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A Sielenkamper - One of the best experts on this subject based on the ideXlab platform.
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massivtransfusion mit dem Rapid Infusion System einfluss auf die korperkerntemperatur
Anaesthesist, 2001Co-Authors: M Booke, A SielenkamperAbstract:Ausgepragte Blutverluste mussen durch aggressive Volumentherapie kompensiert werden. Die Erwarmung der transfundierten Losungen ist bei hohen Flussgeschwindigkeiten meist unzureichend. Die konsekutive Hypothermie kann hamodynamische Instabilitat sowie eine Koagulopathie verursachen. Das Rapid Infusion System® (RIS) soll hohe Flussgeschwindigkeiten bei gleichzeitiger effektiver Erwarmung erlauben. Der Einsatz des RIS wurde bei 43 Patienten, die einer Massivtransfusion bedurften, untersucht. Der mittlere Volumenbedarf betrug 31,7±4,5 l (Minimum: 7,8 l; Maximum: 165,3 l). Dies entspricht im Durchschnitt einem 6,4fachen Austausch des zirkulierenden Blutvolumens (Maximum: 39,4fach). Trotz der hohen Transfusionsmengen, die in der Literatur bis dato nur als Case Reports publiziert sind, konnte die Korperkerntemperatur bei 35,85±0,1°C gehalten werden. Lediglich 5 Patienten hatten eine Temperatur unter 34°C; alle waren polytraumatisiert, und 4 von ihnen hatten bereits praoperativ eine Temperatur unter 34°C. Die Gesamtmortalitat betrug 28% und lag deutlich unter der bisheriger Studien mit geringerem Blutverlust. Der Erhalt der Normothermie und Normovolamie unter dem Einsatz des RIS mag dazu beigetragen haben.
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Massivtransfusion mit dem Rapid Infusion System®Einfluss auf die Körperkerntemperatur
Der Anaesthesist, 2001Co-Authors: M Booke, A SielenkamperAbstract:Ausgeprägte Blutverluste müssen durch aggressive Volumentherapie kompensiert werden. Die Erwärmung der transfundierten Lösungen ist bei hohen Flussgeschwindigkeiten meist unzureichend. Die konsekutive Hypothermie kann hämodynamische Instabilität sowie eine Koagulopathie verursachen. Das Rapid Infusion System^® (RIS) soll hohe Flussgeschwindigkeiten bei gleichzeitiger effektiver Erwärmung erlauben. Der Einsatz des RIS wurde bei 43 Patienten, die einer Massivtransfusion bedurften, untersucht. Der mittlere Volumenbedarf betrug 31,7±4,5 l (Minimum: 7,8 l; Maximum: 165,3 l). Dies entspricht im Durchschnitt einem 6,4fachen Austausch des zirkulierenden Blutvolumens (Maximum: 39,4fach). Trotz der hohen Transfusionsmengen, die in der Literatur bis dato nur als Case Reports publiziert sind, konnte die Körperkerntemperatur bei 35,85±0,1°C gehalten werden. Lediglich 5 Patienten hatten eine Temperatur unter 34°C; alle waren polytraumatisiert, und 4 von ihnen hatten bereits präoperativ eine Temperatur unter 34°C. Die Gesamtmortalität betrug 28% und lag deutlich unter der bisheriger Studien mit geringerem Blutverlust. Der Erhalt der Normothermie und Normovolämie unter dem Einsatz des RIS mag dazu beigetragen haben. Extensive blood loss requires adequate volume replacement. However the infused volume cannot be adequately warmed especially when high Infusion rates are necessary. Subsequently, hypothermia develops and results in hemodynamic instability and coagulopathy. The Rapid Infusion System^® (RIS) allows high Infusion rates (up to 1.5 l/ min) while at the same time guaranteeing sufficient warming. The efficacy of the RIS was investigated in 43 consecutive patients who required a massive transfusion. The average volume transfused in these patients was 31.7±4.5 l (minimum: 7.8 l; maximum: 165.3 l) which is equal to an average exchange of 6.4 times the circulating blood volume (maximum: 39,4 blood volumes). The replacement of such high blood volumes has not yet been published in a series of patients. Despite these high transfusion rates, the body core temperature was maintained at 35.85±0.1°C. Only five patients had a body core temperature below 34°C, all were trauma patients and four of these five patients already had a preoperative temperature below 34°C. The mortality in this study was 28%, which is markedly reduced in comparison to previous publications although they all considered at patients with significantly less blood loss. Maintaining normothermia and normovolemia by the use of the RIS may explain the improved outcome.
