<p>Improving fluid resuscitation in pediatric shock with LifeFlow^®: a retrospective case series and review of the literature</p>

Abstract

Rapid delivery of an intravenous fluid bolus is commonly used in pediatric emergency care for the treatment of shock and hypotension. Early fluid delivery targeted at shock reversal results in improved patient outcomes, yet current methods of fluid resuscitation often limit the ability of providers to achieve fluid delivery goals. We report on the early clinical experience of a new technique for rapid fluid resuscitation. The LifeFlow ® infuser is a manually operated device that combines a syringe, automatic check valve, and high-flow tubing set with an ergonomic handle to enable faster and more efficient delivery of fluid by a single health care provider. LifeFlow is currently FDA-cleared for the delivery of crystalloid and colloids. Four cases are presented in which the LifeFlow device was used for emergent fluid resuscitation: a 6-month-old with septic shock, a 2-year-old with intussusception and shock, an 11-year-old with pneumonia and septic shock, and a 15-year-old with trauma and hemorrhagic shock.

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.…”

“…The device is currently FDA-cleared for infusion of crystalloid and colloid fluids, and is in use at our center for emergency resuscitation. Using common IV gauges LifeFlow can deliver fluid 2 to 4 times faster than standard techniques, and allows providers to observe a clinical response immediately by improvements in vital signs, mental status and skin perfusion 29,[32][33][34] . This study describes the use of the LifeFlow device in a busy academic children's hospital ED with 74,000 patient visits per year.…”