Improving fluid resuscitation in pediatric shock with LifeFlow®: a retrospective case series and review of the literature

Abstract

Mark Piehl,1–4 Cherrelle Smith-Ramsey,5 William A Teeter51Department of Pediatrics, Division of Pediatric Critical Care, WakeMed Health and Hospitals, Raleigh, NC, USA; 2410 Medical, Inc, Durham, NC, USA; 3Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA; 4Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; 5Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USAAbstract: 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.Keywords: hypotension, sepsis, septic shock, fluid therapy

Keywords

• hypotension
• sepsis
• septic shock
• fluid therapy