scholarly journals In vitro delivery accuracy of Computer Controlled Infusion Pump (CCIP) software linked to an Alaris® GH syringe pump for propofol target-controlled infusion in dogs

2018 ◽  
Vol 74 (7) ◽  
pp. 5988-2018
Author(s):  
BARBARA CUNIBERTI ◽  
VILHELMIINA HUUSKONEN ◽  
J.M. LYNNE HUGHES
Keyword(s):  
Prediction Error ◽  
Infusion Pump ◽  
Intraclass Correlation ◽  
Computer Software ◽  
Syringe Pump ◽  
Target Controlled Infusion ◽  
Syringe Driver ◽  
Performance Error ◽  
Delivery Accuracy

We calculated the in vitro delivery accuracy of a computer software (CCIP) linked to an Alaris® GH syringe pump to deliver propofol by target-controlled infusion in dogs. This was studied by simulating an infusion of propofol at two target concentrations (2 and 6 g ml-1) in a 6 and 22 kg dog, each for 10, 60 and 240 minutes in a crossover design. Each infusion was replicated three times (36 infusions). The total volume of propofol delivered at the end of each infusion was measured using a high precision scales and compared with the volume predicted by the software and that displayed by the syringe driver. Median prediction error (MDPE), median absolute performance error (MDAPE), divergence and intraclass correlation coefficient (ICC) were calculated as indexes of bias, accuracy, time-related changes in accuracy and reliability, respectively. The ranges of MDPA and MDAPE for all the infusions were -2.08 – 4.28% and 1.85 – 4.28%. respectively and the median (95% CI) was -1.75% (-1.84 – 1.02%) and 2.18% (2.23 – 4.13%), respectively. The divergence was 0.010 ± 0.004% h-1. The ICC was 1.00% (0.99-1.00%; P<0.0001). The volume of propofol infused by the CCIP linked to an Alaris® GH syringe pump is accurate and has a small tendency to overestimate the real volume delivered. The prediction error fell in the ± 5% range of delivery performance considered clinically acceptable. The performance of the CCIP ameliorates with time and the error will decrease for long infusions, reducing the risk of administering an excessive dose of propofol and increasing the safety of CCIP. The CCIP had also an excellent index of reliability for all the targets, animal body weight and length of infusions tested. In conclusion, CCIP linked to an Alaris® GH syringe pump is precise, reliable and suitable for clinical practice. .

scholarly journals Use of an innovative syringe pump to deliver bolus rFVIIa for patients with haemophilia and inhibitors undergoing surgery

2017 ◽  
Vol 4 (1) ◽  
pp. 35-39
Author(s):  
Debra Pollard ◽  
Barbara Subel ◽  
Pratima Chowdary ◽  
Keith Gomez
Keyword(s):  
Clinical Decision Making ◽  
Elective Surgery ◽  
Infusion Pump ◽  
Clinical Decision ◽  
Severe Haemophilia ◽  
Syringe Pump ◽  
Nursing Time ◽  
Rfviia Administration ◽  
Syringe Driver ◽  
Efficacy Criteria

Abstract Aim: To evaluate the efficacy and safety of using a syringe driver perfusor pump to deliver frequent regular bolus doses of rFVIIa peri- and postoperatively to patients with severe haemophilia and inhibitors. Background: The provision of surgical haemostatic coverage with rFVIIa requires regular bolus doses, initially every two hours and subsequently three-hourly, moving to four- to six-hourly post-operatively. This has implications for safety and nursing time, and can influence clinical decision-making. We investigated the use of an infusion pump to deliver timed and accurate rFVIIa bolus doses during the postoperative period. Methods: Two patients with severe haemophilia A and inhibitors undergoing three procedures were managed with a pre-surgical bolus infusion of 120mcg/kg of rFVIIa, followed by postoperative doses of 90mcg/kg every two hours for the first 72 hours, and every three hours subsequently, with increasing dose intervals thereafter. All postoperative bolus doses were delivered via a pre-programmed infusion pump. The pump also required a constant background infusion set at 0.1ml/ hour for the first patient, and reduced to 0.01ml/hour for the second patient. Results: The pump was simple to use and readily accepted by patients and nursing staff. There were no delayed or missed doses, and good haemostasis was maintained. Overall nursing time involved in reconstituting and administering rFVIIa was reduced from three to six hours per treatment day (with conventional bolus dosing) to just one to two hours per day with the pump. Conclusions: The syringe pump successfully delivered the correct doses at the specified time intervals for all three procedures. The technique met the centre’s safety and efficacy criteria and resulted in a significant reduction in the amount of nursing time needed over a 24-hour period. This novel method of rFVIIa administration appears to be safe and effective in the elective surgery setting, and should be further investigated.

