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25/08/2016

Réchauffer une perfusion: La tubulure +++

An Analysis of the Temperature Change in Warmed Intravenous Fluids during Administration in a Cold Environment at Temperatures of Less than 0

2016 Critical Care Transport Medicine Conference Scientific Forum

SIngleton W et Al. Air Medical Journal 35 (2016) 205-207

 

Objective: This is a non-human simulation study determining the decrease in temperature that occurred to 1L bags of Normal Saline in an austere environment. The bags were warmed to 38°C (100°F), administered through standard intravenous tubing at a set flow rate, while in an environment with ambient temperatures of less than 0°C (32°F). The goal was to determine if there was a significant decrease in fluid temperature from the IV bag through the tubing to the IV catheter administration site.

Methods/Materials: Three trials were run at four different temperatures, 0°C (32°F), -7 °C (20°F), -12°C (10°F ) and 33°C (72°F control ). Each bag of normal saline was warmed to the same temperature 38°C (100°F) utilizing the Soft Sack IV Fluid Warmer. Three of the bags were then placed in a cold austere environment (freezer) at each of the specified temperatures. The remaining bag was kept in the ambient temperature 33°C (72°F control). The fluid was administered through standard intravenous tubing (18 gauge catheter, 20 drop set, 211 cm in length) at a flow rate of 999ml/hr in temperatures less than 0°C (32°F). Fluid was collected in a glass container outside the austere environment with the temperature being recorded at 5 minute intervals.

Results: The results demonstrated a statistically significant (p> 0.05) change in temperature between the IV bag and the administration site. The most rapid change occurred within the first 5 minutes. The temperature change was more significant with the colder ambient temperatures, with an average of 50° difference at -7°C (20°F) and -12°C (10°F ). This is compared to a 27° difference at 0°C and the control temperature of 33°C (72°F control). The temperature of the fluid remaining within the IV bag also decreased an average of 15°C at the control temperature of 33°C (72°F control) and 0°C (32°F), which is statistically significant. The temperature in the bag decreased an average of 35°C at -7°C (20°F) and -12°C (10°F), which was statistically significant (p>0.05).

Conclusion: Based on these results, it appears that the most significant heat loss occurs through the IV tubing itself, the loss occurs rapidly, and is more pronounced at colder ambient air temperatures. Therefore, it may be beneficial to insulate the tubing on a trauma patient receiving warmed IV fluids in a cold environment of less than 0°C (32°F) to help prevent hypothermia.

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