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massive transfusion with the Rapid Infusion System its effect on core body temperature
Anaesthesist, 2001Co-Authors: M Booke, A SielenkamperAbstract:Extensive blood loss requires adequate volume replacement. However the infused volume cannot be adequately warmed especially when high Infusion rates are necessary. Subsequently, hypothermia develops and results in hemodynamic instability and coagulopathy. The Rapid Infusion System (RIS) allows high Infusion rates (up to 1.5 l/min) while at the same time guaranteeing sufficient warming. The efficacy of the RIS was investigated in 43 consecutive patients who required a massive transfusion. The average volume transfused in these patients was 31.7 +/- 4.5 l (minimum: 7.8 l; maximum: 165.3 l) which is equal to an average exchange of 6.4 times the circulating blood volume (maximum: 39.4 blood volumes). The replacement of such high blood volumes has not yet been published in a series of patients. Despite these high transfusion rates, the body core temperature was maintained at 35.85 +/- 0.1 degrees C. Only five patients had a body core temperature below 34 degrees C, all were trauma patients and four of these five patients already had a preoperative temperature below 34 degrees C. The mortality in this study was 28%, which is markedly reduced in comparison to previous publications although they all considered at patients with significantly less blood loss. Maintaining normothermia and normovolemia by the use of the RIS may explain the improved outcome.
Charles J. Coté - One of the best experts on this subject based on the ideXlab platform.
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A comparison of flow rates and warming capabilities of the Level 1 and Rapid Infusion System with various-size intravenous catheters.
Anesthesia & Analgesia, 2003Co-Authors: Sandra L. Barcelona, Fatima Vilich, Charles J. CotéAbstract:UNLABELLED Cases involving massive blood transfusion may require the use of specialized blood warmers, such as the Level 1 (L-1) (Level 1 Technologies, Inc., Rockland, MA) or the Rapid Infusion System (RIS) (Haemonetics Corp., Braintree, MA). In this in vitro study, we compared the Infusion and warming capabilities of the L-1 (model 1000) versus the RIS using pediatric- and adult-sized IV catheters. The time to infuse 2 L of lactated Ringer's solution and the end temperature after Infusion through 20-, 18-, 16-, and 14-gauge catheters, and 4-, 5-, 6-, 7-, and 8.5-French catheters using both the L-1 and RIS were measured. The flow rates of both Systems were similar for 18- and 20-gauge catheters; however, the flow rates with the RIS were progressively faster than the L-1 as catheter size increased to >18 gauge. The heating capabilities of the RIS were superior to the L-1 for all catheters >or=16 gauge. We conclude that the RIS was superior to the L-1 for both flow rates and warming capacity for all IV catheters >18 gauge, i.e., those used for cases with massive blood loss. The RIS provided no advantage (with regard to heating and flow) when used with typical pediatric-sized catheters. IMPLICATIONS The Rapid Infusion System is superior to the Level 1 for warming and flow of crystalloid for IV catheters >18 gauge in vitro. The Rapid Infusion System provides no advantage with catheters typically used in small children (
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a comparison of flow rates and warming capabilities of the level 1 and Rapid Infusion System with various size intravenous catheters
Anesthesia & Analgesia, 2003Co-Authors: Sandra L. Barcelona, Fatima Vilich, Charles J. CotéAbstract:UNLABELLED Cases involving massive blood transfusion may require the use of specialized blood warmers, such as the Level 1 (L-1) (Level 1 Technologies, Inc., Rockland, MA) or the Rapid Infusion System (RIS) (Haemonetics Corp., Braintree, MA). In this in vitro study, we compared the Infusion and warming capabilities of the L-1 (model 1000) versus the RIS using pediatric- and adult-sized IV catheters. The time to infuse 2 L of lactated Ringer's solution and the end temperature after Infusion through 20-, 18-, 16-, and 14-gauge catheters, and 4-, 5-, 6-, 7-, and 8.5-French catheters using both the L-1 and RIS were measured. The flow rates of both Systems were similar for 18- and 20-gauge catheters; however, the flow rates with the RIS were progressively faster than the L-1 as catheter size increased to >18 gauge. The heating capabilities of the RIS were superior to the L-1 for all catheters >or=16 gauge. We conclude that the RIS was superior to the L-1 for both flow rates and warming capacity for all IV catheters >18 gauge, i.e., those used for cases with massive blood loss. The RIS provided no advantage (with regard to heating and flow) when used with typical pediatric-sized catheters. IMPLICATIONS The Rapid Infusion System is superior to the Level 1 for warming and flow of crystalloid for IV catheters >18 gauge in vitro. The Rapid Infusion System provides no advantage with catheters typically used in small children (
M Booke - One of the best experts on this subject based on the ideXlab platform.
