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Flow rates of large animal fluid delivery systems used for high‐volume crystalloid resuscitation
Author(s) -
NolenWalston Rose D.
Publication year - 2012
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/j.1476-4431.2012.00817.x
Subject(s) - medicine , catheter , resuscitation , volumetric flow rate , shock (circulatory) , volume (thermodynamics) , biomedical engineering , anesthesia , surgery , mechanics , physics , quantum mechanics
Objectives 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. Settings University veterinary teaching hospital. Design In vitro experimental study. Interventions 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. Measurements and Main 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.