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Od roku 1951, kdy spatřil světlo světa první lineární dávkovač, se infuzní systémy stále zdokonalují. Jak vypadaly před šedesáti lety a jak vypadají dnes?

První lineární dávkovač
Psal se rok 1951, když první lineární dávkovač přivedla na svět ve spolupráci s Dr. Hessem společnost B. Braun. Ta se nejen kvůli tomuto počinu dodnes řadí k nejvyspělejším výrobcům infuzní techniky. Princip lineárního dávkovače byl znám již v průmyslovém odvětví a do zdravotnictví se postupně začal implementovat. Dávkovač měl nastavenou jednu konstantní rychlost a sloužil výhradně k podávání katecholaminů v intenzivní péči. Postupně přišel požadavek tímto způsobem podávat i další léky a vznikl přístroj druhé generace – Unita 12 – měl proto v roce 1959 již dvanáct rychlostí.

Pumpa pro velké objemy léčiv
Svou roli ve vývoji infuzní techniky však nehrála pouze rychlost, ale také objem a bezpečnostní prvky. Vedle lineárních dávkovačů, které pracují s „nízkoobjemovými“ injekčními stříkačkami, jejichž píst stlačují, byla na počátku 70. let vynalezena infuzní pumpa, jež slouží pro kontinuální aplikaci velkých objemů i více než jednoho litru. Jak se takové množství tekutin aplikovalo pacientům před tímto vynálezem? Využíval se gravitační zákon, podání však nemohlo být podle názoru odborníků přesné.

Alarmy pro bezpečnost pacienta
V dalších letech se vývoj soustředil na bezpečnost pacienta. Práci zdravotnického personálu usnadnil systém alarmů a předalarmů, který signalizoval, že se blíží konec infuze. Sestry tak získaly čas pro přípravu další dávky léku. Infuzní pumpy byly doplněny o detektory vzduchu v infuzních setech a u pacientů se snížil výskyt vzduchových embolií. Kapkové senzory zaregistrují konec infuze a tlaková čidla okluzi v infuzním setu.
Dnešní pumpy obsahují také alarm z prodlení, který ohlašuje, že byl přístroj zapnut, ale nebylo spuštěno samotné podávání infuze. „Dochází k tomu v případě, kdy sestra zapne pumpu, ale v průběhu nastavování parametrů před spuštěním infuze musí přerušit činnost a například řešit urgentní stav jiného pacienta. Přístroj hlásí, aby se vrátila a dokončila nastavení přístroje a spuštění infúze,“ popisuje nové funkce infuzních přístrojů PharmDr. Jiří Lukeš, ředitel společnosti B. Braun.

Současný vývoj
Další snahou techniků bylo omezit závislost vyvíjených produktů na elektrické síti, zpřístupnit infuzní pumpy i pro domácí použití, pro potřeby transportu, sjednotit infuzní systém na jednotlivých odděleních nemocnice a propojit ho s monitoringem. Dnes se do infuzních pump nahrává knihovna léčiv, která přináší další zvýšení bezpečnosti jak pro pacienty, tak i pro obsluhu.
Pokrok v této oblasti je za 61 let neuvěřitelný. Pokud bychom chtěli srovnat přístroje z 90. let (Perfusor Compact) s dnešní generací (Space), bude to stejné, jako bychom za stejné období porovnávali mobilní telefony. I ty dnešní slouží k volání a psaní zpráv, jejich systém je však mnohem propojenější a nabízí řadu nepřeberných funkcí.

Použité zdroje:   Ing. V. Filipcová , FN v Motole: Výběr zajímavostí z historie lineárních dávkovačů, http://www.space.bbraun.com/http://itunes.apple.com/us/app/b.-braun-sgc-tutorial/id410813833?mt=8, Jan Janda: Historie infuzních roztoků a jejich objevitelů; Československá pediatrie 2010

http://braunoviny.bbraun.cz/clanky/infuzni-technika-slavi-60.-vyroci//

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