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Kayser F Enneking - One of the best experts on this subject based on the ideXlab platform.

  • portable infusion pumps used for continuous regional analgesia Delivery Rate accuracy and consistency
    Regional Anesthesia and Pain Medicine, 2003
    Co-Authors: Brian M Ilfeld, Timothy E Morey, Kayser F Enneking
    Abstract:

    Background and Objectives: Multiple benefits of postoperative perineural local anesthetic infusion have been shown including potent analgesia, decreased opioid requirements, and improved rehabilitation. Consequently, portable infusion pumps have been used with increasing frequency to provide perineural infusion for medically unsupervised ambulatory patients. We believe that the infusion Rate accuracy and reliability of these pumps infusing potentially toxic doses of medication should be investigated independently. Therefore, we studied the flow-Rate accuracy and consistency of various portable infusion pumps that have not been examined previously. Methods: Using a computer/mass balance combination to record infusion Rates, 6 pumps (3 electronic and 3 nonelectronic) were tested. Several factors that may influence pump performance were varied: temperature (ambient/skin), battery (replacement/addition), and catheter exchange (wound/perineural). Results: Infusion Rate accuracy differed significantly among the pumps, exhibiting flow Rates within 15% of their expected Rate for 55% to 99% of their infusion duration. Furthermore, the profiles (infusion Rate over time) of the various pumps differed significantly depending on the pump power source. Although elastomeric pump infusion Rate increased with an increase in temperature, battery life was a limiting factor for one of the electronic pumps. Substituting wound catheters with commonly used perineural catheters did not significantly alter infusion profile. Conclusions: Factors such as infusion Rate accuracy and consistency, infusion profile, temperature sensitivity, and battery life affect the dose of medication administered by various portable pumps used for continuous regional analgesia. Health care providers should take these factors into consideration when choosing and using a portable infusion pump for local anesthetic administration. Reg Anesth Pain Med 2003;28:424-432.

  • the Delivery Rate accuracy of portable infusion pumps used for continuous regional analgesia
    Anesthesia & Analgesia, 2002
    Co-Authors: Brian M Ilfeld, Timothy E Morey, Kayser F Enneking
    Abstract:

    UNLABELLED Portable pumps used for local anesthetic infusion during continuous regional analgesia are gaining acceptance. These pumps are often used for ambulatory patients who are medically unsupervised throughout most of the infusion. However, the performance of these pumps, which infuse potentially toxic medication, has not been independently investigated. We investigated the flow Rate accuracy, consistency, and profiles of various portable pumps often used for local anesthetic infusion during continuous regional analgesia. By using a computer/scale combination within a laboratory to record infusion Rates, 6 pumps were tested with their flow regulators at expected (30 degrees-32 degrees C) and increased (34 degrees-36 degrees C) temperatures. Infusion Rate accuracy differed significantly among the pumps, exhibiting flow Rates within +/-15% of their expected Rate for 18%-100% of their infusion duration. An increase in temperature also affected pumps to differing degrees, with infusion Rates increasing from 0% to 25% for each model tested. These results suggest that factors such as flow Rate accuracy and consistency, infusion profile, and temperature sensitivity should be considered when choosing and using a portable infusion pump for local anesthetic administration. IMPLICATIONS Portable pumps often used for local anesthetic infusion during continuous regional analgesia exhibit varying degrees of Delivery Rate accuracy and consistency. Furthermore, increases in temperature result in an increased infusion Rate for various pumps investigated. These factors should be taken into consideration when choosing and using a portable infusion pump.

Marco Das - One of the best experts on this subject based on the ideXlab platform.