scholarly journals Comparative study between target-controlled-infusion and continuous-infusion anesthesia in dogs treated with methotrimeprazine and treated with propofol and remifentanil

2008 ◽  
Vol 23 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Eduardo Hatschbach ◽  
Fernando do Carmo Silva ◽  
Suzane Lílian Beier ◽  
Alfredo Feio da Maia Lima ◽  
Flávio Massone
Keyword(s):  
Comparative Study ◽  
Continuous Infusion ◽  
Infusion Pump ◽  
Recovery Period ◽  
Syringe Pump ◽  
Target Dose ◽  
Target Controlled Infusion ◽  
Pre Treatment

PURPOSE: To compare two propofol infusion techniques in bitches subjected to ovaryhisterectomy by estimating the efficiency of the propofol target-dose, evaluating the cardiorespiratory and hemogasimetric attributes, and the bispectral scale index (BIS) as well as the recovery period characteristics. METHODS: Twenty anesthetized bitches were divided into two groups of 10 each (G1, G2). Animals of G1 were pre-treated with methotrimeprazine and anesthetized with target-controlled propofol infusion by means of a Harvard infusion pump combined to remifentanil through a syringe pump. RESULTS: Bradycardia and light hypotension, hemogasimetric and respiratory stability besides a good myorelaxation, more evident during continuous infusion and good hypnosis. CONCLUSIONS: Dosis used in both techniques, after methotrimeprazine pre-treatment and combined to the opioid, were efficient for the surgery. The target-controlled anesthesia required a smaller anesthetic consumption (propofol) with faster recovery periods.

scholarly journals In Vitro and In Vivo Assessment of a New Workflow for the Acquisition of Mandibular Kinematics Based on Portable Tracking System with Passive Optical Reflective Markers

2021 ◽  
Vol 11 (9) ◽  
pp. 3947
Author(s):  
Marco Farronato ◽  
Gianluca M. Tartaglia ◽  
Cinzia Maspero ◽  
Luigi M. Gallo ◽  
Vera Colombo
Keyword(s):  
Measurement Error ◽  
Tracking System ◽  
Intraclass Correlation ◽  
Optical Tracking ◽  
Optical Tracking System ◽  
Rater Reliability ◽  
Tracking Device ◽  
Mandibular Kinematics

Clinical use of portable optical tracking system in dentistry could improve the analysis of mandibular movements for diagnostic and therapeutic purposes. A new workflow for the acquisition of mandibular kinematics was developed. Reproducibility of measurements was tested in vitro and intra- and inter-rater repeatability were assessed in vivo in healthy volunteers. Prescribed repeated movements (n = 10) in three perpendicular directions of the tracking-device coordinate system were performed. Measurement error and coefficient of variation (CV) among repetitions were determined. Mandibular kinematics of maximum opening, left and right laterality, protrusion and retrusion of five healthy subjects were recorded in separate sessions by three different operators. Obtained records were blindly examined by three observers. Intraclass correlation coefficient (ICC) was calculated to estimate inter-rater and intra-rater reliability. Maximum in vitro measurement error was 0.54 mm and CV = 0.02. Overall, excellent intra-rater reliability (ICC > 0.90) for each variable, general excellent intra-rater reliability (ICC = 1.00) for all variables, and good reliability (ICC > 0.75) for inter-rater tests were obtained. A lower score was obtained for retrusion with “moderate reliability” (ICC = 0.557) in the inter-rater tests. Excellent repeatability and reliability in optical tracking of primary movements were observed using the tested portable tracking device and the developed workflow.

scholarly journals The Accuracy and Reliability of Tooth Shade Selection Using Different Instrumental Techniques: An In Vitro Study

Sensors ◽  
2021 ◽  
Vol 21 (22) ◽  
pp. 7490
Author(s):  
Nattapong Sirintawat ◽  
Tanyaporn Leelaratrungruang ◽  
Pongsakorn Poovarodom ◽  
Sirichai Kiattavorncharoen ◽  
Parinya Amornsettachai
Keyword(s):  
Intraclass Correlation ◽  
In Vitro Study ◽  
Control Group ◽  
Intraoral Scanner ◽  
Control Groups ◽  
B Values ◽  
Cie Lab ◽  
And Control ◽  
Shade Selection

