Evaluation of a New Fluid Warmer Effective at Low to Moderate Flow Rates

Presson, Robert G.; Bezruczko, Alexander P.; Hillier, Simon C.; McNiece, William L.

doi:10.1097/00000542-199305000-00023

Cited by 48 publications

(30 citation statements)

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“…Low flow rates Of the simulated clinical studies evaluating fluid warmer performance (at or including lower flow rates of <0.5 l.h À1 ), the Hotline â counter-current water heat exchanger (Level 1 Technologies Inc, Rockland, MA, USA) consistently delivers the warmest fluid outlet temperatures when compared directly against dry warming devices [15][16][17][18]. The Hotline heat exchanger is incorporated into the delivery tubing by circulating warmed water around a central delivery channel [19].…”

Section: Flow Rate Limitations On Heating Capacitymentioning

confidence: 99%

“…This system prevents the loss of heat from fluid to environment seen at low flow rates with conventional delivery tubing. To circumvent this problem using dry warming apparatus, attempts at insulating the distal delivery tubing have been made, with limited success [17]. The dry wall warmers Flotem (DataChem, Indianapolis, IN, USA) and DW1000A (Baxter Healthcare, Valencia, CA, USA) provide modest distal fluid temperatures of > 32°C at minimum flow rates of 300 and 730 ml.h À1 , respectively.…”

Section: Flow Rate Limitations On Heating Capacitymentioning

confidence: 99%

“…Variations in starting fluid temperature, composition, flow rate and ambient temperature make comparisons between studies challenging. In all but one [14] of the laboratory studies where the capacity of the device to warm red cells was investigated [17,18,25,26], the red cells tested were in fact diluted with crystalloid, making the inferences less clinically relevant.…”

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confidence: 99%

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Peri‐operative warming devices: performance and clinical application

2014

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SummarySince the adverse consequences of accidental peri-operative hypothermia have been recognised, there has been a rapid expansion in the development of new warming equipment designed to prevent it. This is a review of peri-operative warming devices and a critique of the evidence assessing their performance. Forced-air warming is a common and extensively tested warming modality that outperforms passive insulation and water mattresses, and is at least as effective as resistive heating. More recently developed devices include circulating water garments, which have shown promising results due to their ability to cover large surface areas, and negative pressure devices aimed at improving subcutaneous perfusion for warming. We also discuss the challenge of fluid warming, looking particularly at how devices' performance varies according to flow rate. Our ultimate aim is to provide a guide through the bewildering array of devices on the market so that clinicians can make informed and accurate choices for their particular hospital environment.

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Section: Flow Rate Limitations On Heating Capacitymentioning

confidence: 99%

Section: Flow Rate Limitations On Heating Capacitymentioning

confidence: 99%

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confidence: 99%

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Peri‐operative warming devices: performance and clinical application

2014

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“…1 2 Two other studies have shown that using a warming device connected to conventional iv tubing, the infusate temperature decreased as a consequence of heat exchange between the fluid and the environment across the tubing. 14,15 In those two studies, it was clearly demonstrated that the thermal loss was increased at the lower rates of infusion used in children. 14,15 Heat exchange across the polyvinyl chloride tubing wall and the environment is explained by the thermal conductivity of the tubing.…”

Section: Discussionmentioning

confidence: 96%

“…14,15 In those two studies, it was clearly demonstrated that the thermal loss was increased at the lower rates of infusion used in children. 14,15 Heat exchange across the polyvinyl chloride tubing wall and the environment is explained by the thermal conductivity of the tubing. 1 6 The increase in the temperature of PRBC observed in the present study is the result of temperature equilibration with ambient air.…”

Section: Discussionmentioning

confidence: 96%

Active warming of saline or blood is ineffective when standard infusion tubing is used: an experimental study

Bissonnette

Paut

2002

Can J Anesth/J Can Anesth

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Purpose: To determine the effect of infusion rate, tubing length and fluid composition on the temperature of the infusate reaching the distal end of an infusion tubing with and without active fluid warming.Methods: Warmed normal saline (W-NS) and packed red blood cells (W-PRBC), were infused with a fluid warmer through a modified infusion set. The fluids were delivered at eight infusion rates from 50 to 999 mL·hr -1 . The infusate temperature was monitored at 20 cm intervals on the iv tubing. The same temperature monitoring protocol was applied to PRBC without warmer (NoW-PRBC).Results: In W-NS and W-PRBC groups, there was a decrease in the infusate temperature, at each flow rate, from the drip chamber to the distal end of tubing ( P <0.001). In NoW-PRBC group, there was a rapid increase in the infusate temperature from the bag to the drip chamber ( P <0.001). Thereafter, there was no change in temperature, except at the 999 mL·hr -1 infusion rate, where a slight increase in the infusate temperature throughout the tubing was shown. In W-NS and W-PRBC groups increasing the flow rate produced a significant increase in the infusate temperature, at each measurement point ( P <0.001). In the NoW-PRBC group, increasing the flow rate did not alter the infusate temperature. The fluid composition did not influence the infusate temperature.Conclusion: There is an important heat exchange within the tubing, which is aggravated at low flow rates. At infusion rates appropriate for pediatric anesthesia the clinical and economic value of fluid warming without the use of heated extension tubing is questionable.Objectif : Déterminer l'effet de la vitesse de perfusion, de la longueur de la tubulure et de la composition du liquide sur la température de la solution intraveineuse à la partie distale de la tubulure, le liquide étant soumis ou non à un réchauffement actif. Méthode : Une solution salée (SS-R) et un concentré de globules rouges réchauffés (CGR-R) ont été perfusés avec un ensemble à perfusion modifié comprenant un réchauffeur de liquide. Les liquides ont été administrés selon huit vitesses de perfusion, de 50 à 999 mL·h -1 . La température du soluté a été mesurée à des intervalles de 20 cm sur la tubulure iv. Le même protocole de surveillance de la tempéra-ture a été appliqué au CGR non réchauffé (CGR-NonR). Résultats : Dans les groupes SS-R et CGR-R, la température du liquide perfusé a baissé pour toutes les vitesses de perfusion, entre la chambre compte-gouttes et la partie distale de la tubulure (P < 0,001). Dans le groupe CGR-NonR, elle a augmenté rapidement, entre le sac et la chambre compte-gouttes (P < 0,001). Par la suite, il n'y a pas eu

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Perioperative Thermoregulation

Sessler

Geriatric Anesthesiology

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Evaluation of a New Fluid Warmer Effective at Low to Moderate Flow Rates

Cited by 48 publications

References 0 publications

Peri‐operative warming devices: performance and clinical application

Peri‐operative warming devices: performance and clinical application

Active warming of saline or blood is ineffective when standard infusion tubing is used: an experimental study

Perioperative Thermoregulation

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