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Performance Evaluation of Infusion Systems for Red Blood Cell Transfusion
J Lab Med Qual Assur 2019;41:161-165
Published online September 30, 2019
© 2019 Korean Association of External Quality Assessment Service.

Min-Sun Kim1, Jin Seok Kim1, Eunyoung Lim2, Hongchul Park3, Sang-Hyun Hwang1, Heung-Bum Oh1, and Dae-Hyun Ko1

1Department of Laboratory Medicine, 2Children셲 Hospital Nursing Team, and 3Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence to: Dae-Hyun Ko
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-4504 Fax: +82-2-478-0884 E-mail: daehyuni1118@amc.seoul.kr
Received March 22, 2019; Revised August 21, 2019; Accepted August 22, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

Background:

Transfusion in neonates and infants can be performed using an electro-mechanical infusion system that has appropriate accuracy in terms of flow rate, volume, and bolus. However, there are no infusion systems approved for transfusion in Korea. In this study, we evaluate the performance of two electromechanical infusion systems for transfusion in pediatric patients.

Methods:

We tested two systems, Baxter and Terumo, using 9 units of leukocyte-filtered red blood cells. The blood samples were delivered through the systems at constant speeds of 10, 30, and 100 mL/hr, and the accuracy in terms of the delivered volume was estimated. Before and after infusion, hemoglobin, hematocrit, plasma hemoglobin, potassium, and lactate dehydrogenase levels were measured in each sample. The percentage of hemolysis (%Hemolysis) was calculated to evaluate the safety of the infusion systems.

Results:

For Terumo, the mean error rate of the infused volume was less than 5%. We expect that Terumo can transfuse blood at a volume close to the set volume. Further, both infusion systems showed acceptable %Hemolysis levels (mean±standard deviation: Terumo, 0.14±0.04; Baxter, 0.17±0.06).

Conclusions:

Both infusion systems can be used safely for transfusion in pediatric patients.

Keywords : Electromechanical infusion system, Accuracy, Hemolysis
꽌濡

꽦씤怨 떖由 냼븘, 듅엳 떊깮븘뿉寃 쟻삁援 諛 삁냼뙋 닔삁 떆 쟻 뼇쓽 삁븸씠 븘슂븯湲 븣臾몄뿉 젙솗븳 뼇씠 씪젙 냽룄濡 닔삁릺룄濡 븯뒗 寃껋씠 以묒슂븯떎[1]. 洹몃옒꽌 냼븘뿉寃 닔삁 떆 옉 吏곴꼍쓽 諛붾뒛쓣 궗슜븯뿬룄 씪젙븳 二쇱엯냽룄瑜 쑀吏븷 닔 엳怨 닔삁맂 뼇룄 젙솗븯寃 븣 닔 엳뒗 쟾옄湲곌퀎떇 二쇱엯옣移(electromechanical infusion pump)媛 꼸由 궗슜릺怨 엳떎. 쟾옄湲곌퀎떇 二쇱엯옣移섎뒗 以묓솚옄떎, 쓳湲됱떎 諛 떊깮븘떎 벑뿉꽌 벐씠뒗 븘닔옣鍮꾨줈 솚옄뿉寃 誘몄꽭븳 삉뒗 떎웾쓽 빟뭹쓣 二쇱엯떆궗 븘슂媛 엳뒗 寃쎌슦 떆媛꾨떦 젙솗븳 뼇쓽 빟臾쇱쓣 二쇱엯떆궎怨좎옄 븷 븣뿉 以묒슂븳 옣鍮꾩씠떎. 援궡뿉뒗 닔삁슜쑝濡 젙떇 뿀媛諛쏆 二쇱엯옣移섎뒗 븘吏 뾾怨, 湲곗〈뿉 빟臾 삉뒗 닔븸 二쇱엯슜쑝濡 뿀媛諛쏆 二쇱엯옣移섏뿉 삁븸씠 떞湲 삁븸諛깆쓣 뿰寃고븯뿬 삁븸쓣 二쇱엯븯뿬 궗슜븯怨 엳떎.

