J Korean Med Sci.  2022 Mar;37(9):e71. 10.3346/jkms.2022.37.e71.

The Effects of Intravenous Fluid Viscosity on the Accuracy of Intravenous Infusion Flow Regulators

• Ko E
• Song YJ
• Choe K
• Park Y
• Yang S
• Lim CH

• KMID: 2526969
• DOI: http://doi.org/10.3346/jkms.2022.37.e71

Abstract

Intravenous infusion flow regulators (IIFRs) are widely used devices but it is unknown how much the difference between the IIFR scale and the actual flow rate depends on the viscosity of the intravenous (IV) fluid. This study evaluated the effects of viscosity on the flow rate of five IV fluids (0.9% normal saline, Hartmann’s solution, plasma solution-A, 6% hetastarch, and 5% albumin) when using IIFRs. The viscosity of crystalloids was 1.07–1.12 mPa·s, and the viscosities of 6% hetastarch and 5% albumin were 2.59 times and 1.74 times that of normal saline, respectively. When the IIFR scales were preset to 20, 100, and 250 mL/hr, crystalloids were delivered at the preset flow rate within a difference of less than 10%, while 6% hetastarch was delivered at approximately 40% of the preset flow rates and 5% albumin was approximately 80% transmitted. When delivering colloids, IIFRs should be used with caution.

Keyword

Body Fluids; Fluid Therapy; Infusion Pumps; Intravenous Infusions; Solution; Viscosity

Figure

• 

  Fig. 1 The equipment for measuring flow rates. (A) Detailed picture of IIFR. Two types of numeric scales are marked on the IIFR dial. The scales marked as “BAG” indicated by arrow “a” are based on the flow rate of the normal saline contained in the IV fluid plastic bag. The scales marked as “BOT” indicated by arrow “b” are based on the flow rate of the normal saline contained in the infusion bottle. According to the manufacturer’s manual, if the blue arrow is rotated to match the scale with “c”, the fluid is injected at the flow rate (mL/hr) indicated by the number written on the scale. (B) Schematic presentation of the protocol. An IIFR was connected to an IV fluid bag, suspended 100 cm above the distal end of the IIFR. The distal tip of the IIFR was placed horizontally and into a beaker resting on a stable surface. The line of the IIFR was pre-flushed to eliminate air bubbles inside the line, and half of the drip chamber was filled. 1: IV fluid plastic bag or infusion bottle, 2: drip chamber, 3: tube, 4: roller clamp, 5: IV infusion flow regulator, 6: beaker.IIFR = intravenous infusion flow regulator, IV = intravenous.

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