This study aimed to investigate and compare the reliability and accuracy of tooth shade selection in the model using 30 milled crowns via five methods: (1) digital single-lens reflex (DSLR) camera with twin flash (TF) and polarized filter (DSLR + TF), (2) DSLR camera with a ring flash (RF) and polarized filter (DSLR + RF), (3) smartphone camera with light corrector and polarized filter (SMART), (4) intraoral scanner (IOS), and (5) spectrophotometer (SPEC). These methods were compared with the control group or manufacturer’s shade. The CIE Lab values (L, a, and b values) were obtained from five of the methods to indicate the color of the tooth. Adobe Photoshop was used to generate CIE Lab values from the digital photographs. The reliability was calculated from the intraclass correlation based on two repetitions. The accuracy was calculated from; (a) ΔE calculated by the formula comparing each method to the control group, (b) study and control groups were analyzed by using the Kruskal–Wallis test, and (c) the relationship between study and control groups were calculated using Spearman’s correlation. The reliability of the intraclass correlation of L, a, and b values obtained from the five methods showed satisfactory correlations ranging from 0.732–0.996, 0.887–0.994, and 0.884–0.999, respectively. The ΔE from all groups had statistically significant differences when compared to the border of clinical acceptance (ΔE = 6.8). The ΔE from DSLR + TF, DSLR + RF, SMART, and SPEC were higher than clinical acceptance (ΔE > 6.8), whereas the ΔE from IOS was 5.96 and all of the L, a, and b values were not statistically significantly different from the manufacturer’s shade (p < 0.01). The ΔE of the DSLR + RF group showed the least accuracy (ΔE = 19.98), whereas the ∆E of DSLR + TF, SMART, and SPEC showed similar accuracy ∆E (ΔE = 10.90, 10.57, and 11.57, respectively). The DSLR camera combined with a ring flash system and polarized filter provided the least accuracy. The intraoral scanner provided the highest accuracy. However, tooth shade selection deserves the combination of various techniques and a professional learning curve to establish the most accurate outcome.

scholarly journals Reliability analysis of two methods for measuring active enamel demineralization: An in vitro study

2013 ◽  
Vol 07 (02) ◽  
pp. 159-164 ◽  
Author(s):  
Camila Nassur ◽  
Luciana Pomarico ◽  
Lucianne Cople Maia
Keyword(s):  
Image Analysis ◽  
Intraclass Correlation ◽  
In Vitro Study ◽  
Analysis Software ◽  
Computerized Image Analysis ◽  
Enamel Demineralization ◽  
Significant Difference ◽  
Digital Caliper ◽  
Excellent Reproducibility

ABSTRACT Objective: The aim was to evaluate the intra- and inter-examiner reliability of two methods, namely, digital caliper [DC] and computerized image analysis software (Image Tool [IT] version 4.1) for measuring the area of an active enamel demineralization lesion. The effect on that measurement of a window that delimits the lesion was also assessed. Materials and Methods: Thirty-eight circular artificial enamel demineralization lesions (r = 2 mm) were produced on bovine teeth in vitro, which were then measured three times by three examiners, with and without the presence of a window delimiting the area to be measured. The data were analyzed by the intraclass correlation coefficient (ICC) with 95% confidence interval (CI) and by the Altman and Bland analysis. Results: The intra-examiner correlation using the IT method showed excellent reproducibility (mean ICC values 0.922-0.970 with the delimiting window and 0.915-0.990 without the window). However, the intra-examiner correlation using the DC method showed comparatively less reproducibility in the measurements (mean ICC values 0.458-0.648 with the delimiting window and 0.378-0.665 without the window). The inter-examiner correlations showed very good reproducibility of the measurements regardless of the presence or absence of the window for both the DC method (0.811-0.846) and IT method (0.953-0.994). However, the latter method showed less variability within the measurements. Conclusion: However, statistically no significant difference was found between both methodologies. Nevertheless, computerized image analysis with the Image Tool software demonstrated higher intra- and inter-examiner reliability than the digital caliper method, in estimating the area of the enamel demineralization lesion, regardless of the delimiting window.

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.

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