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【Objective】 To study the safety, effectiveness and nursing of blood/fluid warmer during the process of plateletpheresis in winter. 【Methods】 The blood re-transfusion speed during plateletpheresis in winter and the time of blood passing through the blood return pipeline was counted. The vitro blood was heated with a blood/fluid warmer under different temperature settings, and the rising speed of blood temperature was recorded. The blood samples were tested for blood routine examination, free Hb and erythrocyte morphology at 0, 15 and 30 minutes. In the process of plateletpheresis in winter, the blood donors′ ear temperature and the skin temperature near the reinfusion needle in the observation group and the controls were measured, and the blood donors were observed for shivering, arm chills, pain or other discomfort. After the blood donation, the thermal comfort was evaluated. 【Results】 There was no difference in the results of routine blood test and plasma free Hb test of vitro blood after warming at 41℃, 42℃ and 43℃ for 0, 15 and 30 minutes (P>0.05), and no change in erythrocyte morphology was found. The skin temperature near the reinfusion needle (before vs. after the start of phlebotomy) was statistically different by applying blood/fluid warmer or not(P0.05). The vitro blood heating experiment showed that when the room temperature was within 22~24℃, the blood retransfusion speed was (100-120) mL/min; after the application of blood/fluid warmer, the temperature of reinfusion blood could be raised from 27℃ to 33~37℃. The proportion of feeling comfortable and very comfortable and the score of thermal comfort in the blood donors who used the warmer were higher than those in the controls (P<0.05). When the temperature of the warmer was set above 38℃, the average score of thermal comfort of blood donors was above 8. 【Conclusion】 It is safe to apply the blood/fluid warmer during the plateletsapheresis in winter, which can significantly improve the comfort of blood donors and reflect the humanized service of blood stations, and is worth popularizing.
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[Purpose] Acral coldness is a condition in which the fingers and/or toes are cold despite normal central body temperature. Regardless of the presence or absence of disease, many people suffer from acral coldness, especially elderly people. One method of relieving acral coldness is to heat the hands with a disposable warmer called “Kairo,” but this method interferes with daily work. We investigated whether or not heating other upper-limb parts with a pair of warmers can relieve acral coldness. [Methods] After obtaining informed consent, 30 people who usually had acral coldness without other diseases received the Kairo holders for their necks, elbows, and wrists. Eighteen participants used a pair of Kairo warmers for each area for one week, respectively. The remaining participants wore only the holder to know the heat retention effect of the holders. All participants separately evaluated their acral coldness of the upper limbs and the cumbersomeness of holders and/or Kairo by using a 10cm visual analog scale (VAS). To measure the therapeutic effect of the Kairo, the temperature and blood flow of the surface of both hands were examined by thermography and laser speckle contrast analysis (LASCA) at the day after finishing each warming period. These evaluations were conducted after a 20-minute adaptation at 24°C. [Result] The VAS of acral coldness of upper limbs decreased during the periods of warming on the neck and elbows with Kairo compared to the period without Kairo. There was no difference in the VAS value of the cumbersomeness among the neck, elbows, and wrists areas. The hand temperature on the day after the end of warming decreased slightly after elbow warming. [Conclusion] We found that the coldness of the hand was improved by warming other parts, even if the hand was not warmed, but the effect varied depending on the warming area. No therapeutic effect was detected, but this was considered to be a problem in setting the measurement conditions. We believe these results will lead to new ways to improve acral coldness.
