The Experts below are selected from a list of 219 Experts worldwide ranked by ideXlab platform
Sumio Hoka - One of the best experts on this subject based on the ideXlab platform.
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In-line pressure within a HOTLINE^® Fluid Warmer, under various flow conditions
Journal of Clinical Monitoring and Computing, 2015Co-Authors: Midoriko Higashi, Ken Yamaura, Yukie Matsubara, Takuya Fukudome, Sumio HokaAbstract:Roller pump infusion devices are widely used for rapid infusion, and may be combined with separate warming devices. There may be instances however, where the pressures generated by the roller pump may not be compatible with the warming device. We assessed a commonly used roller pump in combination with a HOTLINE^® Fluid Warmer, and found that it could generate pressures exceeding the HOTLINE^® manufacturers specifications. This was of concern because the HOTLINE^® manufacturer guideline states that not for use with pressure devices generating over 300 mmHg. Pressure greater than 300 mmHg may compromise the integrity of the HOTLINE^® Fluid Warming Set. The aim of this study was to compare in-line pressure within a HOTLINE^® Fluid Warmer at different infusion rates of a roller pump using various sizes of intravenous cannulae. The rapid infusion system comprised a 500 mL-normal saline bag, roller pump type infusion device, HOTLINE^® Fluid Warmer (blood and Fluid Warmer system), and six different sizes of intravenous cannulae. In-line pressure was measured proximal to the HOTLINE^® (pre-Warmer) and proximal to the cannula (post-Warmer), at flow rate of 50–160 mL/min. The in-line pressures increased significantly with increasing flow rate. The pre-Warmer pressures exceeded 300 mmHg when the flow rate was ≥120 mL/min with 20-gauge, 48 mm length cannula, 130 with 20-gauge, 25 mm cannula, and 160 mL/min with 18-gauge, 48 mm cannula. However, they were
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in line pressure within a hotline Fluid Warmer under various flow conditions
Journal of Clinical Monitoring and Computing, 2015Co-Authors: Midoriko Higashi, Ken Yamaura, Yukie Matsubara, Takuya Fukudome, Sumio HokaAbstract:Roller pump infusion devices are widely used for rapid infusion, and may be combined with separate warming devices. There may be instances however, where the pressures generated by the roller pump may not be compatible with the warming device. We assessed a commonly used roller pump in combination with a HOTLINE® Fluid Warmer, and found that it could generate pressures exceeding the HOTLINE® manufacturers specifications. This was of concern because the HOTLINE® manufacturer guideline states that not for use with pressure devices generating over 300 mmHg. Pressure greater than 300 mmHg may compromise the integrity of the HOTLINE® Fluid Warming Set. The aim of this study was to compare in-line pressure within a HOTLINE® Fluid Warmer at different infusion rates of a roller pump using various sizes of intravenous cannulae. The rapid infusion system comprised a 500 mL-normal saline bag, roller pump type infusion device, HOTLINE® Fluid Warmer (blood and Fluid Warmer system), and six different sizes of intravenous cannulae. In-line pressure was measured proximal to the HOTLINE® (pre-Warmer) and proximal to the cannula (post-Warmer), at flow rate of 50-160 mL/min. The in-line pressures increased significantly with increasing flow rate. The pre-Warmer pressures exceeded 300 mmHg when the flow rate was ≥120 mL/min with 20-gauge, 48 mm length cannula, 130 with 20-gauge, 25 mm cannula, and 160 mL/min with 18-gauge, 48 mm cannula. However, they were <300 mmHg at any flow rates with 18-gauge, 30 mm cannula and 16-gauge cannulae. The post-Warmer pressures exceeded 300 mmHg at the flow rate of 140 mL/min with 20-gauge, 48 mm cannula, and 160 mL/min with 20-gauge, 25 mm cannula, while they were <300 mmHg at any flow rates with 18 and 16-gauge cannulae. The in-line pressure within a HOTLINE® could exceed 300 mmHg, depending on the flow rate and size and length of cannula. It is important to pay attention to the size and length of cannulae and flow rate to keep the maximum in-line pressure<300 mmHg when a roller pump type infusion device is used.