二쇱엯옣移섎뒗 씪諛섏쟻쑝濡 紐⑦꽣瑜 쉶쟾떆궎뒗 諛⑹떇쑝濡 씪젙웾쓣 誘몃━ 엯젰븳 봽濡쒓렇옩뿉 쓽빐 솚옄뿉寃 二쇱엯븳떎. 二쇱엯옣移섎 궗슜븳 닔삁 떆 씪젙븳 븬젰씠 媛빐吏誘濡 쟻삁援ш 諛붾뒛쓣 넻怨쇳븷 븣 臾쇰━쟻 넀긽쓣 諛쏆븘 슜삁씠 諛쒖깮븷 媛뒫꽦씠 엳떎. 遺遺꾩쓽 二쇱엯옣移섍 쟾삁 궗슜 떆 湲곌퀎쟻 슜삁쓣 씪쑝궎吏 븡吏留 씪遺 젣뭹뿉꽌뒗 쟻삁援ъ젣젣 궗슜 떆 쑁븞쑝濡 떇蹂 媛뒫븳 슜삁씠 諛쒖깮븷 닔 엳떎. 뵲씪꽌 二쇱엯옣移섎 궗슜븯뿬 쟻삁援щ굹 湲고 젣젣瑜 닔삁븯뒗 寃쎌슦뿉뒗 洹 湲곌뎄媛 슜룄뿉 쟻빀븳吏瑜 誘몃━ 솗씤븯뿬빞 븳떎[1].

긽슜 二쇱엯옣移 以 뿰룞슫룞떇(peristaltic type) 닔븸꽭듃뿉 옉슜븯뒗 옉룞諛⑹떇뿉 뵲씪 醫낅쪟媛 굹돇寃 맂떎. Drop諛⑹떇쓽 non-pump슜 二쇱엯냽룄媛 chamber뿉 뼥뼱吏뒗 諛⑹슱 닔뿉 뵲씪 寃곗젙릺硫, 삉 떎瑜 븯굹씤 pump떇 닔븸꽭듃瑜 닃윭二쇨굅굹 諛뼱二쇰뒗 臾쇰━쟻씤 蹂솕뿉 쓽빐 닔븸쓣 蹂대궡二쇰뒗 諛⑹떇쑝濡 二쇱엯냽룄瑜 寃곗젙븯寃 맂떎. 蹂 뿰援ъ뿉꽌뒗 씠 2媛吏 諛⑹떇쓽 二쇱엯옣移섏쓽 二쇱엯냽룄쓽 젙솗룄 슜삁 젙룄 룊媛瑜 넗濡 洹 엫긽쟻 븞젙꽦뿉 븳 媛꾩씠룊媛瑜 떆뻾빐蹂닿퀬옄 븳떎. 씠뒗 냼븘 닔삁 떆 二쇱엯옣移섎 꽑깮븯뒗 뜲 룄쓣 以 닔 엳떎.

옱猷 諛 諛⑸쾿

꽌슱븘궛蹂묒썝뿉꽌 냼븘 솚옄뿉寃 닔삁쓣 븯湲 쐞빐 遺꾪븷삁븸젣젣瑜 젣議고븯怨 궓 蹂닿 쟾 諛깊삁援ъ뿬怨쇱젣嫄곗쟻삁援 젣젣 9떒쐞瑜 긽쑝濡 떎뿕쓣 닔뻾븯떎. 옍뿬 쟻삁援ъ뿉 媛숈 삁븸삎쓽 떊꽑룞寃고삁옣쓣 5:1 鍮꾩쑉濡 꽎뼱 떎뿕쓣 吏꾪뻾븯떎. 뿰援ъ뿉 궗슜맂 쟻삁援щ뒗 蹂닿湲곌컙씠 7씪 씠궡쓽 떊꽑쟻삁援щ 궗슜븯怨 룊洹 hematocrit (Hct) 60%±10%떎.

