Comparison of three infusion pumps as an option for intensive care treatments in monoplace hyperbaric chambers.

Introduction: Hyperbaric oxygen therapy (HBOT) is used in critical care for managing certain severe conditions. However, the reliability of infusion pumps under hyperbaric conditions remains a critical concern. This study evaluated the performance of three infusion pump models - the Mindray BeneFusion VP5, Baxter Flo-Gard 6201, and Braun Infusomat Space - under hyperbaric conditions. Methods: Infusion pumps were modified to deliver flow into an environment pressurised up to 284 kPa. Accuracy of flow delivered into a pressurised monoplace chamber were tested across a range of infusion rates (1-100 mL·h⁻¹), with different absolute chamber pressures during the iso-pressure phase (243-284 kPa) and a range of different pressurisation/decompression rates (6.9-34.5 kPa·min⁻¹). Results: More than 3.6 million measurements were obtained. At iso-pressure the Mindray BeneFusion VP5 and the Baxter Flo-Gard 6201 under-performed at low infusion rates (< 20 mL·h⁻¹) and over-performed at high infusion rates (> 20 mL·h⁻¹). Both models exhibited significant under-delivery during pressurisation and over-delivery during decompression. For all conditions the Mindray BeneFusion VP5 demonstrated superior performance. The Braun Infusomat Space was unsuitable for hyperbaric use, failing to maintain performance at pressures above 90 kPa. Conclusions: The Mindray BeneFusion VP5 outperformed the Baxter Flo-Gard 6201 and Braun Infusomat Space under hyperbaric conditions, offering enhanced reliability for critical care HBOT using monoplace chambers. Clinical protocols should prioritise pumps capable of maintaining flow accuracy during pressure fluctuations. These findings inform best practices for infusion pump use in hyperbaric intensive care, addressing a critical gap in HBOT safety and efficacy.