The laboratory performance of the enFLOW®, buddy lite™and ThermoSens®fluid warmers

Kim, H. J.; Yoo, Sungmook; Jung, Jae Seung; Sun, Kyung; Son, Ho Sung

doi:10.1111/anae.12906

Cited by 13 publications

(14 citation statements)

References 18 publications

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“…This observation may have aligned with one of the periods of absent warming, resulting in the impression that the device had shut down, and it is possible that heating may have been again observed had the experiment continued for a longer period of time. Other authors have also noted poorer performance of the Buddy Lite compared with other warmers at flow rates of 100 ml.min −1 or greater . We believe our study is the first to evaluate the comparative performance of the Hypotherm X LG or the °M Warmer devices.…”

Section: Discussionmentioning

confidence: 70%

Comparison of portable blood‐warming devices under simulated pre‐hospital conditions: a randomised in‐vitro blood circuit study

Weatherall

Gill

Milligan³

et al. 2019

Anaesthesia

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Pre-hospital transfusion of blood products is a vital component of many advanced pre-hospital systems. Portable fluid warmers may be utilised to help prevent hypothermia, but the limits defined by manufacturers often do not reflect their clinical use. The primary aim of this randomised in-vitro study was to assess the warming performance of four portable blood warming devices (Thermal Angel, Hypotherm X LG,°M Warmer, Buddy Lite) against control at different clinically-relevant flow rates. The secondary aim was to assess haemolysis rates between devices at different flow rates. We assessed each of the four devices and the control, at flow rates of 50 ml.min À1 , 100 ml.min À1 and 200 ml.min À1 , using a controlled perfusion circuit with multisite temperature monitoring. Free haemoglobin concentration, a marker of haemolysis, was measured at multiple points during each initial study run with spectrophotometry. At all flow rates, the four devices provided superior warming performance compared with the control (p < 0.001). Only the°M Warmer provided a substantial change in temperature at all flow rates (mean (95%CI) temperature change of 21.

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Section: Discussionmentioning

confidence: 70%

Comparison of portable blood‐warming devices under simulated pre‐hospital conditions: a randomised in‐vitro blood circuit study

Weatherall

Gill

Milligan³

et al. 2019

Anaesthesia

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show abstract

“…The effectiveness of ThermoSens® and Ranger™ have been studied at different flow rates [571316]. However, there were no studies investigating whether ThermoSens® and Ranger™ can effectively deliver warm fluid at low and moderate flow rates (below 1000 ml/h) in clinical and laboratory conditions, except for Jung's report using Ranger™ [7].…”

Section: Discussionmentioning

confidence: 99%

“…This can be aggravated by massive volume resuscitation with room-temperature crystalloid fluid and refrigerated blood transfusions [2]. Many laboratory and clinical studies at moderate and high flow rates (above 1,000 ml/h) have shown that fluid warmers can effectively heat intravenous fluids, and prevent hypothermia [3456]. …”

Section: Introductionmentioning

confidence: 99%

“…Ranger™ warms the intravenous fluids with dry heat technology, using a flat plastic sheet in contact with a counter-current metal heating plate. ThermoSens® also warms fluids with dry heat technology, using plastic cassettes in contact with a heating plate [51213]. Mega Acer Kit® has been recently developed as a device with a convective warming system, which can warm the fluid directly by using heated convective air currents [37].…”

Section: Introductionmentioning

confidence: 99%

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Mega Acer Kit® is more effective for warming the intravenous fluid than Ranger™ and ThermoSens® at 440 ml/h of infusion rate: an experimental performance study