鍮꾧탳 룊媛븷 二쇱엯옣移 諛 닔삁꽭듃뒗 2媛吏瑜 꽑젙븯떎. 븯굹뒗 湲곗〈뿉 蹂몄썝뿉꽌 궗슜 以묒씤 吏곴꼍 3.2 mm씤 닔삁꽭듃-S (Doowon Meditec Co. Ltd., Yongin, Korea)瑜 non-pump삎쓽 FloGard6201 (Baxter; Baxter Healthcare Corp., Deerfield, IL, USA)뿉 옣李⑺븯뿬 궗슜븯怨, 굹癒몄 븯굹뒗 젣씠硫붾뱶(JMED, Seoul, Korea)뿉꽌 吏곴꼍 4.0 mm濡 젣옉븳 닔삁꽭듃媛 옣李⑸맂 pump삎쓽 Terufusion TE LM700 (Terumo; Terumo Medical Corp., Tokyo, Japan)쓣 궗슜븯떎. Terumo쓽 寃쎌슦 쟾슜 닔삁꽭듃留뚯씠 옣李⑹씠 媛뒫븯뿬 씠踰 떎뿕쓣 쐞빐 옣李⑹씠 媛뒫븳 닔삁꽭듃瑜 젣옉븯떎.

룊媛빆紐⑹ 떆媛꾨떦 삁븸 二쇱엯웾쓽 젙솗룄 二쇱엯옣移 넻怨 쟾썑쓽 슜삁 젙룄씠떎. 二쇱엯웾 젙솗룄 룊媛瑜 쐞븯뿬 떆媛꾨떦 삁븸 寃泥 二쇱엯웾쓣 10 mL/hr (180遺), 30 mL/hr (120遺), 100 mL/hr (60遺)濡 꽕젙븯떎. 蹂몄썝뿉꽌 냼븘뿉寃 닔삁 떆 10 mL/kg쓽 삁븸 2-3떆媛꾩뿉 嫄몄퀜 二쇱엯븯怨 엳떎. 蹂몄썝뿉꽌 pump瑜 씠슜븯뿬 닔삁맂 湲곕줉쓣 議곗궗븯쓣 븣 泥댁쨷 3.0 kg씤 떊깮븘쓽 寃쎌슦 30 mL쓽 삁븸쓣 2-3떆媛 룞븞 二쇱엯븯寃 릺硫 빟 10 mL/hr 냽룄濡 二쇱엯븯寃 맂떎. 삉븳 20 kg쓽 냼븘뒗 200 mL쓽 삁븸쓣 2-3떆媛 룞븞 二쇱엯븯뒗 寃쎌슦 빟 100 mL/hr쓽 냽룄濡 二쇱엯븯떎. 씠윴 議곗궗궡슜怨 蹂몄썝 냼븘媛꾪샇 옄臾몄쓣 諛뷀깢쑝濡 二쇱엯냽룄瑜 寃곗젙븯怨, 二쇱엯웾쓣 30-100 mL濡 꽑젙븯떎. 湲곗〈 臾명뿄뿉꽌 떆뻾뻽뜕 二쇱엯냽룄 뿭떆 5, 10, 20 mL/hr濡 궙 냽룄떎[2]. 媛 二쇱엯냽룄蹂꾨줈 3媛쒖쓽 삁븸젣젣瑜 씠슜븯뿬 떎뿕븯怨 넻怨쇳븳 삁븸 硫붿뒪떎由곕뜑濡 諛쏆븘꽌 洹 遺뵾瑜 痢≪젙븯떎. 삤李⑥쑉(error rate) 떎쓬怨 媛숈 怨듭떇쑝濡 怨꾩궛븯떎: 삤李⑥쑉=(떎젣 二쇱엯웾–꽕젙 二쇱엯웾)/꽕젙웾×100 (%).

슜삁 젙룄뿉 빐꽌뒗 二쇱엯옣移 넻怨 쟾썑쓽 삁븸쓣 梨꾩랬븯뿬 슜삁 愿젴 寃궗瑜 떎떆븯뿬 鍮꾧탳븯떎. 二쇱엯 쟾 삁븸뿉 븯뿬 hemoglobin (Hb), Hct, plasma Hb, potassium (K), lactate dehydrogenase (LDH)瑜 痢≪젙븯떎. Hb, Hct Sysmex XN (Sysmex, Kobe, Japan)쑝濡 痢≪젙븯怨, K, LDH뒗 AU5800 (Beckman Coulter Inc., Brea, CA, USA)쓣 씠슜븯뿬 痢≪젙븯떎. Plasma Hb Spectrophotometer (Hitachi U-3310; Hitachi, Tokyo, Japan)瑜 씠슜븯뿬 380 nm (A380), 415 nm (A415), 450 nm (A450)뿉꽌쓽 씉愿묐룄瑜 痢≪젙븯怨 떎쓬怨 媛숈 怨듭떇쓣 씠슜븯뿬 怨꾩궛븯떎: plasma Hb (mg/dL)=83.6×(2×A415–A380–A450).