  • impact of iodine concentration and iodine Delivery Rate on contrast enhancement in coronary ct angiography a randomized multicenter trial ct con
    European Radiology, 2019
    Co-Authors: Marco Rengo, Anoeshka S Dharampal, Marisa Lubbers, Marc C J M Kock, Joachim E Wildberger, Marco Das, Andre Niezen, Fiek Van Tilborg, Marcel J M Kofflard, Andrea Laghi
    Abstract:

    To compare the effect of contrast medium iodine concentration on contrast enhancement, heart Rate, and injection pressure when injected at a constant iodine Delivery Rate in coronary CT angiography (CTA). One thousand twenty-four patients scheduled for coronary CTA were prospectively randomized to receive one of four contrast media: iopromide 300 mg I/ml, iohexol 350 mg I/ml, iopromide 370 mg I/ml, or iomeprol 400 mg I/ml. Contrast media were delivered at an equivalent iodine Delivery Rate of 2.0 g I/s. Intracoronary attenuation was measured and compared (per vessel and per segment). Heart Rate before and after contrast media injection was documented. Injection pressure was recorded (n = 403) during contrast medium injection and compared between groups. Intracoronary attenuation values were similar for the different contrast groups. The mean attenuation over all segments ranged between 384 HU for 350 mg I/ml and 395 HU for 400 mg I/ml (p = 0.079). Dose-length product (p = 0.8424), signal-to-noise ratio (all p > 0.05), time to peak (p = 0.324), and changes in heart Rate (p = 0.974) were comparable between groups. The peak pressures differed: 197.4 psi for 300 mg I/ml (viscosity 4.6 mPa s), 229.8 psi for 350 mg I/ml (10.4 mPa s), 216.1 psi for 370 mg I/ml (9.5 mPa s), and 243.7 psi for 400 mg I/ml (12.6 mPa s) (p < 0.0001). Intravascular attenuation and changes in heart Rate are independent of iodine concentration when contrast media are injected at the same iodine Delivery Rate. Differences in injection pressures are associated with the viscosity of the contrast media. • The contrast enhancement in coronary CT angiography is independent of the iodine concentration when contrast media are injected at body temperature (37 °C) with the same iodine Delivery Rate. • Iodine concentration does not influence the change in heart Rate when contrast media are injected at identical iodine Delivery Rates. • For a fixed iodine Delivery Rate and contrast temperature, the viscosity of the contrast medium affects the injection pressure.

  • intravascular enhancement with identical iodine Delivery Rate using different iodine contrast media in a circulation phantom
    Investigative Radiology, 2013
    Co-Authors: Casper Mihl, Joachim E Wildberger, Tomas Jurencak, Michael J Yanniello, Estelle C Nijssen, John F Kalafut, Georgi Nalbantov, Georg Muhlenbruch, Florian F Behrendt, Marco Das
    Abstract:

    PurposeBoth iodine Delivery Rate (IDR) and iodine concentration are decisive factors for vascular enhancement in computed tomographic angiography. It is unclear, however, whether the use of high–iodine concentration contrast media is beneficial to lower iodine concentrations when IDR is kept identic

Andrea Laghi - One of the best experts on this subject based on the ideXlab platform.

  • impact of iodine concentration and iodine Delivery Rate on contrast enhancement in coronary ct angiography a randomized multicenter trial ct con
    European Radiology, 2019
    Co-Authors: Marco Rengo, Anoeshka S Dharampal, Marisa Lubbers, Marc C J M Kock, Joachim E Wildberger, Marco Das, Andre Niezen, Fiek Van Tilborg, Marcel J M Kofflard, Andrea Laghi
    Abstract:

