scholarly journals The Diagnosis of Intrathecal Infusion Pump System Failure

2005 ◽  
Vol 3;8 (7;3) ◽  
pp. 291-296
Author(s):  
Rodney L. Jones
Keyword(s):  
Infusion Pump ◽  
System Failure ◽  
Pump System ◽  
Intrathecal Infusion

scholarly journals Eptacog Alfa (Activated) Is Physically and Chemically Stable over 24 Hours when Administered as Bolus Injections in an Automated Infusion Pump

TH Open ◽  
2019 ◽  
Vol 03 (01) ◽  
pp. e45-e49 ◽  
Author(s):  
Per Rexen ◽  
Jane Jensen ◽  
Nina Schwerin ◽  
Elena Kozina
Keyword(s):  
Bolus Injection ◽  
Infusion Pump ◽  
Hospital Setting ◽  
Factor Vii ◽  
Acceptance Criteria ◽  
Recombinant Activated Factor Vii ◽  
Pump System ◽  
Promising Alternative ◽  
Bolus Infusion

Introduction Eptacog alfa (activated) is a recombinant activated factor VII (rFVIIa) used for the treatment and prevention of bleeding episodes in patients with congenital hemophilia with inhibitors. Frequent dosing requirements make the use of an automated bolus infusion pump a promising alternative to manual administration. Aims The objective of this in vitro study was to evaluate the physical and chemical stability of room temperature–stable rFVIIa at 25°C over 24 hours in an automated bolus infusion pump. Methods An automated bolus infusion pump with preset bolus injection intervals of 2 to 6 hours was used. Samples of rFVIIa were analyzed for critical quality parameters, presence of leachables, and microbiological growth. The infusion system was evaluated visually. Results rFVIIa is physically and chemically stable when used in an automated bolus infusion pump system for up to 24 hours at 25°C. All critical quality parameter results were within the shelf-life limits and complied with the acceptance criteria. Leachables were observed at concentrations within their respective acceptance criteria. No visual changes in the syringe or infusion tube were observed; inherent particles in the reconstituted rFVIIa similar in size and description to those previously found in rFVIIa were seen. No microbiological growth was detected. Conclusions rFVIIa is stable in a bolus infusion pump system for up to 24 hours at 25°C. Bolus injection intervals of 2 to 6 hours can be used without physical or chemical changes to rFVIIa. This study supports the use of an automated bolus infusion pump in the hospital setting, across all indications for rFVIIa.

Spinal infusion pump-catheter leak detected by high-resolution 3D computed tomography

2011 ◽  
Vol 15 (5) ◽  
pp. 555-557 ◽  
Author(s):  
Jason A. Ellis ◽  
Richard Leung ◽  
Christopher J. Winfree
Keyword(s):  
High Resolution ◽  
Contrast Medium ◽  
Infusion Pump ◽  
Post Injection ◽  
3D Ct ◽  
Intrathecal Catheter ◽  
Pump System ◽  
Plain Radiographs ◽  
Iodinated Contrast ◽  
Catheter System

Implanted intrathecal drug delivery systems may malfunction as a result of fracture of the intrathecal catheter. A suspected catheter fracture not seen on plain radiographs of the catheter system will typically prompt a contrast-enhanced imaging study of the pump. Injection of iodinated contrast medium into the pump system with routine fluoroscopy can sometimes fail to reveal subtle leaks. The authors present a case demonstrating the utility of high-resolution, 3D-CT for intrathecal pump-catheter system interrogation when routine fluoroscopy is unrevealing. In this case, a catheter leak was suspected on the basis of the patient's history, but no obvious fracture was noted on plain radiographs. An intraoperative fluoroscopic study that included multiple injections of contrast medium into the catheter system failed to conclusively show a catheter leak. The authors therefore performed a post-injection 3D-CT study, which clearly demonstrated a leak from the intrathecal catheter just deep to the thoracolumbar fascia. The leak was visible on source images and was especially obvious after 3D reconstruction. This led to surgical revision of the catheter and subsequent resumption of normal pump function. The authors therefore suggest that if a leak is suspected in an implanted intrathecal catheter and routine contrast fluoroscopy is unrevealing, post-injection 3D-CT scanning should be performed to further investigate the possibility of a subtle leak.

