Confirmation of uncontrolled flow dynamics in clinical simulated multi-infusion setups using absorption spectral photometry

Multi-infusion systems are used frequently at intensive care units to administer several liquid therapeutic agents to patients simultaneously. By passively combining the separate infusion lines in one central line, the number of punctures needed to access the patient's body, is reduced. So far, the mutual influence between the different infusion lines is unknown. Although the flow properties of single infusion systems have been investigated extensively, only a few research groups have investigated the flow properties of multi-infusion systems. We showed in a previous study that applying multi-infusion can lead to fluctuations in syringe pump infusions, resulting in uncontrolled and inaccurate drug administration. This study presents a performance analysis of multi-infusion systems as used in the Neonatology Intensive Care Unit. The dynamics between multiple infusion lines in multi-infusion systems were investigated by simulation experiments of clinical conditions. A newly developed real-time spectral-photometric method was used for the quantitative determination of concentration and outflow volume using a deconvolution method of absorption spectra of mixed fluids. The effects for common clinical interventions were studied in detail. Results showed mutual influence between the different infusion lines following these interventions. This mutual influence led to significant volume fluctuations up to 50%. These deviations could result in clinically dangerous situations. A complete analysis of the multiinfusion system characteristics is recommended in further research to estimate both the presence and severity of potential risks in clinical use.