二쇱엯 썑 삁븸뿉 븯뿬꽌룄 plasma Hb, K, LDH瑜 룞씪븳 諛⑸쾿쑝濡 痢≪젙븯떎. 媛 삁븸 寃泥댁뿉 븳 %Hemolysis뒗 떎쓬怨 媛숈 怨듭떇쑝濡 怨꾩궛븯떎: %Hemolysis=(100–Hct)×plasma Hb/total Hb. 媛 삁븸 寃泥대퀎濡 怨꾩궛븳 寃곌낵瑜 鍮꾧탳븯뿬 蹂닿퀬, 10 mL/hr (180遺), 30 mL/hr (120遺), 100 mL/hr (60遺)蹂꾨줈 二쇱엯븳 3媛쒖쓽 삁븸 寃泥댁쓽 plasma Hb, %Hemolysis (mean±standard deviation [SD])瑜 怨꾩궛븯뿬 냽룄蹂꾨줈 슜삁 젙룄뿉 李⑥씠媛 엳뒗吏룄 궡렣蹂댁븯떎. 媛 뜲씠꽣뒗 痢≪젙媛, mean±SD濡 遺꾩꽍븯떎.

寃곌낵

誘몃━ 꽕젙븳 二쇱엯냽룄 諛 떆媛꾩뿉 뵲씪 떎젣 二쇱엯맂 삁븸웾 諛 洹 삤李⑤ Table 1뿉 굹궡뿀떎. 몢 infusion system 紐⑤몢 꽕젙뻽뜕 二쇱엯웾蹂대떎 뜑 留롮 뼇쓽 삁븸씠 떎젣 닾엯맂 寃껋쑝濡 痢≪젙릺뿀떎(Table 1).

Table 1 . Accuracy of the two infusion systems.

Sample no.Infusion rate (mL/hr)Time (min)TerumoBaxter


Infused volume (mL)Error rate (%)Infused volume (mL)Error rate (%)
11018030.10.333.712.3
21018032.37.733.612.0
31018031.13.734.113.7
43012062.54.272.520.8
53012063.15.268.213.7
63012062.54.265.08.3
710060104.64.6110.010.0
810060102.02.0107.97.9
910060101.01.0112.912.9

The instruments were from the following companies: Baxter Health-care Corp. (Deerfield, IL, USA) and Terumo Medical Corp. (Tokyo, Japan)..


Table 2뒗 슜삁 愿젴 떎뿕寃곌낵瑜 蹂댁뿬二쇨퀬 엳떎. 二쇱엯 쟾 K, LDH, plasma Hb, %Hemolysis쓽 룊洹(踰붿쐞) 媛곴컖 18.5 mmol/L(踰붿쐞, 11.6-25.9 mmol/L), 86.3 IU/L(踰붿쐞, 53.9-116.1 IU/L), 32.7 mg/dL(踰붿쐞, 18.6-66.7 mg/dL), 0.10%(踰붿쐞, 0.06%-0.21%)濡 솗씤릺뿀떎. Terumo infusion system쓣 넻怨 썑 삁븸쓽 룊洹 plasma Hb 44.1 mg/dL(踰붿쐞, 18.2-72.0 mg/dL)씠뿀怨, %Hemolysis쓽 寃쎌슦뿉뒗 二쇱엯 썑 룊洹 0.14%(踰붿쐞, 0.06%-0.22%)濡 利앷븯떎. Baxter infusion system쓣 씠슜븳 떎뿕뿉꽌룄 二쇱엯 썑 룊洹 plasma Hb 룊洹 54.2 mg/dL(踰붿쐞, 24.0-84.3 mg/dL)쑝濡 利앷븯떎. %Hemolysis쓽 寃쎌슦, 二쇱엯 썑 룊洹 0.17%(踰붿쐞, 0.07%-0.24%)濡 利앷븯떎.

Table 2 . Effects of the two infusion systems on hemolysis.

