Intravenous Therapy, Fluid Delivery Systems for Resuscitation, and Cell Salvage Devices
Vanessa G. Henke, Warren S. Sandberg, in The MGH Textbook of Anesthetic Equipment, 2011
Overview of Fluid Warming Systems
The primary purpose of IV fluid warmers is to warm infused fluids to near body temperature or slightly above to prevent hypothermia due to infusion of cold fluids. Risks associated with the use of fluid warmers include air embolism, heat-induced hemolysis and vessel injury, current leakage into the fluid path, infection, and pressurized infiltration.42
A fluid warmer is also absolutely indicated for the rapid infusion of cold blood products, due to the risks of cardiac arrest and arrhythmia (especially when the sinoatrial node is cooled to less than 30° C). Cardiac arrest has been demonstrated when adults receive blood or plasma at rates greater than 100 mL/min for 30 minutes.40 The threshold for inducing cardiac arrest is far lower if the transfusion is delivered centrally and in the pediatric population.
Fluid warmers can be broadly categorized into devices designed to warm fluids for routine cases and more complex devices designed for large volume resuscitation. While all fluid warmers contain a heater, a thermostatic control, and, in most cases, a temperature readout, resuscitation fluid warmers are optimized for higher flows, and stop flow to the patient when significant air is detected in the tubing. Simple fluid warmers deliver warmed fluids at rates up to 150 mL/min (and sometimes at higher rates, with specialized disposable sets and pressurized infusions), in contrast to resuscitation fluid warmers that effectively warm fluids at flow rates up to 750 to 1000 mL/min (one resuscitation fluid warmer even eliminates the need for pressurization).
Heating of IV fluids can be accomplished by dry heat exchange, countercurrent heat exchangers, fluid immersion, or (less effectively) by placing part of the fluid circuit in the proximity of a separate heater (such as a forced-air device or heated water mattress).
Post time: Jan-17-2025