Advertisement

Heating Intravenous Fluid Tubing in an Experimental Setting for Prehospital Hypothermia

Published:December 09, 2020DOI:https://doi.org/10.1016/j.amj.2020.10.009

      Abstract

      Objective

      Hypothermia secondary to environmental exposure is a serious condition. Active external warming measures to treat it may prove challenging in the prehospital setting. We conducted an experimental study to measure the ability of commercially available heating elements to warm intravenous (IV) fluids during infusion.

      Methods

      250-milliliter bags of dextrose 10% solution were suspended inside a refrigerator. IV tubing was coiled, and the tubing output was placed inside a thermally insulated cup. The tubing was heated directly with a hand warmer, a meals ready-to-eat heater, or a heating blanket. Fluids were run through the IV line. The temperature of the fluid at the tubing output was measured. The initial and final infusion temperatures for the methods were compared.

      Results

      The use of hand warmers, meals ready-to-eat heaters, and heating blankets to warm IV tubing did increase the temperature of the fluids but was ineffective at achieving the desired mean infusion temperature of 35°C to 42°C.

      Conclusion

      Although the mean temperature increase did not meet the established experimental threshold, further research is needed to determine whether the fluid warming effect of these commercial heating elements used in the prehospital environment is significant enough to limit heat loss while repleting the dextrose of a hypothermic, hypoglycemic patient.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Air Medical Journal
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • McCullough L
        • Arora S
        Diagnosis and treatment of hypothermia.
        Am Fam Physician. 2004; 70: 2325-2332
        • Haverkamp FJC
        • Giesbrecht GG
        • Tan ECTH
        The prehospital management of hypothermia - an up-to-date overview.
        Injury. 2018; 49: 149-164
        • Barthel ER
        • Pierce JR
        Steady-state and time-dependent thermodynamic modeling of the effect of intravenous infusion of warm and cold fluids.
        J Trauma Acute Care Surg. 2012; 72: 1590-1600
        • Gill BS
        • Cox CS
        Thermodynamic and logistic considerations for treatment of hypothermia.
        Mil Med. 2008; 173: 743-748
        • Stone CK
        • Thomas SH
        Controlled trial of an intravenous fluid warmer.
        Air Med J. 1994; 13: 18-20
        • Ndao S
        • Jensen KF
        • Velmahos G
        • King DR
        Design and demonstration of a battery-less fluid warmer for combat.
        J Spec Oper Med. 2013; 13: 31-35
        • Platts-Mills TF
        • Stendell E
        • Lewin MR
        • et al.
        An experimental study of warming intravenous fluid in a cold environment.
        Wilderness Environ Med. 2007; 18: 177-185
        • Bissonnette B
        • Paut O
        Active warming of saline or blood is ineffective when standard infusion tubing is used: an experimental study.
        Can J Anaesth. 2002; 49: 270-275