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What is The Macro Drip Set?

macrodrip versus microdrip

Macro drip set, with a drip factor of 10, 12, 15, or 20 gtt/ml (drops per milliliter), is for rapid infusion of large volumes. Microdrip tubing, delivering 60 gtt/mL, is designed for precise administration in small amounts, especially for neonates or pediatric patients.

Description of the macro drip set

The size of a drop in an intravenous (IV) setup depends on the width of the IV tubing of the IV drip chamber: thinner tubing produces smaller drops, and wider tubing produces larger ones.

There are two major categories of IV tubings:

(1) Macrodrip tubing is wider and produces larger drops. Medical staff commonly used the tubing for routine IV administration, such as infusion of IV fluids that do not contain sensitive medications. Macro drip tubing comes in three sizes: 10 gtt/mL, 15 gtt/mL, and 20 gtt/mLShop macro drip set

(2) Micro drip tubing is narrower and so produces smaller drops. Medical workers use it for children and infants or to infuse sensitive medications where precision in the flow rate is essential. Micro drip or mini drip tubing comes in only one size: 60 gtt/mL. This means 60 drips per milliliter. More information in Spanish. Shop micro drip set

Specific uses of the macro drip set

As mentioned in the preceding, medical staff use the micro drip set to provide lower doses of IV medicine to patients. Medical staff uses it for more delicate drugs. 

However, if medical workers need to infuse higher dosages of medications admixed in the IV fluid, they use the macro infusion set (Perfus Macrogotero) instead. Medical staff uses a macro infusion set when significant volumes of fluid, such as saline solution, are meant to be quickly infused. The macro infusion set can deliver between 10 to 20 gtt/mL. Thus, only ten up to twenty drops are required to infuse one milliliter.

Specifically, in anesthesiology, medical practitioners frequently use gravity-driven macro-drip infusion sets. This setup can deliver 15 drops/mL. They control the flow rate by adjusting the roller clamp and monitor the flow rate by counting the number of drop formations in the dripping chamber. This setup allows the anesthesiologists to deliver high flow rates (>100 ml/min); therefore, the system is suitable for volume replacement and rapid administration of medications.

Specifically, thus, anesthesiologists use macro infusion sets to achieve the following:

(1) To deliver intravenous fluids to patients who need fluid deficit replenishment brought about by fasting before surgery;

(2) To replace ongoing losses of fluids during surgery;

(3) To serve as a vehicle for infusing intravenous medications and anesthetics.

Advantages of using gravity-driven macro drip set

Establishing a reliable intravenous infusion is an essential component of anesthesia practice. Advances in technology have brought several powered infusion devices (infusion pumps). To this day, however, the gravity-driven intravenous infusion sets remain the most frequently used, including anesthesia practice, because of the following reasons:

(1) Use of gravity-driven infusion saves medical practitioners from spending so much funds to acquire the infusion pumps;

(2) The maintenance cost for gravity-driven infusion sets is very much less compared to the maintenance expenses for powered infusion sets;

(3) Using the gravity-driven infusion sets does not require continuing costs for specialized infusion cartridges of IV sets and

(4) The old-fashioned gravity-driven infusion sets are easier and quicker to set up and more cost-effective to operate.

Based on the preceding reasons, prospective and existing health workers, especially anesthesiologists, prefer to use gravity-driven macro infusion sets. Medical workers find them easy to control, and the said infusion set exacts lesser expenses. More information in Spanish

Dangers of using the macro drip set

The most bothering and worrisome danger of using a macro infusion set is the over-administration of fluids and medications.

Over infusion happens when medical workers open the roller clamp so widely to compensate for increased flow impedance. Then suddenly, the flow of fluid normalizes after the obstruction has spontaneously disappeared. Medical practitioners use newer powered infusion pumps to avoid this danger for effective control and higher infusion rates. However, using powered infusion pumps proves to be more costly and labor-intensive.

Percentage utilization of macro drip set

To better understand anesthesiologists’ use and choice of intravenous infusion sets, researchers surveyed anesthesiologists during the annual convention of the American Society of Anesthesiologists (ASA) in Orlando, Florida, USA, in October 1998. One hundred and twenty anesthesiologists who attended the scientific exhibits were asked to complete a questionnaire regarding the use of IV infusion sets in their practice and their choice of an infusion set for a particular clinical case. Ensuing are the results of the survey:

(1) Overwhelming majority (90%) of the surveyed anesthesiologists reported that the practitioners in their departments routinely used gravity-driven IV sets rather than power infusion pumps;

(2) The selection between the micro drip set and the macro drip IV set varied considerably depending on the clinical scenarios.

Elderly diabetic patient with congestive heart failure

The anesthesiologists were asked which IV set to use for a 70-year-old man with diabetes mellitus and a history of congestive heart failure (CHF). The older man will undergo surgery on his foot under spinal anesthesia. The following were the results:

IV set selectedPercentages
Macro drip33%
Micro drip24%
Table 1. Percentage of preferences for IV infusion set to use for an elderly diabetic patient with CHF

Young adult patient for craniotomy

The same population of anesthesiologists was asked which IV set to use for a 40-year-old man undergoing craniotomy (surgery in the brain) to remove a cerebral tumor (tumor in the brain). The following were the results:

IV set selectedPercentages
Macro drip50%
Micro drip7%
Table 2. Percentage of preferences for IV infusion set to use for a young adult patient undergoing craniotomy

The rationale for the selection of macro drip set

An elderly patient with existing diseases

In a 70-year-old man with diabetes mellitus and a history of CHF undergoing a minor surgery under spinal anesthesia, over-administration of fluids can be hazardous and precipitate CHF. Thus, micro-drip would seem to be better suited in this case as it carries less risk of accidental fluid overload.

However, hypotension is also very common after spinal anesthesia. Thus, macro-drip needs to be used so that fast fluid delivery and fast infusion of fluid boluses can be accomplished if they are needed.

Young adult patient for brain surgery

Similarly, intracranial or lung surgery both require fluid restriction to prevent brain edema or “wet lungs” after the operations, thus selecting the micro infusion set as the first logical choice.

However, these surgeries may result in unexpected, sudden, and substantial blood loss, requiring larger boluses of fluids to maintain or increase blood pressure. For this reason, macro-drip infusion needs to be used so that a large amount of fluid can be infused in a shorter time.

Company Introduction

Liaoning KANGYI Medical Equipment Co., Ltd was founded in 1994 and is one of the leading manufacturers of IV sets, syringes, and medical parts in China. Quality is our highest priority, and our quality assurance system is certified and meets the standards of the Chinese National Medical Products Administration, ISO 13485, and the European Union’s CE mark.

We produce over 600 million pieces per year. Our products are sold across China and exported worldwide, to destinations including Europe, South America, Russia, Africa, and the Middle East.

Our company employs over 300 staff, including 50 people working in engineering and technical management. Our premises occupy an area of 20,000 square meters, with a construction area of 15,000 square meters. This space includes a 100,000-class purification workshop that occupies 8,000 square meters.

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