ABSTRACT
[Purpose] Acral coldness is a condition in which the fingers and/or toes are cold despite normal central body temperature. Regardless of the presence or absence of disease, many people suffer from acral coldness, especially elderly people. One method of relieving acral coldness is to heat the hands with a disposable warmer called “Kairo,” but this method interferes with daily work. We investigated whether or not heating other upper-limb parts with a pair of warmers can relieve acral coldness. [Methods] After obtaining informed consent, 30 people who usually had acral coldness without other diseases received the Kairo holders for their necks, elbows, and wrists. Eighteen participants used a pair of Kairo warmers for each area for one week, respectively. The remaining participants wore only the holder to know the heat retention effect of the holders. All participants separately evaluated their acral coldness of the upper limbs and the cumbersomeness of holders and/or Kairo by using a 10cm visual analog scale (VAS). To measure the therapeutic effect of the Kairo, the temperature and blood flow of the surface of both hands were examined by thermography and laser speckle contrast analysis (LASCA) at the day after finishing each warming period. These evaluations were conducted after a 20-minute adaptation at 24°C. [Result] The VAS of acral coldness of upper limbs decreased during the periods of warming on the neck and elbows with Kairo compared to the period without Kairo. There was no difference in the VAS value of the cumbersomeness among the neck, elbows, and wrists areas. The hand temperature on the day after the end of warming decreased slightly after elbow warming. [Conclusion] We found that the coldness of the hand was improved by warming other parts, even if the hand was not warmed, but the effect varied depending on the warming area. No therapeutic effect was detected, but this was considered to be a problem in setting the measurement conditions. We believe these results will lead to new ways to improve acral coldness.
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Objective: To study the effect of Astragali Radix and its components, which were astragalus polysaccharides, astragaloside IV and astragalus calycosin, on the rats model of harmful fluid retention in the upper warmer. Methods: Rats were randomized into the blank group (0.5% CMC Na), the model group (0.5% CMC Na), the water decoction of Astragali Radix group (5.40 g/kg), the astragalus polysaccharides group (1.41 g/kg), the astragaloside IV group (50 mg/kg), the astragalus calycosin group (30 mg/kg), and the positive control group with Qili Qiangxin Capsule (1 g/kg), ten rats in each group. In addition to the control group, the harmful fluid retention in the upper warmer rats model were established in other groups which were induced by combined intervention factors of SC isoproterenol in the scapular region and tracheal intubation. After two weeks of gavage administration, the changes of body weight (BW), heart weight index (HWI), left ventricular mass index (LVWI), lung weight index (LWI), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), plasma creatine kinase (CK), the lung permeability index, the pulmonary alveolus pumpback amount, and the pulmonary dry wet ratio (W/D) in rats model were detected. Results: Compared with model group, the water decoction of Astragali Radix group and its components groups can improve the general condition of rats in varying degrees, BW increased significantly (P < 0.05) and the levels of HWI, LVWI and CK were all decreased in different degrees (P < 0.05 or < 0.01). In the astragalus polysaccharides group, astragaloside IV group and astragalus calycosin group, the levels of LVEF, LVFS and the pulmonary alveolus pumpback amount in rats were significantly increased (P < 0.05), and LWI, the lung permeability index and W/D were significantly decreased (P < 0.05). Conclusion: Astragali Radix and its components can improve the function of heart and lung in response to injury in rats model of harmful fluid retention in the upper warmer.
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BACKGROUND: Few studies have investigated the effectiveness of intravenous fluid warmers at low and moderate flow rates below 1,000 ml/h. In this study, we compared the effectiveness of three different fluid warmers at a low flow rate (440 ml/h). METHODS: We experimentally investigated the fluid warming performances of Mega Acer Kit® (Group M, n = 10), Ranger™ (Group R, n = 10), and ThermoSens® (Group T, n = 10) at 440 ml/h for 60 min. All devices were set at a warming temperature of 41℃ with preheating for 10 min. Intravenous fluids were then delivered through them. The fluid temperature (primary endpoint) was measured at 76 cm from the device after infusion for 60 min. The expected decrease in mean body temperature (secondary endpoint) after 5 h infusion for a 70 kg patient (ΔMBT5) was also calculated. RESULTS: The fluid temperature (mean [95% CI]) at 76 cm from the device, 60 minutes after the infusion was higher in group M (36.01 [35.73–36.29]℃), compared to groups T (29.81 [29.38–30.24]℃) and R (29.12 [28.52–29.72]℃) (P < 0.001). The ΔMBT5 (mean [95% CI]) was significantly smaller in group M (−0.04 [−0.04 to −0.03]℃) than that in groups T (−0.27 [−0.28 to −0.29]℃; P < 0.001) and R (−0.30 [−0.32 to −0.27]℃; P < 0.001). However, none of the fluid warmers provided a constant normothermic temperature above 36.5℃. CONCLUSIONS: Mega Acer Kit® was more effective in warming the intravenous fluid with the smallest expected change in the mean body temperature, compared to Ranger™ and ThermoSens®, at a flow rate of 440 ml/h.
