In vitro delivery accuracy of Computer Controlled Infusion Pump (CCIP) software linked to an Alaris® GH syringe pump for propofol target-controlled infusion in dogs

• Autorzy: Cuniberti B. , Huuskonen V. , Hughes J.M.L.
• Języki publikacji: EN

Abstrakty

EN

We calculated the in vitro delivery accuracy of a computer software (CCIP) linked to an Alaris® GH syringe pump to deliver propofol by target-controlled infusion in dogs. This was studied by simulating an infusion of propofol at two target concentrations (2 and 6 µg ml–1) in a 6 and 22 kg dog, each for 10, 60 and 240 minutes in a crossover design. Each infusion was replicated three times (36 infusions). The total volume of propofol delivered at the end of each infusion was measured using a high precision scales and compared with the volume predicted by the software and that displayed by the syringe driver. Median prediction error (MDPE), median absolute performance error (MDAPE), divergence and intraclass correlation coefficient (ICC) were calculated as indexes of bias, accuracy, time-related changes in accuracy and reliability, respectively. The ranges of MDPA and MDAPE for all the infusions were –2.08-4.28% and 1.85-4.28%, respectively and the median (95% CI) was –1.75% (–1.84-1.02%) and 2.18% (2.23-4.13%), respectively. The divergence was 0.010 ± 0.004% h⁻¹. The ICC was 1.00% (0.99-1.00%; P < 0.0001). The volume of propofol infused by the CCIP linked to an Alaris® GH syringe pump is accurate and has a small tendency to overestimate the real volume delivered. The prediction error fell in the ± 5% range of delivery performance considered clinically acceptable. The performance of the CCIP ameliorates with time and the error will decrease for long infusions, reducing the risk of administering an excessive dose of propofol and increasing the safety of CCIP. The CCIP had also an excellent index of reliability for all the targets, animal body weight and length of infusions tested. In conclusion, CCIP linked to an Alaris® GH syringe pump is precise, reliable and suitable for clinical practice.

Słowa kluczowe

EN

in vitro; delivery accuracy; computer controlled infusion pump; Alaris GH syringe pump; propofol; drug; target-controlled infusion; dog; veterinary medicine

• Wydawca: -
• Czasopismo: Medycyna Weterynaryjna
• Rocznik: 2018
• Tom: 74
• Numer: 07
• Opis fizyczny: p.466-472,fig.,ref.

Twórcy

autor

Cuniberti B.

• UCD Veterinary Hospital, University College Dublin, Belfield, Dublin D04 W6F6, Ireland

autor

Huuskonen V.

• UCD Veterinary Hospital, University College Dublin, Belfield, Dublin D04 W6F6, Ireland

autor

Hughes J.M.L.

• UCD Veterinary Hospital, University College Dublin, Belfield, Dublin D04 W6F6, Ireland

