The impact of syringe infusion pump changeover technology of vasoactive drugs on patients’ hemodynamics: A scoping review

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BACKGROUND: Vasoactive agents are delivered as continuous intravenous infusions in the intensive care unit to support cardiovascular function. Syringe infusion pump changeover may interrupt drug flow and precipitate hemodynamic instability. Although multiple syringe pump changeover techniques exist to minimize interruption, the comparative effects of these on hemodynamic stability and their bedside feasibility have not been systematically evaluated. OBJECTIVE: To systematically describe the existing evidence on the hemodynamic impact of different vasoactive drug syringe pump changeover strategies through a scoping review. METHODS: We searched PubMed, Embase, Web of Science Core Collection, CINAHL, MEDLINE, the Cochrane Library, and clinical trial registries from inception through August 2025 for studies comparing hemodynamic outcomes during syringe pump changeover of vasoactive drugs. RESULTS: 10 studies were included, comprising 4 randomized controlled trials , 2 cohort studies, and 4 studies with other designs, from France, Italy, Australia, America, the United Kingdom, and Japan. Changeover methods were categorized as quick changeover, double pump changeover, automated changeover. Hemodynamic assessment primarily focused on mean arterial pressure variability. Smart syringe pump changeover demonstrated superior performance in minimizing episodes of mean arterial pressure reduction, whereas the overlapping-taper method increased the risk of mean arterial pressure elevation. Variation in nursing workload was observed, with smart syringe pump changeover significantly reducing procedural time. CONCLUSIONS: Syringe pump changeover strategies substantially affect hemodynamic stability. Smart syringe pump changeover demonstrated pronounced safety and efficiency advantages. However, the field exhibits methodological heterogeneity and lacks standardized protocols. Future research should refine smart changeover precision and promote standardized nomenclature and reporting to strengthen knowledge and clinical practice. IMPLICATIONS FOR CLINICAL PRACTICE: This review highlights the need for evidence-based guidelines for syringe pump changeover methods. Standardized procedures and optimized protocols for automated/smart syringe pumps can minimize errors, improve drug delivery accuracy, and enhance critical care quality.

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