Subject(s)
Humans , Acer , Body TemperatureABSTRACT
Objective:To investigate the effect of warmer intravenous infusion combined with local liquid dressing skin daub methods in short-term PN infusion patients with peripheral venous indwelling needle.Methods:Using the single blind random control method,150 PN patients from October 2015 to August 2016 were included.The control group was given the liquid dressing skin daub with 75 cases,and the observation group was given warmer intravenous infusion jointing local liquid dressing skin daub with 75 cases.To observe the incidence of phlebitis and the pain of the infusion catheter site with the infusion limb and the average maintain time of peripheral venous indwelling needle.Results:The incidence of phlebitis was significantly lower in the observation group than that in the control group (P ＜ 0.01) in two groups.The degree of infusion catheter pain with infusion limb pain wasless painful in the observation group than that in the control group (P ＜ 0.005) in two groups.The degree of catheter site pain after pulling out peripheral venous indwelling needle was less painful in the observation group than that in the control group(P ＜ 0.01) in two groups To compare the average maintain time of peripheral venous indwelling needle was (P ＜ 0.001)in two groups.Conclusion:Warmer intravenous infusion combined with liquid dressing skin daub can effectively prevent the occurrence of phlebitis in patients with peripheral venous indwelling needle PN infusion and improve the comfort.
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Maple syrup is the syrup made from the xylem sap of trees like sugar maple, red maple, black maple and some other maple species. From one of nature’s true phenomena the process of maple syrup production gets started. During spring when the nights are very cold, the maple tree absorbs water from the soil. In the daytime due to warmer temperature a pressure is created which pushes the water again to the tree bottom which helps in easy collection of the maple syrup which is very precious actually. It takes almost 12 to 20 days to collect the sap depending on the area / region.
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Intraoperative active warming in daycare surgery may be least popular compared to major elective surgeries due to the lesser risk of perioperative hypothermia. This prospective, single blind, randomized, controlled trial in daycare breast lumpectomy was done to evaluate the routine use of intraoperative forced-air warmer in the presence of other warming modalities in prevention of perioperative hypothermia. Fifty patients were randomized into two groups; Group 1 received forced-air warmer and Group 2 received a standard cotton thermal blanket. Both groups received circulating-water mattress. Intraoperatively, all patients received pre-warmed intravenous fluid with an in-line warmer. Ear and ambient temperature was recorded using infrared ear thermometer and digital thermo-hygrometer respectively. Measurement was done before induction, every 15 minutes intraoperatively, upon arrival in recovery room and 30 mins later, postoperatively. All patients were normothermic prior to induction of anaesthesia. During the initial half an hour post-induction, both groups mean core temperature decreased at approximately 0.5˚C. Both showed no statistical difference in mean core temperature (0.04 ˚C) within the initial half an hour. The next half an hour, both groups had approximately 0.2˚C decrement but this time, Group 2 had a slightly higher mean core temperature than Group 1 which maintained until the end of surgery. Overall, within the initial one hour postinduction of GA, there was a drop of 0.7˚C and 0.6°C in Group 1 and Group 2 respectively, however the difference in final mean core temperature between the two groups was 0.05°C and it was not statistically significant (p value < 0.05). None of the patients experienced intraoperative hypothermia (< 36˚C) and all remained in the normothermic range with no shivering or sense of feeling cold, postoperatively. The results of the present study found no significant difference in the changes of final core temperature with or without the usage of intraoperative forced-air warmer in the presence of other warming measures in daycare breast lumpectomy.
