Comparison of the effectiveness of the piston-pump method versus the pressure-infusor method for rapid infusion of fluids

Abstract Background The piston-pump method is a simple method for rapid administration of fluids. However, some problems regarding effectiveness in increasing the flow rate of fluid administration, occurrence of excessive pressure in the infusion circuit and vessel, and bacterial contamination of fluids are unsolved. We compared the effectiveness of using the piston-pump method with that of the pressure-infusor method.Methods Twelve anesthesiologists were classified randomly into the piston-pump and pressure-infusor groups. They were asked to infuse 500 ml of 0.9% saline three times successively through a 16-G intravenous cannula as rapidly as possible using a pump with a 50-ml syringe or a pressure-infusor at 300 mmHg. The time taken for infusion, the pressure in the infusion circuit and substitute vessel, and bacterial contamination were examined. Results The infusion time (mean ± SD) in the pressure-infusor and piston-pump groups was 233 ± 19 s and 301 ± 48 s, respectively (P < 0.01). There was a significant difference in the infusion time at the first and third attempts of infusion only in the piston-pump group (P 200 (P < 0.01) and in the substitute vessel was 5 ± 1 and 17 ± 7 (P < 0.01) in the pressure-infusor and piston-pump groups, respectively. A pressure of -200 mmHg or less occurred at all infusion attempts in the piston-pump group. Bacterial infection was not observed in either group. Conclusions If fluids must be administered rapidly, use of the pressure-infusor is more efficient than the piston-pump method because the latter is less effective in infusing fluids rapidly and associated with excessive positive and negative pressure in the infusion circuit. However, this method should be considered as first aid until a commercially available rapid transfusion and infusion system has been prepared.