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Weaver LK, Ray, D., Haberstock D. Comparison of three intravenous infusion pumps for monoplace hyperbaric chambers. Undersea Hyperb Med; 32(6):451-456. We compared the infusion accuracy of the Baxter Flo-Gard® 6201, IVAC® 530 and Abbott Lifecare®3HB pumps with saline and enteral formula at chamber pressures from 86.1 kPa (0.85 atm abs) to 304 kPa (3.0 atm abs). The Baxter pump infused ±10% saline at all tested pressures and rates (1-1,999 ml/hr). At 1 ml/hour, the IVAC infused 18% more saline than expected (86.1 kPa). The Abbott infused -15% and -23% than expected at 202.6 kPa (999 ml/hr) and 304 kPa (800 ml/hr), respectively. A 10-minute chamber compression and decompression (86.1-304-86.1 kPa) resulted in lower-than-expected measured volumes during compression (64-112%) and higher-than-expected measured volumes during decompression (62-114%) at rates of 1, 5, and 10 ml/hr for all pumps. Enteral infusions (100 ml/hour) resulted in -20% to +12% fluid volume discrepancies. In conclusion, the Baxter pump had the best overall performance. Changes observed during compression and decompression may be clinically important.
INTRODUCTION
Many patients treated with hyperbaric oxygen (HBO^sub 2^) in monoplace hyperbaric chambers require continuous intravenous (IV) infusions during treatment. Intravenous infusions include crystalloid solutions and medications such as antibiotics, anxiolytics, analgesics, and others. Patients with life-threatening illnesses such as severe sepsis, gas gangrene, and necrotizing fasciitis may need large volume IV infusions and carefully controlled infusions of cardiovascular vasoactive drugs or insulin delivered at rates as low as 1 ml/hr. Rapid fluid resuscitation may be necessary while treating some critically ill patients during HBO^sub 2^ therapy (1,2). Critically ill patients also warrant aggressive, tight glucose control with insulin infusions to reduce mortality (3). Therefore, accurate insulin infusions are potentially important during HBO^sub 2^ therapy.
Although enteral feeding may be discontinued for HBO^sub 2^ therapy, there are some circumstances where continuing enterai feeding during HBO^sub 2^ therapy might be important. For example, a patient with brittle diabetes needing a continuous insulin infusion during twice daily HBO^sub 2^ treatments for severe infection might have glucose instability if enterai feeding is discontinued.
Previously, we tested the Baxter Flo-Gard® 6201 infusion pump (Baxter Healthcare Corporation, Deerfield, Illinois 60015) (4). Although the Baxter pump performed well for monoplace hyperbaric chamber application, it was not originally intended for this purpose....