Sample no.BaselineTerumo–post infusionBaxter–post infusion



K (mmol/L)LDH (IU/L)Plasma Hb (mg/dL)%Hemo (%)K (mmol/L)LDH (IU/L)Plasma Hb (mg/dL)%Hemo (%)K (mmol/L)LDH (IU/L)Plasma Hb (mg/dL)%Hemo (%)
121.6116.121.60.0921.3129.035.80.1521.4136.555.00.24
225.961.932.70.0925.587.960.70.1725.8112.884.30.24
311.7109.521.80.1011.0118.829.00.1411.0124.335.30.17
411.666.118.60.0611.863.418.20.0611.867.924.00.07
522.353.933.80.0921.867.947.30.1222.084.055.70.14
621.070.125.30.0820.781.636.60.1120.885.437.60.12
720.288.249.80.1320.481.151.30.1320.578.854.20.14
820.6116.166.70.2119.065.445.70.1419.469.663.50.20
911.794.524.20.0711.996.872.00.2212.2107.677.90.24
Mean±SD18.5±5.0886.3±22.8532.7±15.970.10±0.0418.1±4.9488.0±21.9044.1±0.040.14±0.0418.3±5.0096.3±23.3254.2±18.560.17±0.06

Both systems showed increased %Hemolysis after infusion. The instruments were from the following companies: Baxter Healthcare Corp. (Deerfield, IL, USA) and Terumo Medical Corp. (Tokyo, Japan). Abbreviations: K, potassium; LDH, lactate dehydrogenase; plasma Hb, plasma hemoglobin; %Hemo, %Hemolysis; SD, standard deviation..


二쇱엯냽룄蹂꾨줈 plasma Hb 諛 %Hemolysis瑜 鍮꾧탳빐遊ㅼ쓣 븣, %hemolysis 룊洹좎 Terumo, Baxer 媛곴컖 10 mL/hr씪 븣뒗 0.15%, 0.22%, 30 mL/hr씪 븣뒗 0.10%, 0.11%, 100 mL/hr씪 븣뒗 0.16%, 0.19%씠뿀怨, plasma Hb 룊洹좎 Terumo, Baxer 媛곴컖 10 mL/hr씪 븣뒗 41.8 mg/dL, 58.2 mg/dL, 30 mL/hr씪 븣뒗 34.0 mg/dL, 39.1 mg/dL, 100 mL/hr씪 븣뒗 56.3 mg/dL, 65.2 mg/dL 닔以씠뿀떎(Table 3).

Table 3 . Effects on hemolysis according to infusion rates.

Infusion rate (mL/hr)BaselineTerumo–post infusionBaxter–post infusion



Plasma Hb (mg/dL)%Hemolysis (%)Plasma Hb (mg/dL)%Hemolysis (%)Plasma Hb (mg/dL)%Hemolysis (%)
1025.4±5.190.09±0.0041.8±13.630.15±0.0158.2±20.130.22±0.03
3025.9±6.220.07±0.0134.0±12.020.10±0.0239.1±12.980.11±0.03
10046.9±17.50.14±0.0656.3±11.310.16±0.0465.2±9.750.19±0.04

Values are presented as mean±standard deviation. Each number represents an average value of three samples. The instruments were from the following companies: Baxter Healthcare Corp. (Deerfield, IL, USA) and Terumo Medical Corp. (Tokyo, Japan)..

Abbreviation: Hb, hemoglobin..


怨좎같

쟾옄湲곌퀎떇 二쇱엯옣移섎뒗 씪젙븳 냽룄濡 닔븸젣젣瑜 二쇱엯븷 닔 엳怨 二쇱엯맂 뼇쓣 젙솗븯寃 븣 닔 엳뼱 냼븘 삉뒗 留뚯꽦 떊吏덊솚 솚옄뿉꽌 쓷엳 궗슜맂떎. 엫긽쁽옣뿉꽌뒗 떎뼇븳 긽슜 二쇱엯옣移섍 궗슜릺怨 엳쑝硫, 媛곸쥌 젣젣 닾뿬 떆 빟臾 삉뒗 삁븸젣젣쓽 궪닾븬, 二쇱엯웾, 빟臾 怨듦툒젅李, 씪愿꽦, 젙솗꽦, 二쇱엯냽룄 벑쓣 怨듯넻쟻쑝濡 怨좊젮빐빞 슚怨쇱쟻씤 솚옄愿由ъ뿉 룄씠 릺硫 踰꾨젮吏뒗 빟臾쇰룄 以꾩씪 닔 엳떎[3-5]. 씪諛섏쟻씤 닔븸 럩봽쓽 二쇱엯냽룄뿉 븳 삤李⑥쑉 ±5% 誘몃쭔쑝濡 븣젮졇 엳떎. 삉븳 elastic infusion pump瑜 蹂닿퀬맂 二쇱엯냽룄뿉 븳 삤李⑥쑉 ±15% 誘몃쭔쑝濡 븣젮졇 엳떎[6].