Gregory A Nuttall - One of the best experts on this subject based on the ideXlab platform.
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Platelet transfusion: The effects of a Fluid Warmer on platelet function.
Transfusion, 2020Co-Authors: Melissa K Mattson, Cory Groves, Mark M Smith, Jon M Christensen, Dong Chen, James R Stubbs, Brad S Karon, Gregory A NuttallAbstract:Platelet (PLT) transfusions are an important component of hemostatic resuscitation. The AABB has published several guidelines recommending that PLT units should not be infused through blood warming devices. Thirty-one units of hospital blood bank apheresis PLTs were obtained. PLT-rich plasma (PRP) aggregometry and thromboelastography (TEG) were performed on the unit samples before and after the units were infused through a Ranger blood/Fluid warming device. There were no differences in any of the aggregometry results before and after infusion of the PLTs through the blood Warmer (all P > .32). There was a significant reduction in the TEG maximum amplitude (MA) of 69.8 ± 7.9 mm before and 66.0 ± 8.8 mm after (P < .001) infusion of the PLTs through the blood Warmer and α angle 61.8 ± 9.4° before and 59.3 ± 8.2° after (P = .044) infusion of the PLTs through the blood Warmer, although both mean values were within normal range for the TEG and not clinically significant. There were very good correlations of aggregometry and TEG results before and after infusion of the PLTs through the blood Warmer device. This study did not demonstrate significant deleterious effect on PLT function from infusing apheresis PLT units through a blood warming device by PRP aggregometry. We did detect a statistically significant-but not clinically significant-reduction in TEG MA and α angle. The prohibition of transfusing PLT units though the Ranger blood warming device is not indicated. © 2020 AABB.
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platelet transfusion the effects of a Fluid Warmer on platelet function
Transfusion, 2020Co-Authors: Melissa K Mattson, Cory Groves, Mark M Smith, Jon M Christensen, Dong Chen, James R Stubbs, Brad S Karon, Gregory A NuttallAbstract:Platelet (PLT) transfusions are an important component of hemostatic resuscitation. The AABB has published several guidelines recommending that PLT units should not be infused through blood warming devices. STUDY DESIGN AND METHODS Thirty-one units of hospital blood bank apheresis PLTs were obtained. PLT-rich plasma (PRP) aggregometry and thromboelastography (TEG) were performed on the unit samples before and after the units were infused through a Ranger blood/Fluid warming device. RESULTS There were no differences in any of the aggregometry results before and after infusion of the PLTs through the blood Warmer (all P > .32). There was a significant reduction in the TEG maximum amplitude (MA) of 69.8 ± 7.9 mm before and 66.0 ± 8.8 mm after (P < .001) infusion of the PLTs through the blood Warmer and α angle 61.8 ± 9.4° before and 59.3 ± 8.2° after (P = .044) infusion of the PLTs through the blood Warmer, although both mean values were within normal range for the TEG and not clinically significant. There were very good correlations of aggregometry and TEG results before and after infusion of the PLTs through the blood Warmer device. CONCLUSION This study did not demonstrate significant deleterious effect on PLT function from infusing apheresis PLT units through a blood warming device by PRP aggregometry. We did detect a statistically significant-but not clinically significant-reduction in TEG MA and α angle. The prohibition of transfusing PLT units though the Ranger blood warming device is not indicated.
Aree Jandonpai - One of the best experts on this subject based on the ideXlab platform.
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Effect of Fluid Flow Rate on Efficacy of Fluid Warmer: An In Vitro Experimental Study.