    To compare the effect of contrast medium iodine concentration on contrast enhancement, heart Rate, and injection pressure when injected at a constant iodine Delivery Rate in coronary CT angiography (CTA). One thousand twenty-four patients scheduled for coronary CTA were prospectively randomized to receive one of four contrast media: iopromide 300 mg I/ml, iohexol 350 mg I/ml, iopromide 370 mg I/ml, or iomeprol 400 mg I/ml. Contrast media were delivered at an equivalent iodine Delivery Rate of 2.0 g I/s. Intracoronary attenuation was measured and compared (per vessel and per segment). Heart Rate before and after contrast media injection was documented. Injection pressure was recorded (n = 403) during contrast medium injection and compared between groups. Intracoronary attenuation values were similar for the different contrast groups. The mean attenuation over all segments ranged between 384 HU for 350 mg I/ml and 395 HU for 400 mg I/ml (p = 0.079). Dose-length product (p = 0.8424), signal-to-noise ratio (all p > 0.05), time to peak (p = 0.324), and changes in heart Rate (p = 0.974) were comparable between groups. The peak pressures differed: 197.4 psi for 300 mg I/ml (viscosity 4.6 mPa s), 229.8 psi for 350 mg I/ml (10.4 mPa s), 216.1 psi for 370 mg I/ml (9.5 mPa s), and 243.7 psi for 400 mg I/ml (12.6 mPa s) (p < 0.0001). Intravascular attenuation and changes in heart Rate are independent of iodine concentration when contrast media are injected at the same iodine Delivery Rate. Differences in injection pressures are associated with the viscosity of the contrast media. • The contrast enhancement in coronary CT angiography is independent of the iodine concentration when contrast media are injected at body temperature (37 °C) with the same iodine Delivery Rate. • Iodine concentration does not influence the change in heart Rate when contrast media are injected at identical iodine Delivery Rates. • For a fixed iodine Delivery Rate and contrast temperature, the viscosity of the contrast medium affects the injection pressure.

Joachim E Wildberger - One of the best experts on this subject based on the ideXlab platform.

  • impact of iodine concentration and iodine Delivery Rate on contrast enhancement in coronary ct angiography a randomized multicenter trial ct con
    European Radiology, 2019
    Co-Authors: Marco Rengo, Anoeshka S Dharampal, Marisa Lubbers, Marc C J M Kock, Joachim E Wildberger, Marco Das, Andre Niezen, Fiek Van Tilborg, Marcel J M Kofflard, Andrea Laghi
    Abstract:

    To compare the effect of contrast medium iodine concentration on contrast enhancement, heart Rate, and injection pressure when injected at a constant iodine Delivery Rate in coronary CT angiography (CTA). One thousand twenty-four patients scheduled for coronary CTA were prospectively randomized to receive one of four contrast media: iopromide 300 mg I/ml, iohexol 350 mg I/ml, iopromide 370 mg I/ml, or iomeprol 400 mg I/ml. Contrast media were delivered at an equivalent iodine Delivery Rate of 2.0 g I/s. Intracoronary attenuation was measured and compared (per vessel and per segment). Heart Rate before and after contrast media injection was documented. Injection pressure was recorded (n = 403) during contrast medium injection and compared between groups. Intracoronary attenuation values were similar for the different contrast groups. The mean attenuation over all segments ranged between 384 HU for 350 mg I/ml and 395 HU for 400 mg I/ml (p = 0.079). Dose-length product (p = 0.8424), signal-to-noise ratio (all p > 0.05), time to peak (p = 0.324), and changes in heart Rate (p = 0.974) were comparable between groups. The peak pressures differed: 197.4 psi for 300 mg I/ml (viscosity 4.6 mPa s), 229.8 psi for 350 mg I/ml (10.4 mPa s), 216.1 psi for 370 mg I/ml (9.5 mPa s), and 243.7 psi for 400 mg I/ml (12.6 mPa s) (p < 0.0001). Intravascular attenuation and changes in heart Rate are independent of iodine concentration when contrast media are injected at the same iodine Delivery Rate. Differences in injection pressures are associated with the viscosity of the contrast media. • The contrast enhancement in coronary CT angiography is independent of the iodine concentration when contrast media are injected at body temperature (37 °C) with the same iodine Delivery Rate. • Iodine concentration does not influence the change in heart Rate when contrast media are injected at identical iodine Delivery Rates. • For a fixed iodine Delivery Rate and contrast temperature, the viscosity of the contrast medium affects the injection pressure.