Subject(s)
Mastectomy, SegmentalABSTRACT
BACKGROUND: We used warming fluid for maintenance of body temperature in operating room or intensive care unit. This study was aimed to investigate the effect of infusion rate and catheter length on the temperature of warming fluid. METHODS: Normal saline was used for testing infusion and temperature of infusion was maintained by a warmer as 40degrees C. The temperatures of solution in infusion line were measured at 0, 25, 50, 75, and 100 cm apart from warmer at six different flow rates (100, 200, 300, 700, 1,400, and 2,100 ml/h). We also measured the temperature changes at room temperature (RT) and 5degrees C, 10degrees C, and 15degrees C above RT. RESULTS: The time to maintain solution temperature as 40degrees C was 165, 122, 37, 37, 21, and 19 s at flow rate 100, 200, 300, 700, 1,400, and 2,100 ml/h. The peak temperature was 43.58 +/- 0.58, 44.43 +/- 1.18, 44.37 +/- 0.70, 43.79 +/- 0.61, 42.82 +/- 0.97, and 42.11 +/- 0.92degrees C according to increasing flow rate. The temperature at 100 cm apart from warmer was 23.96 +/- 1.53, 25.46 +/- 2.76, 29.32 +/- 3.47, 31.40 +/- 5.38, 31.39 +/- 6.75, and 38.14 +/- 0.96degrees C according to increasing flow rate. CONCLUSIONS: These results suggested that the decreasing rate of temperature was related inversely to the flow rate and directly to the catheter length. There may be needed a rapid infusion pump with adequate heating system at a high flow rate and to locate the warmer close to patient for reserving a heating effect.
Subject(s)
Humans , Body Temperature , Catheters , Heating , Hot Temperature , Infusion Pumps , Intensive Care Units , Operating RoomsABSTRACT
BACKGROUND: The precise measurement of body temperature during anesthesia is important to prevent hypothermia.The aim of this study was to compare the urinary bladder temperature to the esophageal, nasopharyngeal, rectal and skin temperatures, and to compare three heating methods during spine surgery. METHODS: Forty-two patients with ASA physical status I-II, who were scheduled to undergo spine surgery in the prone position, were included in this study.The patients were randomly divided into 4 groups:Group I was treated without any heating methods; group 2, with fluid-warmers; group 3, with forced air-warmers; and group 4, with a combination of both heating methods.After the induction of anesthesia, the esophageal, nasopharyngeal, rectal, urinary bladder and skin temperature was monitored every 15 minute for 3 hours.The urinary bladder temperature was compared to the esophageal, nasopharyngeal, rectal and skin temperatures. RESULTS: The urinary bladder temperature was found to be higher than the esophageal and the nasopharyngeal temperatures (P < 0.01).The urinary bladder temperature of group 3 was higher than that of group 1 at 180 minutes after induction of anesthesia (P < 0.05).The urinary bladder temperature of group 4 was higher than that of group 1 at 150 minutes (P < 0.05), as well as at 165 and 180 minutes (P < 0.05).The skin temperatures of groups 3 and 4 were higher than group 1 (P < 0.001). CONCLUSIONS: The urinary bladder temperature was higher than the esophageal temperature and correlated with the esophageal, nasopharyngeal and rectal temperatures.During spine surgery in the prone position, a forced air-warmer was found to be the most effective but a combination of all the methods tested was found to be even more effective.
Subject(s)
Humans , Anesthesia , Body Temperature , Heating , Hot Temperature , Prone Position , Skin , Skin Temperature , Spine , Urinary BladderABSTRACT
BACKGROUND: Currently available warming devices are often heavy and cumbersome, requiring development of more portable, user friendly, high efficiency fluid and blood warmer. The intravenous fluid heating capabilities of a new, heat-plate print circuit board (PCB) based warmer at various low flow rates were tested. METHODS: Model Joyother BM-1(R) was investigated for normal saline (0.9% NaCl) and colloid at various infusion rates (60-6000 ml/hr). Final temperatures were measured by electronic thermometer after passing through the warmer. Effective warming was defined as a fluid temperature > or = 32degrees C. Ambient temperature was maintained at 22-25degrees C. Degree of heating capability and temperature decrease were compared and correlated between different flow rates. RESULTS: The device warmed the room temperature crystalloid and colloid efficiently. Its warming capability was continuously improved as the flow rates increased in all tested flow rates, reaching maximum 41degrees C. After the warming, the temperature decrease showed high negative correlation with the flow rates. The extent of cooling was less in colloid. No overheating was noted at sudden brake. CONCLUSIONS: Joyother BM-1(R) heated crystalloid and colloid sufficiently and safely enough for clinical application (exit temperature > or = 35degrees C) at various flow rates. The warming capacity and the length of the intravenous tube infusion system determined the efficiency of the warmer. Further study is warranted for the efficiency of warming for the blood and its element changes.