Anesthesiology Research and Practice, 2018Co-Authors: Vorasruang Thongsukh, Chanida Kositratana, Aree JandonpaiAbstract:Introduction. In patients who require a massive intraoperative transfusion, cold Fluid or blood transfusion can cause hypothermia and potential adverse effects. One method by which to prevent hypothermia in these patients is to warm the intravenous Fluid before infusion. The aim of this study was to determine the effect of the Fluid flow rate on the efficacy of a Fluid Warmer. Methods. The room air temperature was controlled at 24°C. Normal saline at room temperature was used for the experiment. The Fluid was connected to an infusion pump and covered with a heater line, which constantly maintained the temperature at 42°C. The Fluid temperature after warming was measured by an insulated thermistor at different Fluid flow rates (100, 300, 600, 900, and 1200 mL/h) and compared with the Fluid temperature before warming. Effective warming was defined as an outlet Fluid temperature of >32°C. Results. The room temperature was 23.6°C ± 0.9°C. The Fluid temperature before warming was 24.95°C ± 0.5°C. The outlet temperature was significantly higher after warming at all flow rates ( ). The increases in temperature were 10.9°C ± 0.1°C, 11.5°C ± 0.1°C, 10.2°C ± 0.1°C, 10.1°C ± 0.7°C, and 8.4°C ± 0.2°C at flow rates of 100, 300, 600, 900, and 1200 mL/h, respectively. The changes in temperature among all different flow rates were statistically significant ( ). The outlet temperature was >32°C at all flow rates. Conclusions. The efficacy of Fluid warming was inversely associated with the increase in flow rate. The outlet temperature was 32°C, indicating effective maintenance of the core body temperature by infusion of warm Fluid.
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Effect of Fluid Flow Rate on Efficacy of Fluid Warmer: An In Vitro Experimental Study
Hindawi Limited, 2018Co-Authors: Vorasruang Thongsukh, Chanida Kositratana, Aree JandonpaiAbstract:Introduction. In patients who require a massive intraoperative transfusion, cold Fluid or blood transfusion can cause hypothermia and potential adverse effects. One method by which to prevent hypothermia in these patients is to warm the intravenous Fluid before infusion. The aim of this study was to determine the effect of the Fluid flow rate on the efficacy of a Fluid Warmer. Methods. The room air temperature was controlled at 24°C. Normal saline at room temperature was used for the experiment. The Fluid was connected to an infusion pump and covered with a heater line, which constantly maintained the temperature at 42°C. The Fluid temperature after warming was measured by an insulated thermistor at different Fluid flow rates (100, 300, 600, 900, and 1200 mL/h) and compared with the Fluid temperature before warming. Effective warming was defined as an outlet Fluid temperature of >32°C. Results. The room temperature was 23.6°C ± 0.9°C. The Fluid temperature before warming was 24.95°C ± 0.5°C. The outlet temperature was significantly higher after warming at all flow rates (p
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effect of Fluid flow rate on the warming efficacy of Fluid Warmer
วิสัญญีสาร (Thai Journal of Anesthesiology), 2014Co-Authors: Vorasruang Thongsukh, Chanida Kositratana, Aree JandonpaiAbstract:Background: In patients who needed intraoperative massive transfusion, cold Fluid/blood transfusion can cause hypothermia and leading to other consequence complications. One of warming methods to prevent hypothermia in these patients is warming intravenous Fluid before infusion. Aim of this study was to assess the effect of Fluid flow rate on the warming efficacy of Fluid Warmer. Methods: The room air temperature was controlled at 24°C. Normal saline at the room air temperature was used for experimentation. The Fluid connected with infusion pump and cover with the heater line which constantly set point at 42°C. The temperature of Fluid after warming was measured by insulated thermistor on the difference Fluid flow rates; 100, 300, 600, 900, and 1,200 mL/h in compared with the temperature of Fluid prior warming. The effective warming was defined as the outlet Fluid > 32°C. Results: The room temperature was 23.6 ± 0.9°C. The temperature of Fluid prior warming was 24.95 ± 0.5°C. There were significantly increased on outlet temperatures after warming in all difference flow rates (P –value < 0.001). The increased temperature were 10.9 ± 0.1°C, 11.5 ± 0.1°C, 10.2 ± 0.1°C, 10.1 ± 0.7°C and 8.4 ± 0.2°C according to flow rate of 100, 300, 600, 900, and 1,200 mL/h. The changes in temperature among all different flow rates were significantly difference (P - value < 0.001). At all flow rates, the outlet temperatures are above 32°C. Conclusions: These results suggested that the efficacy of warming was inversely correlated with the increasing of flow rate. In overall flow rates, the outlet temperature cannot reach to 42°C as the set point, but higher than 32°C which benefit to infusion over than the room temperature Fluid for maintaining the core temperature in patient.
