Basic Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Sep 19, 2020; 9(2): 17-28
Published online Sep 19, 2020. doi: 10.5409/wjcp.v9.i2.17
Does carrier fluid reduce low flow drug infusion error from syringe size?
Zachary C Madson, Sitaram Vangala, Grace T Sund, James A Lin
Zachary C Madson, Pediatric Hospitalist Medicine, Lutheran Children's Hospital, Fort Wayne, IN 46804, United States
Sitaram Vangala, Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
Grace T Sund, Department of Nursing, UCLA Mattel Children's Hospital, Los Angeles, CA 90095, United States
James A Lin, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
Author contributions: Madson ZC and Lin JA conceived and designed and personally conducted all the experiments, made observations, analyzed results, and wrote the initial draft and revisions of the manuscript; Sund GT helped to conceive and design and interpret the experiments; Vangala S provided statistical analysis, analyzed results, and helped draft and revise portions of the manuscript. All authors reviewed and approved of the manuscript.
Supported by NIH National Center for Advancing Translational Sciences (NCATS) UCLA CTSI, No. UL1TR001881.
Institutional review board statement: This work was performed at UCLA Medical Center, Santa Monica and the UCLA Department of Medicine Statistics Core.
Conflict-of-interest statement: The authors report no financial relationships relevant to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: James A Lin, BSc, MD, Assistant Professor, Attending Doctor, Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, A2-383 MDCC, Los Angeles, CA 90095, United States. jameslin@mednet.ucla.edu
Received: April 30, 2020
Peer-review started: April 30, 2020
First decision: May 24, 2020
Revised: June 7, 2020
Accepted: August 31, 2020
Article in press: August 31, 2020
Published online: September 19, 2020
Processing time: 140 Days and 5.8 Hours
Core Tip

Core Tip: Infusions of critical drugs in infants frequently require low flow rates. We previously observed errors in low flow infusions that were directly proportional to syringe size. Because low flow infusions in clinical practice are essentially always co-infused with a primary carrier fluid, we now use a similar model to test whether carrier fluid improves accuracy and flow continuity of low flow drug from large compared to smaller syringes. We report that despite carrier fluid, larger syringes were associated with less overall drug and fluid volumes delivered, worse flow continuity, and other flow problems in low flow infusions compared to smaller syringe sizes. Carrier fluid should not be used to compensate for errors introduced by syringe size in critical low flow drug infusions. Syringe size should be matched to the rate of infusion.