Abstract
The study evaluated the warming ability and flow rates associated with four fluid warming devices during pressure driven infusion and during wide open gravity driven roller clamp infusion. Warmers tested were the Astotherm, Flotem IIe, Level 1 System 250 and a modified cardioplegia heat exchanger. Fluids tested were crystalloid, red cells diluted with 200 ml, 0.9% saline, and undiluted red cells. The volume of fluid and outlet temperatures (point where iv tubing would be attached to the patient) were measured for each fluid and compared among warmers for each flow rate condition. For pressure driven infusion of red cells and crystalloid, the System 250, and modified heat exchanger delivered warmer fluids (33-35° C) at higher flow rates (160–740 ml · min− 1) than the Astotherm and Flotem (23–31° C, 44–268 ml · min− 1, P< 0.05). For gravity driven infusion, the System 250 delivered the warmest fluids (33–36° C, P < 0.05) compared with the modified heat exchanger (29–35°C), Astotherm (26–32°C) and Flotem (26–27° C). In conclusion, the modified heat exchanger and System 250 were moderately effective (outlet temperture >32°C) in warming crystalloid and red cells at pressure driven flow rates. Only the System 250 warmed red cells >35° C at gravity driven flow rates. The Flotem and Astotherm were not effective in warming rapidly infused solutions. None of the warmers tested was able to deliver fluids at normothermia (>36.5° C).
Résumé
Ce travail évalue la capacité de réchauffement et les débits produits par quatre appareils de réchauffement destinés à la perfusion sous pression et à la perfusion par gravité. Les réchauffeurs sont l’Astotherm, le Flotem IIe, le Level 1 System 250 et une échangeur de chaleur de cardioplégie modifié. Les liquides étudiés sont les cristalloïdes, des hématies rouges dilués avec 200 ml, du physiologique 0,9% et des hématies non diluées. Le volume de liquide et la température à la sortie (au point d’attache de la tubulure au patient) sont mesurés pour chacun des liquides et comparés entre les réchauffeurs pour chacun des débits obtenus. Pour la perfusion sous pression des hématies et des cristalloïdes, le System 250 et l’échangeur de chaleur modifié fournissent des liquides plus chauds 03–35° C) à plus haut dédits (160–740 ml · min− 1, P < 0,05) que l’Asthotem et le Flotem (23–31°C, 44–268 ml · min− 1, P < 0,05). Pour les perfusions sous gravité, le System 250 fournit les liquides les plus chauds 33–36° C, P< 0,05) comparativement à l’échangeur modifié (29–35° C), l’Astotherm (26–32°C) et le Flotem (26–27°C). En conclusion, l’échangeur de chaleur modifié et le System 250 sont moyennement efficace (température à la sortie >32° C) pour réchauffer les cristalloïdes et les hématies à des débits contrôlés par la pression. Seul le System 250 réchauffe les hématies à plus de 35°C à des débits contrôlés par la gravité. Le Flotem et l’Astotherm sont inefficaces pour réchauffer des solutions perfusées rapidement. Aucun des réchauffeurs essayés ne fournit de liquides normothermiques (>36,5°C).
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Patel, N., Smith, C.E. & Pinchak, A.C. Comparison of fluid warmer performance during simulated clinical conditions. Can J Anaesth 42, 636–642 (1995). https://doi.org/10.1007/BF03011886
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DOI: https://doi.org/10.1007/BF03011886