B411 Development of Portable Infusion Pump System

2008 ◽  
Vol 2008.19 (0) ◽  
pp. 151-152
Author(s):  
Yusuke MUKASA ◽  
Hiroyuki KOYAMA ◽  
Takashi KOMEDA ◽  
Atsushi SEKIGUCHI ◽  
Takashi MORITA
Keyword(s):  
Infusion Pump ◽  
Pump System

Prospective assessment of continuous intrathecal infusion of baclofen for spasticity caused by acquired brain injury: a preliminary report

1997 ◽  
Vol 87 (3) ◽  
pp. 415-419 ◽  
Author(s):  
Jay M. Meythaler ◽  
Anne McCary ◽  
Mark N. Hadley
Keyword(s):  
Brain Injury ◽  
Infusion Pump ◽  
Acquired Brain Injury ◽  
Intrathecal Baclofen ◽  
Intrathecal Administration ◽  
Content Type ◽  
Severe Spasticity ◽  
Prospective Assessment ◽  
Intrathecal Infusion ◽  
Fine Print

✓ Twelve consecutive patients with severe spasticity and hypertonia following acquired brain injury were treated with continuous intrathecal infusion of baclofen via an implanted, programmable infusion pump—catheter system for a minimum of 3 months. In every case intrathecal baclofen therapy resulted in a statistically significant reduction in upper- and lower-extremity tone, spasm frequency, and reflexes, contributing to improved functional abilities. There were no untoward side effects or complications associated with treatment. This preliminary assessment indicates that intrathecal administration of baclofen is effective in treating the disabling spasticity caused by acquired brain injury in selected patients.

The Role of Surgical Placement and Pump Orientation in Intrathecal Pump System Failure: A Technical Report

2003 ◽  
Vol 38 (2) ◽  
pp. 107-109 ◽  
Author(s):  
Rob D. Dickerman ◽  
Q.E. Stevens ◽  
Steven J. Schneider
Keyword(s):  
System Failure ◽  
Pump System ◽  
Technical Report

Benefit from and tolerance to continuous intrathecal infusion of morphine for intractable cancer pain

1982 ◽  
Vol 57 (3) ◽  
pp. 360-364 ◽  
Author(s):  
Harry S. Greenberg ◽  
James Taren ◽  
William D. Ensminger ◽  
Kathleen Doan
Keyword(s):  
Pain Relief ◽  
Intrathecal Morphine ◽  
Infusion Pump ◽  
Dose Requirement ◽  
Percutaneous Injection ◽  
Content Type ◽  
Morphine Dose ◽  
Lumbosacral Plexopathy ◽  
Intractable Cancer Pain ◽  
Intrathecal Infusion

✓ A patient with painful bilateral metastatic lumbosacral plexopathy from cervical cancer was treated with levorphanol tartrate (Levo-Dromoran), 4 mg orally every 4 hours, with poor pain relief. A lumbar subarachnoid catheter was then placed percutaneously. A bolus of 1 mg of morphine gave complete pain relief for 17 hours. Over the next week, the dose requirement increased to 10 mg/day, infused by an external pump. A permanently implantable infusion pump with a 50-cc drug chamber and flow rate of 3.4 cc/day was placed in the abdomen and attached to the lumbar subarachnoid catheter. The pump was refilled by percutaneous injection. Morphine was infused continuously at 15 mg/day, affording the patient increased mobility and no pain for 7 days. When the pain returned, the morphine dose was increased to 17.5 mg/day, and the patient was allowed to take oral Levo-Dromoran for pain. The intrathecal morphine dose was constant within 2-week periods, but was increased from 17.5 to 96 mg/day because of inadequate pain relief. Oral Levo-Dromoran intake averaged 3.4 mg/day. Levo-Dromoran intake was less during the 1st week of each 2-week cycle than the last week (mean 15.0 versus 38.0 mg/wk, p < 0.05). No sedation or respiratory depression was seen.

scholarly journals Efficacy of Telavancin in the Treatment of Experimental Endocarditis Due to Glycopeptide-Intermediate Staphylococcus aureus