젣議곗궗뿉꽌 빟臾 삉뒗 닔븸 二쇱엯슜쑝濡 뿀媛 떆 젣떆븳 삤李⑥쑉(Terumo: ±5%, Baxter: ±7%)怨 鍮꾧탳빐 遊ㅼ쓣 븣 Terumo쓽 寃쎌슦 2, 5 삁븸 寃泥대 젣쇅븯怨 5% 삤李⑥쑉 씠궡怨, Baxter쓽 寃쎌슦 삤李⑥쑉 씠궡쓽 삁븸 寃泥대뒗 뾾뿀떎. 닔븸 pump쓽 삤李⑥쑉 湲곗쑝濡 鍮꾧탳빐蹂댁븯쓣 븣 Baxter 옣鍮꾩 떖由 Terumo 옣鍮꾩쓽 二쇱엯냽룄뿉 븳 룊洹 삤李⑥쑉씠 5% 誘몃쭔쓽 寃곌낵瑜 蹂댁뿬 二쇱엯냽룄뿉 뵲씪 꽕젙맂 슜웾뿉 媛源앷쾶 솚옄뿉寃 二쇱엯맆 닔 엳쓣 寃껋쑝濡 삁痢≫븷 닔 엳뿀떎. 鍮꾨줉 빟臾쇱뿉 븳 룊媛씠湲 븯吏留 湲곗〈 臾명뿄怨 鍮꾧탳빐遊ㅼ쓣 븣 젙솗룄뿉 겙 李⑥씠瑜 蹂댁씠吏 븡븯떎[5]. 떎留 삁븸 닔븸怨 젏룄쓽 李⑥씠媛 엳뼱 닔븸怨 媛숈 湲곗쓣 쟻슜븯湲곗뿉뒗 뼱졄떎. 삉븳 蹂 뿰援ъ뿉꽌뒗 떊꽑룞寃고삁옣쑝濡 씗꽍맂 삁븸쓣 궗슜븯吏留 닔삁뿉 씠슜븯뒗 냽異뺤쟻삁援щ뒗 젏룄媛 뜑 넂湲 븣臾몄뿉 떎젣 삤李⑤뒗 뜑 而ㅼ쭏 닔 엳떎. Non-pump슜쓽 Baxter뒗 닔븸꽭듃瑜 닃윭二쇰뒗 臾쇰━쟻씤 蹂솕뿉 븳 蹂듭썝젰씠 蹂댁옣릺吏 븡吏留 pump떇쓽 Terumo뒗 臾쇰━쟻씤 븬젰쑝濡 닔븸쓣 궡蹂대궡 二쇱엯웾씠 蹂듭썝릺뒗 뒫젰씠 drop슜蹂대떎 뜑 슦닔븯湲 븣臾몄뿉 씠윴 李⑥씠瑜 媛졇삤뒗 寃껋쑝濡 蹂댁씤떎. 洹 쇅뿉룄 二쇱엯옣移섎 궗슜븷 븣 二쇱쓽빐빞 븷 젏 遺쟻젅븳 닔삁꽭듃瑜 벐怨 엳뒗吏, drip detector쓽 쐞移, 諛고꽣由ъ쟾젰, 삩룄 벑씠 엳떎[4,5].

