Flow rates of large animal fluid delivery systems used for high-volume crystalloid resuscitation
The author declares no conflict of interests.
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Dr. Rose Nolen-Walston, New Bolton Center, University of Pennsylvania, 382 West Street Rd, Kennett Square, PA 19348, USA.
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.
University veterinary teaching hospital.
In vitro experimental study.
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.
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.