Comparison of portable blood-warming devices under simulated pre-hospital conditions: a randomised in-vitro blood circuit study
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AbstractPre-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, BuddyLite)againstcontrolatdifferentclinically-relevantflowrates.Thesecondaryaimwastoassesshaemolysis ratesbetweendevicesatdifferent flowrates.Weassessedeachofthefourdevicesandthecontrol,at flowrates of50 ml.min1,100 ml.min1 and200 ml.min1,usingacontrolledperfusioncircuitwithmultisitetemperature monitoring.Freehaemoglobinconcentration, amarker ofhaemolysis,wasmeasuredatmultiplepointsduring 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 temperatureatallflowrates(mean(95%CI)temperaturechangeof21.1(19.8–22.4) C,20.4(19.1–21.8) Cand 19.4 (17.7–21.1) C at 50 ml.min1, 100 ml.min1 and 200 ml.min1, respectively). There was no association between warming and haemolysis with any device (p = 0.949) or flow rate (p = 0.169). Practical issues, which may be relevant to clinical use, also emerged during testing. Our results suggest that there were significant differences in the performance of portable blood warming devices used at flow rates encountered in clinical practice.
Acceptance Date29/03/2019
All Author(s) ListA.Weatherall, M.Gill, J.Milligan, C.Tetlow, C.Harris, A.Garner, A.Lee
Journal nameAnaesthesia
Volume Number74
Issue Number8
Pages1026 - 1032
LanguagesEnglish-United Kingdom

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