  • intravascular enhancement with identical iodine Delivery Rate using different iodine contrast media in a circulation phantom
    Investigative Radiology, 2013
    Co-Authors: Casper Mihl, Joachim E Wildberger, Tomas Jurencak, Michael J Yanniello, Estelle C Nijssen, John F Kalafut, Georgi Nalbantov, Georg Muhlenbruch, Florian F Behrendt, Marco Das
    Abstract:

    PurposeBoth iodine Delivery Rate (IDR) and iodine concentration are decisive factors for vascular enhancement in computed tomographic angiography. It is unclear, however, whether the use of high–iodine concentration contrast media is beneficial to lower iodine concentrations when IDR is kept identic

Brian M Ilfeld - One of the best experts on this subject based on the ideXlab platform.

  • portable infusion pumps used for continuous regional analgesia Delivery Rate accuracy and consistency
    Regional Anesthesia and Pain Medicine, 2003
    Co-Authors: Brian M Ilfeld, Timothy E Morey, Kayser F Enneking
    Abstract:

    Background and Objectives: Multiple benefits of postoperative perineural local anesthetic infusion have been shown including potent analgesia, decreased opioid requirements, and improved rehabilitation. Consequently, portable infusion pumps have been used with increasing frequency to provide perineural infusion for medically unsupervised ambulatory patients. We believe that the infusion Rate accuracy and reliability of these pumps infusing potentially toxic doses of medication should be investigated independently. Therefore, we studied the flow-Rate accuracy and consistency of various portable infusion pumps that have not been examined previously. Methods: Using a computer/mass balance combination to record infusion Rates, 6 pumps (3 electronic and 3 nonelectronic) were tested. Several factors that may influence pump performance were varied: temperature (ambient/skin), battery (replacement/addition), and catheter exchange (wound/perineural). Results: Infusion Rate accuracy differed significantly among the pumps, exhibiting flow Rates within 15% of their expected Rate for 55% to 99% of their infusion duration. Furthermore, the profiles (infusion Rate over time) of the various pumps differed significantly depending on the pump power source. Although elastomeric pump infusion Rate increased with an increase in temperature, battery life was a limiting factor for one of the electronic pumps. Substituting wound catheters with commonly used perineural catheters did not significantly alter infusion profile. Conclusions: Factors such as infusion Rate accuracy and consistency, infusion profile, temperature sensitivity, and battery life affect the dose of medication administered by various portable pumps used for continuous regional analgesia. Health care providers should take these factors into consideration when choosing and using a portable infusion pump for local anesthetic administration. Reg Anesth Pain Med 2003;28:424-432.

  • the Delivery Rate accuracy of portable infusion pumps used for continuous regional analgesia
    Anesthesia & Analgesia, 2002
    Co-Authors: Brian M Ilfeld, Timothy E Morey, Kayser F Enneking
    Abstract:

    UNLABELLED Portable pumps used for local anesthetic infusion during continuous regional analgesia are gaining acceptance. These pumps are often used for ambulatory patients who are medically unsupervised throughout most of the infusion. However, the performance of these pumps, which infuse potentially toxic medication, has not been independently investigated. We investigated the flow Rate accuracy, consistency, and profiles of various portable pumps often used for local anesthetic infusion during continuous regional analgesia. By using a computer/scale combination within a laboratory to record infusion Rates, 6 pumps were tested with their flow regulators at expected (30 degrees-32 degrees C) and increased (34 degrees-36 degrees C) temperatures. Infusion Rate accuracy differed significantly among the pumps, exhibiting flow Rates within +/-15% of their expected Rate for 18%-100% of their infusion duration. An increase in temperature also affected pumps to differing degrees, with infusion Rates increasing from 0% to 25% for each model tested. These results suggest that factors such as flow Rate accuracy and consistency, infusion profile, and temperature sensitivity should be considered when choosing and using a portable infusion pump for local anesthetic administration. IMPLICATIONS Portable pumps often used for local anesthetic infusion during continuous regional analgesia exhibit varying degrees of Delivery Rate accuracy and consistency. Furthermore, increases in temperature result in an increased infusion Rate for various pumps investigated. These factors should be taken into consideration when choosing and using a portable infusion pump.