二쇱엯옣移섏쓽 꽦뒫 솚옄쓽 븞쟾뿉 吏곸젒쟻씤 쐞빐瑜 以 닔 엳떎. 誘멸뎅 떇뭹쓽빟뭹븞쟾泥(US Food and Drug Administration)뿉꽌 湲곕줉맂 떎濡瑜 蹂대㈃, 遺꾨쭔 以 삦떆넗떊쓣 怨듦툒븯湲 쐞빐 二쇱엯옣移섏뿉 二쇱엯냽룄瑜 2 mL/hr濡 꽕젙 썑 떆옉踰꾪듉쓣 닃쑝굹 빟臾 二쇱엯씠 媛묒옄湲 怨쇰웾씠 二쇱엯릺뼱 깭븘쓽 떖諛 닔媛 븯릺뿀뜕 蹂닿퀬媛 엳떎[7]. 뵲씪꽌 엫긽쁽옣뿉꽌뒗 二쇱엯옣移섎 궗슜븯湲 쟾뿉 洹 꽦뒫뿉 븳 룊媛瑜 닔뻾븯뒗 寃껋씠 븞쟾븳 吏꾨즺瑜 쐞븳 湲몄씠 맆 寃껋씠떎.

삁븸씠 二쇱엯릺뒗 룞븞 쟻삁援ш 諛쏅뒗 넀긽 젙룄뒗 뿬윭 슂씤뱾뿉 쓽빐 쁺뼢쓣 諛쏅뒗 寃껋쑝濡 븣젮졇 엳떎. 삁븸젣젣쓽 梨꾩랬 썑 蹂닿湲곌컙, 궗슜븳 二쇱궗移 諛붾뒛 吏곴꼍, 씪젙븳 二쇱엯냽룄瑜 쑀吏븯湲 쐞빐 媛빐吏 븬젰 벑씠 洹멸쾬씠굹 臾댁뾿蹂대떎 二쇱슂븳 슂씤 二쇱엯옣移 옄泥댁쓽 듅꽦 諛 옉룞諛⑹떇씠떎[8-10].

듅엳 뿰룞諛⑹떇쓽 pump뒗 슜삁怨 愿젴씠 엳떎怨 븳떎. 湲곗〈뿉 蹂닿퀬맂 13媛쒖쓽 蹂닿퀬 以 10媛쒖뿉꽌 뿰룞諛⑹떇 二쇱엯옣移섏뿉꽌 슜삁씠 愿李곕릺뿀떎怨 븯쑝굹, cassette mechanism쓣 벐뒗 volumetric 二쇱엯옣移섎뒗 6媛쒖쓽 蹂닿퀬 以 4媛쒖뿉꽌 슜삁怨 뿰愿씠 뾾쓬씠 諛앺議뚮떎[11]. 援궡뿉꽌 吏꾪뻾맂 븳 뿰援ш껐怨쇱뿉꽌뒗 냼븘 닔삁 떆 二쇱엯옣移섏뿉 뵲瑜 슜삁 젙룄瑜 鍮꾧탳빐遊ㅼ쓣 븣 쟾삁濡 떆뻾븳 寃쎌슦 紐⑤몢 plasma Hb쓽 利앷媛 愿李곕릺吏 븡븯怨, 냽異뺤쟻삁援щ 二쇱엯븳 寃쎌슦뿉 plasma Hb쓽 利앷媛 愿李곕릺뿀쑝굹 넻怨꾩쟻쑝濡 쑀쓽븳 닔以 븘땲뿀떎[2]. 씠踰 뿰援ъ뿉꽌 plasma Hb쓽 利앷뒗 留덉갔媛吏濡 愿李곕릺뿀쑝굹 寃泥 닔媛 쟻뼱 넻怨꾩쟻씤 遺꾩꽍쓣 뵲濡 떎떆븯吏뒗 븡븯떎. 洹몃윭굹 %Hemolysis瑜 湲곗쑝濡 蹂댁븯쓣 븣 몢 system 紐⑤몢 1% 誘몃쭔쓽 슜삁쓣 蹂댁뿬 100 mL/hr 씠븯쓽 뒓由 냽룄濡 삁븸쓣 二쇱엯븯뒗 寃쎌슦뿉 몢 옣鍮 紐⑤몢 엫긽 쟻슜뿉꽌 쐞뿕씠 뾾쓣 寃껋쑝濡 뙋떒맂떎[12,13]. 븯吏留 븘二 넂 냽룄뿉꽌뒗 슜삁씠 뜑 利앷븷 媛뒫꽦씠 엳떎.

