Hypothermia in emergency surgery: the importance of blood heating during transfusion

Blood products are typically stored at low temperatures to maintain their quality and integrity. Nevertheless, when it comes to trauma cases, the swift infusion of cold blood and blood-related products can induce substantial drops in the body's core temperature, worsening hypothermia in emergency surgical situations. Hypothermia can exert profound effects on multiple bodily systems, including the cardiovascular, gastrointestinal, endocrine, immune, and coagulation systems. This may lead to decreased cardiac output, increased vascular resistance, gastrointestinal complications, insulin resistance, immune system suppression, and issues with blood clotting.

Moreover, without blood heating, acidosis may develop, further complicating the patient's condition. Acidosis can reduce the effectiveness of ionotropic medications and hinder the stabilization of hemodynamics, a crucial factor in trauma cases.

Hypothermia, along with concurrent acidosis and coagulopathy, forms the critical "lethal triad" in trauma patients. Studies have revealed that administering cold blood can result in a reduction of internal body temperature by 0.5-1°C, and in some cases even more substantial drops [1]. As a result, blood heating prior to transfusion has become a common practice to prevent complications associated with hypothermia.

Reliable blood heating devices play a critical role, particularly in pediatric trauma cases where maintaining thermal balance is essential due to the smaller body surface area. These devices facilitate efficient patient warming through blood transfusion, reducing the risk of iatrogenic hypothermia and preventing disturbances in blood coagulation during treatment.

AMPIRmini: the device for blood heating

TAHAT celebrates 15 years of excellence in manufacturing the AMPIRmini Portable Blood and Fluid Warmer, a revolutionary solution that has enhanced the quality of patient care.

This portable and lightweight blood warmer is ideal for emergency blood transfusions, plasma and IV infusions, and transfusions. It efficiently guards against hypothermia and its associated complications prior to arrival at a healthcare facility. It can operate either on battery power or electric mains, providing flexibility in various medical settings.

 

 

 

 

The AMPIRmini portable blood warmer is suitable for use beyond hospital settings, including medical aviation, ambulances, emergency rescue, disaster medicine, and field hospitals.

Blood warmer consists of:

1. Control unit

• LED display indicates current and set temperatures
• Separate control buttons
• 2 operating modes:
  - Manual mode of blood heating: the temperature can be set between 34°С and 42°С with 0.1°С increments;
  - Auto mode of blood heating: temperature is maintained at 36.6°С
• Audible and visual alarms, self-diagnostics at the power-up and during operation

2. Integrated heat exchanger

• Open System. Any standard IV lines can be used, incl. pediatric (optional)
• The heat exchanger can be placed very close to the injection site, providing minimum distance from the heat exchanger to the patient.
• Max. flow rate - 2 000 ml/h
• Duralumin heating plate: high thermal conductivity, durability and resistance to mechanical stress

3. Uninterruptible power supply

• Battery-powered operation up to 5 hours
• Simultaneous operation and charging
• Connection to a car 12V socket
• Charging panel

4. Mounting belt

• The device can be placed very close to the patient: on an IV stand, near the injection site, on top of a bed or stretcher.

The portable AMPIRmini not only boosts the effectiveness of medical procedures but also plays a pivotal role in preventing complications associated with the infusion of cold fluids.

To sum up, it is crucial to maintain core body temperature during emergency surgeries, and the practice of blood heating before transfusion is crucial in preventing hypothermia-related complications. This approach leads to improved outcomes and reduces the risks associated with hypothermia in trauma patients.

 

References:

1. Boyan CP, Howland WS (1961) Blood temperature: a critical factor in massive transfusion. Anesthesiology 22: 559-563.