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massivtransfusion mit dem Rapid Infusion System einfluss auf die korperkerntemperatur
Anaesthesist, 2001Co-Authors: M Booke, A SielenkamperAbstract:Ausgepragte Blutverluste mussen durch aggressive Volumentherapie kompensiert werden. Die Erwarmung der transfundierten Losungen ist bei hohen Flussgeschwindigkeiten meist unzureichend. Die konsekutive Hypothermie kann hamodynamische Instabilitat sowie eine Koagulopathie verursachen. Das Rapid Infusion System® (RIS) soll hohe Flussgeschwindigkeiten bei gleichzeitiger effektiver Erwarmung erlauben. Der Einsatz des RIS wurde bei 43 Patienten, die einer Massivtransfusion bedurften, untersucht. Der mittlere Volumenbedarf betrug 31,7±4,5 l (Minimum: 7,8 l; Maximum: 165,3 l). Dies entspricht im Durchschnitt einem 6,4fachen Austausch des zirkulierenden Blutvolumens (Maximum: 39,4fach). Trotz der hohen Transfusionsmengen, die in der Literatur bis dato nur als Case Reports publiziert sind, konnte die Korperkerntemperatur bei 35,85±0,1°C gehalten werden. Lediglich 5 Patienten hatten eine Temperatur unter 34°C; alle waren polytraumatisiert, und 4 von ihnen hatten bereits praoperativ eine Temperatur unter 34°C. Die Gesamtmortalitat betrug 28% und lag deutlich unter der bisheriger Studien mit geringerem Blutverlust. Der Erhalt der Normothermie und Normovolamie unter dem Einsatz des RIS mag dazu beigetragen haben.
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Massivtransfusion mit dem Rapid Infusion System®Einfluss auf die Körperkerntemperatur
Der Anaesthesist, 2001Co-Authors: M Booke, A SielenkamperAbstract:Ausgeprägte Blutverluste müssen durch aggressive Volumentherapie kompensiert werden. Die Erwärmung der transfundierten Lösungen ist bei hohen Flussgeschwindigkeiten meist unzureichend. Die konsekutive Hypothermie kann hämodynamische Instabilität sowie eine Koagulopathie verursachen. Das Rapid Infusion System^® (RIS) soll hohe Flussgeschwindigkeiten bei gleichzeitiger effektiver Erwärmung erlauben. Der Einsatz des RIS wurde bei 43 Patienten, die einer Massivtransfusion bedurften, untersucht. Der mittlere Volumenbedarf betrug 31,7±4,5 l (Minimum: 7,8 l; Maximum: 165,3 l). Dies entspricht im Durchschnitt einem 6,4fachen Austausch des zirkulierenden Blutvolumens (Maximum: 39,4fach). Trotz der hohen Transfusionsmengen, die in der Literatur bis dato nur als Case Reports publiziert sind, konnte die Körperkerntemperatur bei 35,85±0,1°C gehalten werden. Lediglich 5 Patienten hatten eine Temperatur unter 34°C; alle waren polytraumatisiert, und 4 von ihnen hatten bereits präoperativ eine Temperatur unter 34°C. Die Gesamtmortalität betrug 28% und lag deutlich unter der bisheriger Studien mit geringerem Blutverlust. Der Erhalt der Normothermie und Normovolämie unter dem Einsatz des RIS mag dazu beigetragen haben. Extensive blood loss requires adequate volume replacement. However the infused volume cannot be adequately warmed especially when high Infusion rates are necessary. Subsequently, hypothermia develops and results in hemodynamic instability and coagulopathy. The Rapid Infusion System^® (RIS) allows high Infusion rates (up to 1.5 l/ min) while at the same time guaranteeing sufficient warming. The efficacy of the RIS was investigated in 43 consecutive patients who required a massive transfusion. The average volume transfused in these patients was 31.7±4.5 l (minimum: 7.8 l; maximum: 165.3 l) which is equal to an average exchange of 6.4 times the circulating blood volume (maximum: 39,4 blood volumes). The replacement of such high blood volumes has not yet been published in a series of patients. Despite these high transfusion rates, the body core temperature was maintained at 35.85±0.1°C. Only five patients had a body core temperature below 34°C, all were trauma patients and four of these five patients already had a preoperative temperature below 34°C. The mortality in this study was 28%, which is markedly reduced in comparison to previous publications although they all considered at patients with significantly less blood loss. Maintaining normothermia and normovolemia by the use of the RIS may explain the improved outcome.
