300mL/hr may be used in clinical practice. The objective of this in vitro study was to determine the pressure generated by a programmed bolus delivered by a CADD-Solis Programmed Intermittent Bolus (CADD-PIB) pump at infusion rates of 100, 175, and 300 cc/hr.

Methods: A CADD-Solis PIB pump was connected to a three-way adapter connected to a 17G single orifice epidural catheter and a pressure transducer (BC Group DPM-2300). No epidural filter was used. The pressures were recorded by computer. Calibration runs were performed at 100, 175, and 300 cc/hr until peak pressures generated at each flow were within 10%. Three runs at each flow were performed. The experiment was repeated with a second 17G single orifice epidural catheter for validation. Differences in the peak and mean pressures were compared among flows using analysis of variance.

Results: The mean peak pressure generated at 100cc/hr was 3.84 ± 0.24 pressure per square inch (psi), at 175cc/hr was 5.00 ± 0.23 psi, at 300cc/hr was 7.31 ± 0.48 psi. The average mean pressures were 2.02 ± 0.12 psi at 100 cc/hr, 3.42 ± 0.18 psi at 175 cc/hr, and 5.55 ± 0.30 psi at 300 cc/hr, respectively. There was a difference among flows in both the peak and mean pressures generated (P<0.001 for each). A schematic diagram representing pressure waveforms is shown (Figure).

Conclusions: This study demonstrated that as flow increases, the peak and mean pressures increase as well. This is in contrast to the findings of previous studies which found no change in peak pressure with increases in flow; however, the flow rates in those studies were less than 100 cc/hr. Pressure may vary with epidural catheters of different sizes, with different infusion tubing, and with different pump characteristics. Understanding the pressure generated during infusion may assist with calibration of pressure-triggered catheter occlusion alarms, and also serve as a comparison for other programmed intermittent bolus pumps.

References

1. OJAnes 2013:3:214-217

2. Anaesthesia 1999:54:666-669



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