EVALUATION OF A NEW FLUID WARMER EFFECTIVE AT LOW TO MODERATE FLOW-RATES

Background. The tendency of intravenous fluid exiting the heat exchang er of a fluid warmer to cool to room temperature increases as the rate of infusion slows and the length of tubing between the heat exchanger and the patient increases. Thus, slow to moderate flow rates result i n the delivery of fluid near room temperature despite the use of a flu id warmer. The volumes infused even at low flow rates may be large rel ative to the size of infants and children and may result in a signific ant decrease in patient temperature. Methods: A new warmer (Hotline(R) , Level 1 Technologies) that actively heats the fluid in the delivery tubing was evaluated and compared to two different conventional dry-wa ll warmers: the model DW1000A (Baxter Health Care) and the FloTem(R) I Ie (DataChem). Cold blood (4-10-degrees-C) and room temperature saline (22-degrees-C) were pumped through the warmers and the delivered temp erature was measured as the flow rate was varied from 50 to 12,000 ml/ h. Results: The Hotline(R) was more effective than the Baxter or the F loTem(R)IIe at flow rates between 50 and 6,000 ml/h for saline and at flow rates between 50 and 3,000 ml/h for blood. Insulating the tubing beyond the heat exchangers of the conventional warmers improved their performance, but the delivered temperatures were still less than those of the Hotline(R) at low flow rates. Conclusions. The Hotline(R) is m ore effective than conventional warmers at slow flow rates, and may be useful for preventing hypothermia when large volumes of fluid relativ e to patient size are infused at slow rates.