Midoriko Higashi - One of the best experts on this subject based on the ideXlab platform.
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In-line pressure within a HOTLINE^® Fluid Warmer, under various flow conditions
Journal of Clinical Monitoring and Computing, 2015Co-Authors: Midoriko Higashi, Ken Yamaura, Yukie Matsubara, Takuya Fukudome, Sumio HokaAbstract:Roller pump infusion devices are widely used for rapid infusion, and may be combined with separate warming devices. There may be instances however, where the pressures generated by the roller pump may not be compatible with the warming device. We assessed a commonly used roller pump in combination with a HOTLINE^® Fluid Warmer, and found that it could generate pressures exceeding the HOTLINE^® manufacturers specifications. This was of concern because the HOTLINE^® manufacturer guideline states that not for use with pressure devices generating over 300 mmHg. Pressure greater than 300 mmHg may compromise the integrity of the HOTLINE^® Fluid Warming Set. The aim of this study was to compare in-line pressure within a HOTLINE^® Fluid Warmer at different infusion rates of a roller pump using various sizes of intravenous cannulae. The rapid infusion system comprised a 500 mL-normal saline bag, roller pump type infusion device, HOTLINE^® Fluid Warmer (blood and Fluid Warmer system), and six different sizes of intravenous cannulae. In-line pressure was measured proximal to the HOTLINE^® (pre-Warmer) and proximal to the cannula (post-Warmer), at flow rate of 50–160 mL/min. The in-line pressures increased significantly with increasing flow rate. The pre-Warmer pressures exceeded 300 mmHg when the flow rate was ≥120 mL/min with 20-gauge, 48 mm length cannula, 130 with 20-gauge, 25 mm cannula, and 160 mL/min with 18-gauge, 48 mm cannula. However, they were
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in line pressure within a hotline Fluid Warmer under various flow conditions
Journal of Clinical Monitoring and Computing, 2015Co-Authors: Midoriko Higashi, Ken Yamaura, Yukie Matsubara, Takuya Fukudome, Sumio HokaAbstract:Roller pump infusion devices are widely used for rapid infusion, and may be combined with separate warming devices. There may be instances however, where the pressures generated by the roller pump may not be compatible with the warming device. We assessed a commonly used roller pump in combination with a HOTLINE® Fluid Warmer, and found that it could generate pressures exceeding the HOTLINE® manufacturers specifications. This was of concern because the HOTLINE® manufacturer guideline states that not for use with pressure devices generating over 300 mmHg. Pressure greater than 300 mmHg may compromise the integrity of the HOTLINE® Fluid Warming Set. The aim of this study was to compare in-line pressure within a HOTLINE® Fluid Warmer at different infusion rates of a roller pump using various sizes of intravenous cannulae. The rapid infusion system comprised a 500 mL-normal saline bag, roller pump type infusion device, HOTLINE® Fluid Warmer (blood and Fluid Warmer system), and six different sizes of intravenous cannulae. In-line pressure was measured proximal to the HOTLINE® (pre-Warmer) and proximal to the cannula (post-Warmer), at flow rate of 50-160 mL/min. The in-line pressures increased significantly with increasing flow rate. The pre-Warmer pressures exceeded 300 mmHg when the flow rate was ≥120 mL/min with 20-gauge, 48 mm length cannula, 130 with 20-gauge, 25 mm cannula, and 160 mL/min with 18-gauge, 48 mm cannula. However, they were <300 mmHg at any flow rates with 18-gauge, 30 mm cannula and 16-gauge cannulae. The post-Warmer pressures exceeded 300 mmHg at the flow rate of 140 mL/min with 20-gauge, 48 mm cannula, and 160 mL/min with 20-gauge, 25 mm cannula, while they were <300 mmHg at any flow rates with 18 and 16-gauge cannulae. The in-line pressure within a HOTLINE® could exceed 300 mmHg, depending on the flow rate and size and length of cannula. It is important to pay attention to the size and length of cannulae and flow rate to keep the maximum in-line pressure<300 mmHg when a roller pump type infusion device is used.