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massive transfusion with the Rapid Infusion System its effect on core body temperature
Anaesthesist, 2001Co-Authors: M Booke, A SielenkamperAbstract:Extensive blood loss requires adequate volume replacement. However the infused volume cannot be adequately warmed especially when high Infusion rates are necessary. Subsequently, hypothermia develops and results in hemodynamic instability and coagulopathy. The Rapid Infusion System (RIS) allows high Infusion rates (up to 1.5 l/min) while at the same time guaranteeing sufficient warming. The efficacy of the RIS was investigated in 43 consecutive patients who required a massive transfusion. The average volume transfused in these patients was 31.7 +/- 4.5 l (minimum: 7.8 l; maximum: 165.3 l) which is equal to an average exchange of 6.4 times the circulating blood volume (maximum: 39.4 blood volumes). The replacement of such high blood volumes has not yet been published in a series of patients. Despite these high transfusion rates, the body core temperature was maintained at 35.85 +/- 0.1 degrees C. Only five patients had a body core temperature below 34 degrees C, all were trauma patients and four of these five patients already had a preoperative temperature below 34 degrees C. The mortality in this study was 28%, which is markedly reduced in comparison to previous publications although they all considered at patients with significantly less blood loss. Maintaining normothermia and normovolemia by the use of the RIS may explain the improved outcome.
Sandra L. Barcelona - One of the best experts on this subject based on the ideXlab platform.
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A comparison of flow rates and warming capabilities of the Level 1 and Rapid Infusion System with various-size intravenous catheters.
Anesthesia & Analgesia, 2003Co-Authors: Sandra L. Barcelona, Fatima Vilich, Charles J. CotéAbstract:UNLABELLED Cases involving massive blood transfusion may require the use of specialized blood warmers, such as the Level 1 (L-1) (Level 1 Technologies, Inc., Rockland, MA) or the Rapid Infusion System (RIS) (Haemonetics Corp., Braintree, MA). In this in vitro study, we compared the Infusion and warming capabilities of the L-1 (model 1000) versus the RIS using pediatric- and adult-sized IV catheters. The time to infuse 2 L of lactated Ringer's solution and the end temperature after Infusion through 20-, 18-, 16-, and 14-gauge catheters, and 4-, 5-, 6-, 7-, and 8.5-French catheters using both the L-1 and RIS were measured. The flow rates of both Systems were similar for 18- and 20-gauge catheters; however, the flow rates with the RIS were progressively faster than the L-1 as catheter size increased to >18 gauge. The heating capabilities of the RIS were superior to the L-1 for all catheters >or=16 gauge. We conclude that the RIS was superior to the L-1 for both flow rates and warming capacity for all IV catheters >18 gauge, i.e., those used for cases with massive blood loss. The RIS provided no advantage (with regard to heating and flow) when used with typical pediatric-sized catheters. IMPLICATIONS The Rapid Infusion System is superior to the Level 1 for warming and flow of crystalloid for IV catheters >18 gauge in vitro. The Rapid Infusion System provides no advantage with catheters typically used in small children (
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a comparison of flow rates and warming capabilities of the level 1 and Rapid Infusion System with various size intravenous catheters
Anesthesia & Analgesia, 2003Co-Authors: Sandra L. Barcelona, Fatima Vilich, Charles J. CotéAbstract:UNLABELLED Cases involving massive blood transfusion may require the use of specialized blood warmers, such as the Level 1 (L-1) (Level 1 Technologies, Inc., Rockland, MA) or the Rapid Infusion System (RIS) (Haemonetics Corp., Braintree, MA). In this in vitro study, we compared the Infusion and warming capabilities of the L-1 (model 1000) versus the RIS using pediatric- and adult-sized IV catheters. The time to infuse 2 L of lactated Ringer's solution and the end temperature after Infusion through 20-, 18-, 16-, and 14-gauge catheters, and 4-, 5-, 6-, 7-, and 8.5-French catheters using both the L-1 and RIS were measured. The flow rates of both Systems were similar for 18- and 20-gauge catheters; however, the flow rates with the RIS were progressively faster than the L-1 as catheter size increased to >18 gauge. The heating capabilities of the RIS were superior to the L-1 for all catheters >or=16 gauge. We conclude that the RIS was superior to the L-1 for both flow rates and warming capacity for all IV catheters >18 gauge, i.e., those used for cases with massive blood loss. The RIS provided no advantage (with regard to heating and flow) when used with typical pediatric-sized catheters. IMPLICATIONS The Rapid Infusion System is superior to the Level 1 for warming and flow of crystalloid for IV catheters >18 gauge in vitro. The Rapid Infusion System provides no advantage with catheters typically used in small children (
M Namini - One of the best experts on this subject based on the ideXlab platform.
