Department of Anesthesiology, Rambam healthcare campus, Haifa, Israel.
Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Emerg Med J. 2018 Sep;35(9):564-570. doi: 10.1136/emermed-2017-207112. Epub 2018 Jun 7.
Warming intravenous fluids is essential to prevent hypothermia in patients with trauma, especially when large volumes are administered. Prehospital and transport settings require fluid warmers to be small, energy efficient and independent of external power supply. We compared the warming properties and resistance to flow of currently available battery-operated fluid warmers.
Fluid warming was evaluated at 50, 100 and 200 mL/min at a constant input temperature of 20°C and 10°C using a cardiopulmonary bypass roller pump and cooler. Output temperature was continuously recorded.
Performance of fluid warmers varied with flows and input temperatures. At an input temperature of 20°C and flow of 50 mL/min, the Buddy Lite, enFlow, Thermal Angel and Warrior warmed 3.4, 2.4, 1 and 3.6 L to over 35°C, respectively. However, at an input temperature of 10°C and flow of 200 mL/min, the Buddy Lite failed to warm, the enFlow warmed 3.3 L to 25.7°C, the Thermal Angel warmed 1.5 L to 20.9°C and the Warrior warmed 3.4 L to 34.4°C (p<0.0001).
We found significant differences between the fluid warmers: the use of the Buddy Lite should be limited to moderate input temperature and low flow rates. The use of the Thermal Angel is limited to low volumes due to battery capacity and low output temperature at extreme conditions. The Warrior provides the best warming performance at high infusion rates, as well as low input temperatures, and was able to warm the largest volumes in these conditions.
为预防创伤患者低体温，输注的静脉液体需进行预热，尤其当输注大容量液体时。在院前和转运环境下，液体加温器需具备体积小、节能且无需外部电源等特点。本研究比较了目前可用的几种电池供电式液体加温器的加热性能和抗流阻能力。
使用心肺旁路滚压泵和冷却器，在输入温度为 20°C 和 10°C 时，以 50、100 和 200mL/min 的流速评估液体加热情况。连续记录输出温度。
液体加温器的性能随流速和输入温度的不同而变化。在输入温度为 20°C、流速为 50mL/min 时，Buddy Lite、enFlow、Thermal Angel 和 Warrior 分别将 3.4、2.4、1 和 3.6L 液体加热至超过 35°C。然而，在输入温度为 10°C、流速为 200mL/min 时，Buddy Lite 无法加热，enFlow 将 3.3L 液体加热至 25.7°C，Thermal Angel 将 1.5L 液体加热至 20.9°C，Warrior 将 3.4L 液体加热至 34.4°C（p<0.0001）。
我们发现不同液体加温器之间存在显著差异：Buddy Lite 的使用应限制在中等输入温度和低流速范围内。由于电池容量和极端条件下的低输出温度，Thermal Angel 的使用仅限于低容量。在高输注率、低输入温度下，Warrior 提供最佳的加热性能，并且能够在这些条件下加热最大体积的液体。
