Case Reports: Rapid Fluid Delivery for Hypotension via a Novel Device (LifeFlow®) Leads to Improved Patient Outcome

Abstract

Introduction: Critically ill patients presenting to the emergency department with shock often require a rapid intravenous fluid bolus to correct hypotension, restore tissue perfusion, and prevent cardiovascular collapse. In patients who require intravenous fluid bolus administration, a variety of barriers can limit effective resuscitation, including difficult vascular access, technically complex or slow infusion devices, and inadequate nursing resources. LifeFlow  (410 Medical, Inc., Durham, NC) is a handheld, manually-operated device that allows the user to precisely and rapidly deliver appropriate measured boluses of crystalloid fluid during resuscitation. No reports of the clinical use of LifeFlow currently exist in the literature.Aim: To report the first clinical cases of the use of LifeFlow for the rapid delivery of fluid resuscitation in adult patients with hypotension.Methods: A convenience sample of the first patients to use LifeFlow for fluid resuscitation was queried and patient's charts were reviewed for relevant case information. Results:We present five cases of critically ill patients with shock and hypotension that benefited from fluid resuscitation via LifeFlow. In each case, shock was quickly reversed as a result of rapid delivery of one or more fluid boluses, preventing the need for central venous access and other interventions. Conclusion:Rapid administration of controlled resuscitative fluid led to significant clinical improvements in each of the cases. The LifeFlow device facilitated rapid fluid delivery, allowing clinicians to make prompt clinical assessments and potentially avoid the need for additional interventions.

The Use of a Rapid Fluid Infusion System in Children

“…The precise rate of fluid administration was often difficult to determine from chart review. Given the typical delivery times observed with LifeFlow usage, if no time was recorded 5 minutes was noted as the default time, based on several references documenting the delivery of 500-1000ml of crystalloid in less than 5 minutes [36][37][38][39] . Vital signs after fluid bolus was defined as the first set of vital signs immediately following the fluid bolus.…”