Subject(s)
Colloids , Heating , Hot Temperature , Hypothermia , ThermometersABSTRACT
The efficiency of the Siriraj Blood Warmer invented by the investigators was evaluated. The warmer operates by heat exchange with a water-bath at 39.50 C. The blood is warmed during its passage through a 270-cm blood warming coil which is in the water-bath. Simulation of massive transfusion and exchange transfusion was performed by using water in a 500-ml bottle refrigerated at 40 C for 24 hours. A blood transfusion set was attached to the bottle and a blood warming coil. A three-way stopcock (the proximal stopcock) connected the blood warming coil to the female adaptor end of a 50-cm extension set. Another three-way stopcock (the distal stopcock) was placed to the male adaptor end of the extenaion set. A 2-ml syringe where the temperature of the water passing through was recorded was attached to each three-way stopcock. The Terumo Infusion Pump was used to control the flow rate at 200, 250, and 300 ml/hr for massive transfusion. Either a 5-ml or a 10-ml syringe was attached to the proximal three-way stopcock for the push-pull technique of exchange transfusion. The water temperature was recorded every minute for 15 minutes. The moan water temperatures at the proximal syringe were 37.98 + 0.030 C, 38.19 + 0.030 C, 38.21 + 0.50 C for the flow rates of 200, 300 ml/hr, respectively, and 36.2 + 0.20 C, 37.2 + 0.20 C for the flow when using the 5-ml and the 10ml syringes, respectively. The mean water temperatures at the distal syringe decreased to 32.1 + 0.10 C, 33.0 + 0.10 C, 33.8 + 0.10 C, 32.4 + 0.30 C, and 35.7 + 0.30 C, respectively. The water temperatures were directly related to the flow rates, but the mean differences between the water temperatures were inversely related to the flow rate. Fifteen pairs of blood samples drawn from 15 units of whole blood before and immediately after free haemoglobin were not statistically significant. The Siriraj Blood Warmer can work very efficiently in warming blood for massive and exchange transfusions and does not make a significant change in plasma potassium or increase haemolysis.
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Objective To improve work efficiency and safety of blood transfusion in the battlefield.Methods Polyurethanes material was adopted to construct the insulation layer.Low density polyethylene,glass reinforced plastics and low-temperature bio-chemical method also got involved in.Results The blood warmer was passive,small,easy-to-carry and mobile,whose temperature regulation was realized by the input of cold or warm water.Conclusion Being advanced and easy-to-operate,the blood warmer has a brilliant future.
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The efficacy of the Siriraj Radiant Warmer Model-2, invented by the investigators for treating environmental hypothermia in newborn infants, was studied. Eleven healthy infants, with a mean birth weight of 2,570+433 g (range 1,910-3,040), mean age at study of 13.2+14.3 hours (range 1-39), and mean pretreatment rectal temperature of 35.7+0.45 0C (range 35.0-36.5) were incubated for two hours in the nursery. The mean rectal temperature rose within 15 minutes of warming and remained within the normal range 45 minutes after treatment. Eight sick infants, admitted to the newborn unit, with a mean body weight of 2,268+499 g (range 1,710-3,000), mean age at study of 10+5.5 days (range 21 hours-19 days), and mean pretreatment rectal temperature of 36.2+0.350C (range 35.7-36.6) were warmed for 48 hours. Within 4 hours of warming, the mean rectal temperature reached 37.00C and stabilized throughout the warming period in all infants but one, whose rectal temperature was 37.60C at the 32nd hour. The Siriraj Radiant Warmer Model-2 can by safely used for rewarming hyporthermic infants and stabilizing body temperature both in short-term warming.
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Objective To develop a simple film-developing heating device for army hospital below division. Methods An electric hand warmer was transformed and tests were made many times with different movement temperature of thermostat. Results The simple film-developing heating device could basically keep the photographic developer in constant temperature for best development effect in winter and spring. With simple structure and long service life, it is safe and convenient. Conclusion The simple film-developing heating device is desirable to be used in winter and spring and meets the practical requirements in the basic unit army hospital.