Wilson K, Fourtounas M, Anamourlis C
Department of Anaesthesiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
South Afr J Crit Care. 2022 Nov 22;38(3). doi: 10.7196/SAJCC.2022.v38i3.549. eCollection 2022.
Accidental intraoperative hypothermia is a common and avoidable adverse event of the perioperative period and is associated with detrimental effects on multiple organ systems and postoperative patient outcomes. In a resource-limited environment, prevention of intraoperative hypothermia is often challenging. Resourceful clinicians overcome these challenges through creative devices and frugal innovations.
To investigate the thermal performance of two Baragwanath Rewarming Appliances (BaRA) against that of the Hotline device to describe an optimal setup for these devices.
This was a quasi-experimental laboratory study that measured the thermal performance of two BaRA devices and the Hotline device under a number of scenarios. Independent variables including fluid type, flow rate, warming temperature and warming transit distance were sequentially altered and temperatures measured along the fluid stream. Change in temperature (ΔT) was calculated as the difference between entry and exit temperature for each combination of variables for each warming device.
A total of 219 experiments were performed. At a temperature of 43.0°C and a transit distance of 200 cm, the BaRA A configuration either matched or exceeded the ΔT of the Hotline over all fluid type and flowrate combinations. The BaRA B configuration does not provide comparable thermal performance to the Hotline. Measured flowrates were noticeably slower than manufacturer-quoted values for all intravenous (IV) cannulae used.
A warm-water bath at 43.0°C with 200 cm of submerged IV tubing provides thermal performance comparable to the Hotline device, with all fluid type and flowrate combinations.
The present study provides an evidence-based method for warming intravenous fluid in resource-limited scenarios.
术中意外低温是围手术期常见且可避免的不良事件，会对多个器官系统及术后患者预后产生不利影响。在资源有限的环境中，预防术中低温往往具有挑战性。足智多谋的临床医生通过创造性的设备和节俭的创新来克服这些挑战。
研究两种巴拉圭纳升温装置（BaRA）与热线装置的热性能，以描述这些装置的最佳设置。
这是一项准实验性实验室研究，在多种场景下测量了两种BaRA装置和热线装置的热性能。依次改变包括液体类型、流速、升温温度和升温传输距离等自变量，并沿液流测量温度。对于每个升温装置的每个变量组合，温度变化（ΔT）计算为入口温度与出口温度之差。
共进行了219次实验。在43.0°C的温度和200 cm的传输距离下，BaRA A配置在所有液体类型和流速组合中，其ΔT均达到或超过了热线装置。BaRA B配置的热性能无法与热线装置相媲美。对于所有使用的静脉输液（IV）套管，测得的流速明显低于制造商公布的值。
43.0°C的温水浴和200 cm浸没的静脉输液管，在所有液体类型和流速组合下，提供的热性能与热线装置相当。
本研究为资源有限场景下静脉输液加温提供了一种基于证据的方法。