二쇱엯옣移섏쓽 醫낅쪟뿉 뵲씪 쑁븞쑝濡 愿李곕릺뒗 슜삁씠 諛쒖깮븷 닔 엳뼱 쟻삁援щ굹 湲고 젣젣瑜 二쇱엯옣移섎 씠슜빐 닔삁븷 寃쎌슦 湲곌뎄媛 슜룄뿉 쟻빀븳吏 誘몃━ 솗씤빐빞 븯吏留 援궡뿉꽌뒗 닔삁슜쑝濡 뿀媛諛쏆 젣뭹씠 븘吏곸 뾾떎. 肉먮쭔 븘땲씪 4媛쒖썡 誘몃쭔 냼븘뿉꽌 씪젙븳 냽룄濡 二쇱엯븷 븣, 24寃뚯씠吏쓽 移댄뀒꽣濡 슜삁 벑쓽 臾몄젣뾾씠 궗슜븷 닔 엳떎怨 븯吏留 二쇱엯옣移섎 궗슜븯吏 븡뒗떎硫 씪젙븳 냽룄濡 二쇱엯븯뒗 寃껋 嫄곗쓽 遺덇뒫븯떎. 떊깮븘/냼븘 닔삁 떆 syringe pump瑜 궗슜븯뿬 닔삁쓣 떆뻾븯뒗 寃쎌슦룄 엳쑝굹, 蹂몄썝뿉꽌뒗 냼븘뿉꽌 媛먯뿼쓽 슦젮濡 씪諛섏쟻씤 二쇱엯옣移섎 궗슜븯怨 엳떎. 뵲씪꽌 蹂 룊媛뿉꽌뒗 syringe pump쓽 鍮꾧탳뒗 떆뻾븯吏 븡븯떎.

蹂 뿰援ъ뿉꽌뒗 留ㅼ슦 쟻 닔쓽 삁븸 寃泥대줈留 떎뿕븳 젏, 몢 媛쒖쓽 닔삁꽭듃媛 떎瑜대떎뒗 젏, 냽異뺤쟻삁援ъ쓽 긽痢듭븸씠 쟻뼱꽌 寃궗瑜 쐞븯뿬 遺덇뵾븯寃 떊꽑룞寃고삁옣쓣 샎빀븯뿬 떎뿕븳 젏, 100 mL/hr 씠븯쓽 냽룄濡쒕쭔 룊媛븳 젏 벑쓽 븳怨꾧 엳떎. 洹몃━怨 떎젣 솚옄뿉寃 븞쟾꽦뿉 븳 룊媛뒗 떎젣 닔삁씠 씠猷⑥뼱吏吏 븡쑝硫 泥댁쇅 寃궗寃곌낵留뚯쑝濡쒕뒗 븞젙꽦쓣 뙋떒븯湲곕뒗 뼱졄떎뒗 젣븳젏씠 엳떎. 洹몃윭굹 蹂 뿰援щ뒗 엫긽쁽옣뿉꽌 닔삁 닔뻾쓣 쐞븳 媛꾩씠룊媛濡쒖꽌 쓽쓽媛 엳떎怨 깮媛곷릺硫, 뼢썑 젙떇 닔삁슜 뿀媛瑜 뼸湲 쐞븳 洹쒕え 꽦뒫룊媛媛 엳뼱빞 븷 寃껋쑝濡 깮媛곷맂떎. 二쇱엯옣移섏쓽 닔삁슜 뿀媛瑜 쐞븳 꽦뒫룊媛뿉뒗 닔삁웾 諛 닔삁냽룄쓽 젙솗꽦, 쟻삁援 닔삁쓽 寃쎌슦 슜삁 젙룄뿉 븳 湲곗씠 룷븿릺뼱빞 븷 寃껋쑝濡 깮媛곷맂떎.

蹂 뿰援ш껐怨쇨 援궡뿉꽌 냼븘 솚옄뿉꽌 닔삁쓣 닔뻾븯뒗 뜲뿉 李멸퀬븷 닔 엳뒗 뜲씠꽣瑜 젣怨듯븷 닔 엳쓣 寃껋씠씪 깮媛곷릺硫, 븵쑝濡 닔삁슜 二쇱엯옣移섏뿉 븳 泥닿퀎쟻씤 룊媛 諛 뿀媛옉뾽씠 븘슂븷 寃껋쑝濡 뿬寃⑥쭊떎

References
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