Smart infusion pump

Overview

Smart, computerized infusion pumps have developed to the point that they are readily available on the market from a variety of vendors, and for a variety of uses.

It is important to distinguish the different types of pumps by modality. The common modalities are (1) large volume parenteral infusions (LVPs), (2) syringe infusions, (3) epidural infusions and (4) patient-controlled analgesia infusions.

Some pumps are purpose-built exclusively to be used for only a single modality, whereas other pumps have been engineered to support multiple infusion modalities.

Klas recently (2008) reviewed several pump vendor products. The represented vendors were B. Braun, Baxter, Cardinal Health, Hospira, Sigma and Smiths Medical.

Some smart pumps have become network devices, connecting to wireless networks in hospitals and clinics using IEEE 802.11 standards for wireless local area network communications.

Smart Infusion Pump quality data

One fascinating advantage of smart infusion pump technology is the ability to capture information from the pump programming process for later review and analysis. Typically, smart infusion pumps include drug libraries or databases of drug-specific information. These drug libraries can include lower and upper bounds governing safe and appropriate infusion rates for standard infusions as they are defined by the hospital, health-system or clinic. These lower and upper infusion rate bounds are then used to provide administration decision support at the point-of-care. Overridable soft stops and rigid hard stops are both supported by some of the smart pump software.

The smart pump use data that can be collected at the level of the smart infusion pump and then aggregaged into a smart infusion pump database on central server or servers includes records of the administration warnings and alerts that have fired and the administering clinicians responses to those alerts.

Maddox et al. report some of these data in a paper on smart infusion devices for patient-controlled analgesia (PCA). In this study, the PCA pump system included a novel, integrated, continous capnographic quality of respiration monitoring system augmented by pulse-oximetry (see Am J Health-Syst Pharm Vol. 63: Jan 15, 2006). These authors present several cases where automated respiratory monitoring by the PCA smart pump system alerted clinicians early-on to potential narcotic-induced repiratory depression before life-saving measures were needed. The authors also report "examples of averted programming errors" from the smart PCA pump activity database.