Infusion pump

The pump user interface usually requests detailed settings for the type of infusion from the technician or nurse:

• Continuous infusion usually consists of small infusion pulses (typically in the range of 500 nanoliters to 10,000 microliters, depending on the design of the pump) with a pulse repetition rate that depends on the programmed infusion rate.
• Intermittent infusion occurs at a “high” infusion rate with programmable time intervals. This mode is often used to control the dosage of antibiotics or other drugs that can irritate blood vessels.
• Patient-driven is an on-demand infusion, and limits are usually programmed to prevent overdose. The speed is controlled by pressing a button that the patient can perform on his own. This method is used for patient-controlled analgesia (PCA) , in which small doses of Opioid analgesics are repeated, the intake of which is blocked before the dose, which can lead to respiratory depression.
• A complete parenteral nutrition infusion curve mimics a normal diet.

Some pumps offer modes in which dosages may vary depending on the time of day. This allows you to organize circadian cycles that may be required for certain types of drugs.

Reusable

It is customary to distinguish 2 base classes of infusion pumps.

• large volumes - they can pump enough solution to feed the patient
• small volume - for the introduction of hormonal drugs ( insulin pump ) or other drugs, such as opiates .

In these classes, pumps can be identified for use.

• in a hospital
• portable
• special systems for use in the field

For large volume pumps, one type of peristaltic pump is usually used. Classic designs use computer-controlled rollers to periodically squeeze a silicone tube through which fluid flows.

Small-volume pumps typically use a computer-controlled drive to move the piston of an installed syringe.

Disposable

Disposable infusion pumps (microinfusion pumps) are divided into:

• infusion rate
  • constant infusion rate
  • variable infusion rate
• by the presence of a PCA bolus
  • with a PCA bolus
  • no PCA bolus

Modern (for 2003) infusion pumps can have the following safety functions:

• Certified pumps must meet increased fault tolerance requirements. No reason for failure should make the pump silently fail, at least the pumping stations should stop and at least an audible indication of errors should be issued. This is the minimum requirement for all infusion pumps for people, regardless of patient age. For veterinary infusion pumps this is not required.
• The presence of batteries so that the pump can operate when the power supply is turned off or off.
• Pressure sensor - detects when the patient’s veins are blocked or the system tubes are twisted.
• Air sensor in the line - ultrasonic transmitter and receiver, which determine air intake, are usually used as a sensor.
• The pressure sensor can detect when the bag or syringe is empty.
• Drug libraries with programmable limits for individual drugs can avoid medical errors.
• Mechanisms for avoiding an uncontrolled flow of drugs.
• Many pumps record the internal log of the last several thousand therapy events. Log entries are usually labeled with a date and time from the pump clock. The ability to delete the log is usually password protected.

Infusion pumps are used for long-term accurate administration of microdoses of drugs when their dilution (for example, in physiological saline ) is impossible (for example, in the case of epidural anesthesia ) or undesirable ( heart failure , edema ). These devices are most actively used in departments of anesthesiology and intensive care.

Typical use cases:

• The need for controlled intra- and postoperative analgesia, including obstetrics for labor pain relief;
• Conducting chemotherapy and analgesia in oncology;
• The introduction of nitrates and anticoagulants in cardiology;
• Long-term administration of vascular drugs in neurology.

Infusion pumps have been the source of many patient safety concerns, and problems with these pumps have been associated with more than 56,000 reports of adverse events over the past five years (in the US ), including at least 500 deaths. ^[1] As a result of the US Food and Drug Administration (FDA) launched comprehensive initiatives to improve their safety, stricter regulation of infusion pumps has also been proposed.

• Intravenous infusion
• Parenteral Administration
• Parenteral nutrition
• Clinical nutrition