Evaluation of Intravenous Infusion Systems for Adenosine

Adenosine is used routinely in cardiac perfusion imaging in lieu of exercise stress to enhance coronary blood flow. Since it is a potent drug, intravenous (IV) infusion of adenosine must be carefully controlled to provide optimal pharmacologic effect and minimal adverse effects. There has been particular concern about a sudden increase in adenosine delivery at the time of radiotracer administration which has prompted recommendations for using separate IV infusion sites or double lumen IV catheter sets. To evaluate infusion control, five IV infusion systems were evaluated for their ability to accurately deliver adenosine with co-administration of a radiopharmaceutical, such as thallium-201 eo•Tt) into the infusion line. A decrease in adenosine infusion occurred with the Buretrol gravity drip system when 201 T/ was injected into the infusion line. A temporary, intermittent decrease of adenosine infusion also occurred with the IMED infusion system because of its pumping mechanism. No significant change in adenosine infusion occurred with either the Harvard or Medfusion syringe pumps or with the IVAC infusion pump. No significant increase or bolus effect of adenosine administration occurred with any of the infusion systems.