David Roxby - One of the best experts on this subject based on the ideXlab platform.
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Warming blood prior to transfusion using latent heat.
Emergency Medicine Australasia, 2020Co-Authors: David Roxby, Magdalena Sobieraj-teague, Jacoba Von Wielligh, Romi Sinha, Bryone J. Kuss, Anne Louise Smith, Mark McewenAbstract:Objective Major trauma is associated with blood loss and hypothermia. It is common to replace lost Fluid with red cells stored at 2-6°C, and/or colloid/crystalloid Fluid stored at ambient temperature, thus increasing hypothermia risk. At trauma and medical retrieval sites, mains electricity powered Fluid Warmers cannot be generally used. Latent heat provides an alternate practical method of portable temperature-controlled intravenous Fluid warming. This work investigates the safety and efficacy of a Fluid Warmer powered by latent heat. Methods Twenty-five haematology patients received red cell transfusions, one through a Fluid Warmer, using latent heat from a super-cooled liquid and one without warming. Temperature of donor red cell units was measured after passing through Fluid Warmers. Blood samples were collected from red cell units and patients, prior and after each transfusion. These were tested for haemolysis markers (plasma haemoglobin, potassium, lactate dehydrogenase, bilirubin) and for traces of super-cooled liquid. Patient physiological parameters (oxygen saturation, pulse, temperature, blood pressure, respiration) were monitored during each transfusion. Results Patient's physiological signs remained stable and no transfusion reactions were observed during warm transfusions. Latent heat Fluid Warmers increased the temperature of red cell units to approximately 35°C. There were no significant differences in haemolysis markers following warmed and unwarmed transfusions, and no contamination of red cell units by super-cooled liquid was detected. Conclusion The latent heat Fluid Warmer was shown to safely warm transfused blood in a controlled clinical setting.
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Can latent heat safely warm blood? – in vitro testing of a portable prototype blood Warmer
BMC Emergency Medicine, 2007Co-Authors: Mark P Mcewen, David RoxbyAbstract:Background Trauma/retrieval patients are often in shock and hypothermic. Treatment of such patients usually involves restoring their blood volume with transfusion of blood (stored at 2°C – 6°C) and/or crystalloids or colloids (stored at ambient temperature). Rapid infusion of these cold Fluids can worsen or even induce hypothermia in these patients. Warming of intravenous Fluids at accident sites has traditionally been difficult due to a lack of suitable portable Fluid Warmers that are not dependent on mains electrical or battery power. If latent heat, the heat released when a liquid solidifies (an inherently temperature limiting process) can warm intravenous Fluids, portable devices without a reliance on electrical energy could be used to reduce the incidence of hypothermia in trauma patients. Methods Rapid infusion of red cells into patients was timed to sample typical clinical flow rates. An approved dry heat blood Warmer was compared with a prototype blood Warmer using a supercooled liquid latent heat storage material, to warm red cells whilst monitoring inlet and outlet temperatures. To determine the effect of warming on red cell integrity compared to the normal storage lesion of blood, extracellular concentrations of potassium, lactate dehydrogenase and haemoglobin were measured in blood which had been warmed after storage at 2°C – 6°C for 1 to 42 days. Results A prototype latent heat Fluid Warmer consistently warmed red cells from approximately 4°C to approximately 35°C at typical clinical flow rates. Warming of stored blood with latent heat did not affect red cell integrity more than the approved dry heat blood Warmer. Conclusion Using latent heat as an energy source can satisfactorily warm cold blood or other intravenous Fluids to near body temperature, without any adverse affects.