Effect of Fluid Flow Rate on Efficacy of Fluid Warmer: An In Vitro Experimental Study

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.

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.

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 < 0.001). 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 (p < 0.001). The outlet temperature was >32°C at all flow rates.

The efficacy of fluid warming was inversely associated with the increase in flow rate. The outlet temperature was <42°C at fluid flow rates of 100 to 1200 mL/h. However, all outlet temperatures reached >32°C, indicating effective maintenance of the core body temperature by infusion of warm fluid.