Bibliografia

• Adapa R. M., Axell R. G., Mangat J. S., Carpenter T. A., Absalom A. R.: Safety and performance of TCI pumps in a magnetic resonance imaging environment. Anaesthesia 2012, 67, 33-39.
• Beths T., Glen J. B., Reid J., Monteiro A. M., Nolan A. M.: Evaluation and optimisation of a target-controlled infusion system for administering propofol to dogs as part of a total intravenous anaesthetic technique during dental surgery. Vet. Rec. 2001, 148, 198-203.
• Cicchetti D. V.: Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol. Assess. 1994, 6, 284-290.
• Cockshott I. D., Douglas E. J., Plummer G. F., Simons P. J.: The pharmacokinetics of propofol in laboratory animals. Xenobiotica 1992, 22, 369-375.
• Egan T. D.: Target-Controlled Drug Delivery Progress toward an Intravenous “Vaporizer” and Automated Anesthetic Administration. Anesthesiology 2003, 99, 1214-1219.
• Gepts E., Camu F., Cockshott I. D., Douglas E. J.: Disposition of propofol administered as constant rate intravenous infusions in humans. Anesth. Analg. 1987, 66, 1256-1263.
• Glen J. B.: The development of ‘Diprifusor’: a TCI system for propofol. Anaesthesia 1998, 53, 13-21.
• Hughes J. M., Nolan A. M.: Total Intravenous Anesthesia in Greyhounds: Pharmacokinetics of Propofol and Fentanyl – A Preliminary Study. Vet. Surg. 1999, 28, 513-524.
• Kenny G. N., White M.: A portable target controlled propofol infusion system. Int. J. Clin. Monit. Comput. 1992, 9, 179.
• Kim J. Y., Moon B. K., Lee J. H., Jo Y. Y., Min S. K.: Impact of priming the infusion system on the performance of target-controlled infusion of remifentanil. Korean J. Anesthesiol. 2013, 64, 407-413.
• Marsh B. M. W. M. N., White M., Morton N., Kenny G. N. C.: Pharmacokinetic model driven infusion of propofol in children. Br. J. Anaesth. 1991, 67, 41-48.
• Neff T., Fischer J., Fehr S., Baenziger O., Weiss M.: Start-up delays of infusion syringe pumps. Pediat. Anesth. 2001, 11, 561-565.
• Nolan A. M., Reid J.: Pharmacokinetics of propofol administered by infusion in dogs undergoing surgery. Br. J. Anaesth. 1993, 70, 546-551.
• O’Kelly S. W., Edwards J. C.: A comparison of the performance of two types of infusion device. Anaesthesia 1992, 47, 1070-1072.
• Reid J., Nolan A. M.: Pharmacokinetics of propofol as an induction agent in geriatric dogs. Res. Vet. Sci. 1996, 61, 169-171.
• Schraag S., Flaschar J.: Delivery performance of commercial target-controlled infusion devices with Diprifusor® module. Eur. J. Anaesthesiol. 2002, 19, 357-360.
• Schüttler J., Kloos S., Schwilden H., Stoeckel H.: Total intravenous anaesthesia with propofol and alfentanil by computer-assisted infusion. Anaesthesia 1988, 43, 2-7.
• Shafer A., Doze V. A., Shafer S. L., White P. F.: Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. Anesthesiology 1988, 69, 348-356.
• Shafer S. L., Gregg K. M.: Algorithms to rapidly achieve and maintain stable drug concentrations at the site of drug effect with a computer-controlled infusion pump. J. Pharmacokinet. Biopharm. 1992, 20, 147-169.
• Shafer S. L., Siegel L. C., Cooke J. E., Scott J. C.: Testing computer-controlled infusion pumps by simulation. Anesthesiology 1988, 68, 261-266.
• Struys M. M., De Smet T., Glen J. I. B., Vereecke H. E., Absalom A. R., Schnider T. W.: The history of target-controlled infusion. Anesth. Analg. 2016, 122, 56-69.
• Swinhoe C. F., Peacock J. E., Glen J. B., Reilly C. S.: Evaluation of the predictive performance of a ‘Diprifusor’ TCI system. Anaesthesia 1998, 53, 61-67.
• Tseng C. T., Sakai D. M., Libin M., Mostowy M., Cheetham J., Campoy L., Gleed R. D., Martin-Flores M.: Partial neuromuscular block impairs arytenoid abduction during hypercarbic challenge in anesthetized dogs. Vet. Anaesth. Analg. 2017, 44, 1049-1056.
• Vanelderen P. J., Soetens F. M., Soetens M. A., Janssen H. J., De Wolf A. M.: Hypoglycemia caused by siphoning of an insulin infusion. J. Clin. Anesth. 2007, 19, 251-255.
• Varvel J. R., Donoho D. L., Shafer S. L.: Measuring the predictive performance of computer-controlled infusion pumps. J. Pharmacokinet. Biopharm. 1992, 20, 63-94.
• Weiss M., Hug M. I., Neff T., Fischer J.: Syringe size and flow rate affect drug delivery from syringe pumps. Can. J. Anesth. 2000, 47, 1031-1035.
• White M., Kenny G. N. C.: Intravenous propofol anaesthesia using a computerised infusion system. Anaesthesia 1990, 45, 204-209.

Identyfikatory

DOI

10.21521/mw.5988