Kim

et al. 2017

Korean J Anesthesiol

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BackgroundFew studies have investigated the effectiveness of intravenous fluid warmers at low and moderate flow rates below 1,000 ml/h. In this study, we compared the effectiveness of three different fluid warmers at a low flow rate (440 ml/h).MethodsWe experimentally investigated the fluid warming performances of Mega Acer Kit® (Group M, n = 10), Ranger™ (Group R, n = 10), and ThermoSens® (Group T, n = 10) at 440 ml/h for 60 min. All devices were set at a warming temperature of 41℃ with preheating for 10 min. Intravenous fluids were then delivered through them. The fluid temperature (primary endpoint) was measured at 76 cm from the device after infusion for 60 min. The expected decrease in mean body temperature (secondary endpoint) after 5 h infusion for a 70 kg patient (ΔMBT5) was also calculated.ResultsThe fluid temperature (mean [95% CI]) at 76 cm from the device, 60 minutes after the infusion was higher in group M (36.01 [35.73–36.29]℃), compared to groups T (29.81 [29.38–30.24]℃) and R (29.12 [28.52–29.72]℃) (P < 0.001). The ΔMBT5 (mean [95% CI]) was significantly smaller in group M (−0.04 [−0.04 to −0.03]℃) than that in groups T (−0.27 [−0.28 to −0.29]℃; P < 0.001) and R (−0.30 [−0.32 to −0.27]℃; P < 0.001). However, none of the fluid warmers provided a constant normothermic temperature above 36.5℃.ConclusionsMega Acer Kit® was more effective in warming the intravenous fluid with the smallest expected change in the mean body temperature, compared to Ranger™ and ThermoSens®, at a flow rate of 440 ml/h.

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“…While there are data supporting the warming performance of the enFlow (Vyaire Medical, Chicago, IL, USA), with crystalloids , there are no data on its impact on pressures when used in‐line with an extracorporeal circuit. In this in vitro experimentation we aimed at studying this blood warmer to ensure that its smaller size does not increase the resistance beyond a tolerable clinical threshold and aimed at evaluating its warming performance with blood at high flow.…”

mentioning

confidence: 99%

In Vitro Evaluation of Resistance and Warming Performance of a Small Blood Warmer on a Continuous Renal Replacement Therapy Circuit

et al. 2019

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Children on extracorporeal devices are at increased risk of hypothermia and require circuits with lower extracorporeal volume to avoid blood priming. We performed an in vitro study of the enFlow blood warmer to assess its warming performance and impact on circuit resistance at a high blood flow rate. The enFlow was added on the return line of a continuous renal replacement therapy circuit in a closed circuit primed with expired packed red blood cells (40% Hct). Return venous pressure and temperature pre‐ and post‐ both enFlow and Prismaflo II were measured at varying blood flow with different combination of the two blood warmers. Each variable was recorded eight times over 2 min. Return venous pressure was higher with the enFlow but was still within clinically usable range (127.5 ± 4.6 vs. 45.3 ± 1.4 mm Hg at 200 mL/min, P < 0.05). The enFlow was able to achieve post‐warmer temperature between 34.1 and 35.2°C even at 200 mL/min with blood, lower than what was observed with crystalloid, but still more effective than the Prismaflo II (P < 0.05 vs. enFlow post‐warmer temperature) achieving between 32.8 and 34.0°C. Combining both warmers achieved a higher post‐warmer temperature between 35.1 and 36.5°C. The enFlow can warm blood at high flow rates with minimal extracorporeal volume increase (~5 mL) and improve hypothermia prevention but may have resistance issues at the highest flows. The use of this device could benefit pediatric practice where smaller extracorporeal volumes are needed and patients are at increased risk of hypothermia.

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The laboratory performance of the enFLOW^®, buddy lite^™and ThermoSens^®fluid warmers

Cited by 13 publications

References 18 publications

Comparison of portable blood‐warming devices under simulated pre‐hospital conditions: a randomised in‐vitro blood circuit study

Comparison of portable blood‐warming devices under simulated pre‐hospital conditions: a randomised in‐vitro blood circuit study

Mega Acer Kit® is more effective for warming the intravenous fluid than Ranger™ and ThermoSens® at 440 ml/h of infusion rate: an experimental performance study

In Vitro Evaluation of Resistance and Warming Performance of a Small Blood Warmer on a Continuous Renal Replacement Therapy Circuit

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