• Neris Peduzzi, Martin Batliner, Beate Grass, Philipp K Buehler, Marianne Schmid Daners, Mirko Meboldt, and Markus Weiss.
• Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland.
• Paediatr Anaesth. 2020 Aug 1; 30 (8): 885-891.

ObjectiveThe current study aimed to evaluate the extent of the slide-stick phenomenon in differently designed infusion syringes at various infusion rates and filling positions.MethodsFluid delivery from three 50-mL infusion syringe brands (BD; Codan; Fresenius) was investigated using a flow sensor at flow rates of 0.5, 1.0, or 5.0 mL h-1 , with the syringes filled with either 10, 30, or 50 mL of distilled water. Two identical models (A/B) of the same infusion pump model were used. The effect of flow rate variations on the plasma concentration of a continuous epinephrine infusion in a 3 kg neonate receiving a continuous infusion of 0.1 μg kg min-1 epinephrine was studied using a pharmacokinetic simulation model.ResultsConsiderable variations in calculated plasma epinephrine concentration were detected between flow rates of 5 and 0.5 or 1 mL h-1 for all syringe types and filling volumes. The median deviation of plasma concentration for the 5 mL h-1 flow rate varied depending on assembly from 1.3% (Codan) to 1.8% (Fresenius). This was more pronounced for lower flow rates, where at 1 mL h-1 the deviation varied from 3.3% (BD) to 4.8% (Fresenius) and at 0.5 mL h-1 from 4.9% (BD) to 5.4% (Fresenius). Differences between filling volumes (within syringe type and flow rate) did not appear to have relevant influence on variations in calculated plasma epinephrine concentration.ConclusionInfusion set rate rather than syringe brand or filling volume was a major predictor for syringe stiction-related amount of variation in the calculated plasma epinephrine concentration.© 2020 John Wiley & Sons Ltd.

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