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The Rapid Infusion System: a superior method for the resuscitation of hypovolemic trauma patients.
Resuscitation, 1991Co-Authors: C M Dunham, H Belzberg, R Lyles, L Weireter, D Skurdal, G Sullivan, T Esposito, M NaminiAbstract:Abstract The Rapid Infusion System (RIS), which can deliver fluids/blood products Rapidly at precise rates and normothermic conditions, was compared with conventional fluid administration (CFA) in a randomized study of 36 hypovolemic trauma patients. Admission stratification criteria of the groups were similar relative to age, Glasgow Coma Score (GCS), Injury Severity Score (ISS) and plasma lactate. Despite the lack of difference in blood loss between the 24-h survivors of the two groups, the CFA group required greater total fluids ( 23.6 20.21 ), red blood cells ( 5.6 4.61 ), fresh frozen plasma (FFP) ( 2.8 1.91 ), platelets ( 523 204 ml ), and crystalloids ( 12.9 10.6 1 ). Lactate levels were lower in the RIS group at virtually all times from hours 1 to 24 ( 4.3 5.3 mM/l , t-value = 3.3, DF = 279, P = 0.001). Post-admission hypothermia was greater in the CFA group at all times during the first 24 h ( 35.2 36.4 ° C , t-value = 5.6, DF = 250, P = 0.001). The mean partial thromboplastin time was significantly higher in the CFA group ( 47.3 35.1 s , t-value = 3.1, DF = 279, P = 0.002). The PTT and PT were related to the degree of lactic acidosis (P = 0.0001) and hypothermia (P = 0.001) but not to the amount of FFP given (P = 0.14). The hospital costs, days in the ICU, and days on the ventilator were greater for the CFA group, as was the incidence of pneumonia ( 0 11 vs. 6 17 ; P = 0.03). Hypovolemic trauma patients resuscitated with the R IS needed fewer fluid/blood products and had less coagulopathy. more Rapid resolution of hypoperfusion acidosis; better temperature preservation; and fewer hospital complications than those resuscitated with conventional methods of fluid/blood product administration.
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The Rapid Infusion System: a superior method for the resuscitation of hypovolemic trauma patients.
Resuscitation, 1991Co-Authors: C M Dunham, H Belzberg, R Lyles, L Weireter, D Skurdal, G Sullivan, T Esposito, M NaminiAbstract:The Rapid Infusion System (RIS), which can deliver fluids/blood products Rapidly at precise rates and normothermic conditions, was compared with conventional fluid administration (CFA) in a randomized study of 36 hypovolemic trauma patients. Admission stratification criteria of the groups were similar relative to age, Glasgow Coma Score (GCS), Injury Severity Score (ISS) and plasma lactate. Despite the lack of difference in blood loss between the 24-h survivors of the two groups, the CFA group required greater total fluids (23.6/20.21), red blood cells (5.5/4.61), fresh frozen plasma (FFP) (2.8/1.91), platelets (523/204 ml), and crystalloids (12.9/10.61). Lactate levels were lower in the RIS group at virtually all times from hours 1 to 24 (4.3/5.3 mM/l, t-value = 3.3, DF = 279, P = 0.001). Post-admission hypothermia was greater in the CFA group at all times during the first 24 h (35.2/36.4 degrees C, t-value = 5.6, DF = 250, P = 0.001). The mean partial thromboplastin time was significantly higher in the CFA group (47.3/35.1 s, t-value = 3.1, DF = 279, P = 0.002). The PTT and PT were related to the degree of lactic acidosis (P = 0.0001) and hypothermia (P = 0.001) but not to the amount of FFP given (P = 0.14). The hospital costs, days in the ICU, and days on the ventilator were greater for the CFA group, as was the incidence of pneumonia (0/11 vs. 6/17; P = 0.03). Hypovolemic trauma patients resuscitated with the RIS needed fewer fluid/blood products and had less coagulopathy; more Rapid resolution of hypoperfusion acidosis; better temperature preservation; and fewer hospital complications than those resuscitated with conventional methods of fluid/blood product administration.