2007 ◽  
Vol 51 (7) ◽  
pp. 2373-2377 ◽  
Author(s):  
José M. Miró ◽  
Cristina García-de-la-Mària ◽  
Yolanda Armero ◽  
Elisa de-Lazzari ◽  
Dolors Soy ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Statistical Significance ◽  
Infusion Pump ◽  
Treated Group ◽  
Control Group ◽  
Pump System ◽  
Once Daily ◽  
End Of Treatment ◽  
Computer Controlled ◽  
Trough Levels

ABSTRACT The efficacy of telavancin, a novel lipoglycopeptide, was evaluated in experimental endocarditis in rabbits using two clinical isolates of glycopeptide-intermediate Staphylococcus aureus: ATCC 700788 and HIP 5836. Infected rabbits were treated for 2 days with telavancin (10 mg/kg of body weight once daily intravenously) or vancomycin (1 g twice daily intravenously), administered with a computer-controlled infusion pump system simulating human serum kinetics. Vegetations were harvested at 16 h postinoculation in the control group and at the end of treatment in the drug-treated group. For ATCC 700788, MICs and minimal bactericidal concentrations (MBCs), respectively, were 1 mg/liter and 4 mg/liter for telavancin and 8 mg/liter and 128 mg/liter for vancomycin. For HIP 5836, MICs and MBCs, respectively, were 4 mg/liter and 8 mg/liter for telavancin and 8 mg/liter and 128 mg/liter for vancomycin. Peak and trough levels were 90 μg/ml and 6 μg/ml, respectively, for telavancin and 46 μg/ml and 6 μg/ml, respectively, for vancomycin. In glycopeptide-intermediate S. aureus ATCC 700788, telavancin sterilized 6 of 16 vegetations (37%), whereas vancomycin sterilized 4 of 20 (20%) (P = 0.29) compared with 0 of 17 in the control group. In HIP 5836 experiments, telavancin and vancomycin sterilized 5 of 16 (31%) and 1 of 15 (7%) vegetations (P = 0.17), respectively, compared with none in the control group. Telavancin reduced vegetation titers by 2.0 and 2.3 logs greater than vancomycin for the ATCC 700788 (4.6 [2.0 to 5.8] versus 6.6 [2.0 to 6.9] log CFU/g vegetation; P = 0.05) and HIP 5836 (4.4 [2.0 to 7.4] versus 6.7 [4.5 to 8.7] log CFU/g vegetation; P = 0.09) strains, respectively; these differences did not reach statistical significance. All isolates from vegetations remained susceptible to telavancin after therapy. The results suggest that telavancin may be an effective treatment for endocarditis caused by glycopeptide-intermediate S. aureus.

scholarly journals Nurse and Pharmacist Knowledge of Intravenous Smart Pump System Setup Requirements

2021 ◽  
Vol 55 (1) ◽  
pp. 51-58
Author(s):  
Karen K. Giuliano ◽  
Jeannine W.C. Blake
Keyword(s):  
Response Rate ◽  
Infusion Pump ◽  
Secondary Analysis ◽  
Direct Care ◽  
Innovative Technology ◽  
Pump System ◽  
Final Sample ◽  
Infusion Systems ◽  
Head Height ◽  
Smart Pump

Abstract Objective: The primary purpose of this research was to describe nurse and pharmacist knowledge of setup requirements for intravenous (IV) smart pumps that require head height differentials for accurate fluid flow. Methods: A secondary analysis of anonymous electronic survey data using a database of prerecruited clinicians was conducted. A survey was sent by email to 173 pharmacists and 960 nurses. The response rate for pharmacists was 58% (100 of 173), and the response rate for nurses was 52% (500 of 960). After removing respondents who did not provide direct care and who did not use a head height differential IV infusion system, the final sample for analysis was 186 nurses and 25 pharmacists. Results: Overall, less than one-half of respondents (40%) were aware that manufacturer guidelines for positioning the primary infusion bag relative to the infusion pump were available. Slightly more (49.5%) were aware of the required head height differentials for secondary infusion. Only five respondents selected the correct primary head height, eight respondents selected the correct secondary head height, and one respondent selected both the correct primary and secondary head heights. Conclusion: The results of this study identify a substantial lack of knowledge among frontline clinicians regarding manufacturer recommendations for accurate IV administration of primary and secondary infusions for head height differential infusion systems. Both increased clinician education and innovative technology solutions are needed to improve IV smart pump safety and usability.

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