Prevention of drug delivery disturbances during continuous intravenous infusion: an in vitro study on a new multi-lumen infusion access device

Abstract

Objective: Stopping and restarting carrier fluid flow and performing simultaneous drug infusions can lead to hazardous disturbances in drug delivery. The present study was designed to assess in vitro whether using a multi-lumen infusion access device could prevent noradrenaline disturbances.

Study design: In vitro laboratory work.

Methods: Two infusion devices were studied: a standard device with a four-port manifold and a 150cm extension line and a nine-lumen infusion device (Edelvaiss-Multiline(®)) with eight accesses connected to nine separate lumens in a single tube of 150cm: seven accesses connected to seven peripheral lumens and one for the carrier fluid access connected to two lumens. Two experimental protocols of noradrenaline infusion were made: (a) drug flow rate change and (b) stop-and-go carrier fluid flows. Two parameters were studied: drug mass flow rate and flow change efficiency (FCE) calculated from the ratio of the area under the experimental mass flow rate curve to the area under the theoretical instantaneous mass flow rate curve.

Results: Variations in noradrenaline mass flow rate were more rapid with the Edelvaiss-Multiline(®) when the noradrenaline infusion rate was increased or decreased. FCE was significantly different from one infusion device to the other during both noradrenaline flow rate increase (standard vs. nine-lumen: 58% vs. 84%; P=0.008) and decrease (175% vs. 108%; P=0.008). Decreased drug delivery after stopping carrier fluid flow (standard vs. nine-lumen: 21% vs. 98%; P=0.008) and sudden temporary increases on resumption (253% vs. 103%; P=0.008) were reduced in magnitude and duration when using the Edelvaiss-Multiline(®) with a significant difference in FCE between the two infusion devices.

Conclusions: Using the nine-lumen infusion device reduces drug delivery disturbances during continuous intravenous infusion.

Keywords: Chlorure de sodium/administration et dosage; Drug delivery systems/instrumentation; Infusions; Material testing; Norepinephrine/administration and dosage; Norépinephrine/administration et dosage; Parenteral; Parentéral; Perfusions; Sodium Chloride/administration and dosage; Systèmes de délivrance de médicament/instrumentation; Test de matériel.