Clinical Notes
The Power Infuser: A New Device for Rapid
Fluid Infusion
BERNARD L. LOPEZ, MD, LINDA DAVIS-MOON, MSN, CRNP, WILLIAM STERIOUS, MD,
MICHAEL BULETTE, MD, XIN LIANG-MA, MD, P
H
D,
AND THEODORE A. CHRISTOPHER, MD
This study examined the effectiveness and ease of use of the ID Power
Infuser, a pocket-sized device that can infuse fluid at rates up to 6 L/hr.
Forty-six adults presenting with non-traumatic hypotension or clinical
hypovolemia had 0.9% NaCl solution infused by the ID Power Infuser
through a peripheral IV catheter. Eighteen patients with hemodynamic
evidence of hypovolemia had a mean infusion rate of 2 L/hr with time to
resolution of hypovolemia 28.5 ؎ 7 min, 14 of these had an infusion
rate > 4 L/hr with resolution of hypovolemia of 13.7 ؎ 5.8 min. Resolution
of hypovolemia was significantly faster compared with a group receiving
gravity infusion. Use of the Power Infuser was deemed easy (VAS ؍ 1.9 ؎
1.9 cm). The ID PowerInfuser can accurately and quickly deliver IV crys-
talloid in the ED and has the potential to reduce morbidity, time in the ED,
and costs. (Am J Emerg Med 2003;21:129-132. Copyright 2003, Elsevier
Science (USA). All rights reserved.)
Hypovolemia is a common condition found in ED pa-
tients. Whether the etiology is loss of fluid or blood, in its
most severe form, hypovolemia can lead to decreased tissue
perfusion and shock. Circulatory support through IV vol-
ume administration (along with stabilization of the patient’s
airway and breathing) is the mainstay of treatment and is
aimed at elevating and restoring both intravascular volume
as well as myocardial left ventricular end-diastolic volume.
1
Initial volume replacement typically occurs with an isotonic
crystalloid solution and is continued until the patient returns
to a more euvolemic state.
The infusion of fluid in hypovolemia is commonly done
through gravity. Gravity infusion is the current standard of
care in emergency medicine given its ease and speed of
initiation. Factors such as intravenous catheter size and
placement affect the speed of fluid resuscitation.
2
Gravity
infusion can be hastened by use of a pressure cuff inflated
around the IV fluid bag.
3,4
Finally, more rapid volume
infusion can be performed by the use of an in-line mechan-
ical pump. Current mechanical infusion devices are typi-
cally used with the administration of blood products.
3
Al-
though effective, they are large and cumbersome and may
not be practical for routine use in the ED.
The Power Infuser (Infusion Dynamics, Plymouth Meet-
ing, PA) is a new, rapid IV crystalloid or colloid infuser that
is approved for the treatment of hypovolemia. It is a device
that is capable of delivering fluid up to a rate of 6 L/hr. The
ID Power Infuser has the following advantages: 1) it is a
small device (approximately the size of a cigarette pack)
that requires no external energy source (it is battery-pow-
ered); 2) it is easy to use because it is hooked on to the end
of the conventional IV tubing and it requires minimal set-up
time; 3) its infusion rate can be set between 0.2 and 6 L/hr
with a dial; and 4) it can be set to deliver a 250-cc bolus of
fluid (Fig. 1). The device, however, has not been tested in
the ED environment.
The purpose of this study was to examine the use of the
Power Infuser on patients presenting to the ED with evi-
dence of hypovolemia. We hypothesize that this device is
accurate, fast, and easy to use in the ED setting and provides
faster fluid resuscitation when compared with standard
gravity infusion.
METHODS
The Power Infuser is a new, rapid IV crystalloid infuser
approved by the Food and Drug Administration for the
treatment of hypovolemia and hypovolemic shock. The
device is intended to support primary IV fluid resuscitation
therapy to rapidly restore intravascular volume and blood
pressure in patients with clinical shock, hypotension, and
hypoperfusion states as a result of hemorrhagic blood loss,
occult hemorrhage, neurogenic shock, septic shock, or de-
hydration.
The study was approved by the Institutional Review
Board of Thomas Jefferson University. This was a prospec-
tive, observational study examining the use of the ID Power
Infuser in a convenience sample of adult subjects (age Ն18
yrs) who presented to the Thomas Jefferson University
Hospital ED with clinical evidence of hypovolemia and/or
hypotension. Patients were eligible for the study if they
were simply judged by the treating physician to have the
need for rapid IV fluid therapy. Subjects included in this
From the Department of Emergency Medicine, Jefferson Medical
College, Thomas Jefferson University, Philadelphia, PA.
Manuscript received and accepted May 28, 2002.
Presented at the ACEP Research Forum Chicago, IL October
2001.
Address reprint requests to Bernard L. Lopez, MD Department of
Emergency Medicine Thomas Jefferson University Hospital 1020
Sansom Street 239 Thompson Building Philadelphia, PA 19107.
E-mail: bernard.lopez@mail.tju.edu
Key Words: Shock, rapid infusion, hypovolemia.
Copyright 2003, Elsevier Science (USA). All rights reserved.
0735-6757/03/2102-0009$30.00/0
doi:10.1053/ajem.2003.50033
129