EFFECTIVELY WARMING BLOOD & IV FLUIDS TRANSFUSED THROUGH RAPID INTERMITTENT (BOLUS) FLOW METHODS

QinFlow is proud to announce that the Warrior line is now validated to effectively warm rapid intermittent (aka “bolus”) flows generated via various intermittent transfusion techniques to accelerate the delivery of blood and fluid products to critically-ill patients.

WHAT ARE INTERMITTENT (BOLUS) FLOWS?

Emergency teams often apply pressure bag to accelerate the flow of blood and fluid products to critically-ill patients or use electro-mechanical pump to control the flow rate or the total volume delivered. Both methods deliver a fairly constant flow. However, in many instances, and especially for the sickest patients, emergency teams may apply various types of flow-inducing methods to accelerate the flow of blood/fluids to patients, control the volume (e.g. as typical for pediatric patients), or both. These methods typically generate intermittent (or bolus) flow pattern. Popular methods include the “push-pull” method, and a hand pump. A new device called the LifeFlow® PLUS introduces an intuitive and novel method of rapid delivery. Irrespective of the flow-inducing method used, it is important to note that all these methods generate rapid flows that are delivered intermittently; that is, a fast pulse of high flow followed by short period of no-flow (in which the device is reloaded with blood/fluid), and so on, until the transfusion ends.

HOW DO PREVAILING WARMERS DEAL WITH THE INTERMITTENT-FLOW CHALLENGE?

The potentially aggressive nature of the intermittent flows generated by the techniques listed above poses great challenges on prevailing blood and IV fluid warming devices, which were predominantly designed to handle constant flows generated by gravity, pressure bag, or mechanical pump. In order for the warmers to sufficiently perform, the warmers typically require the following 4 characteristics:

1. Real-Time Sensing: continuous, real-time sensing is required in order to promptly identify changes in the flow so that the warmer will be able to react to these changes in a fast manner;
2. High Delivery Rate / High Efficiency: high delivery rate of 180ml/min or higher for 4°C fluid/blood is required in order to properly warm the intermittent flows before they reach the patient. High efficiency is required so as to effect immediate changes in the warming profile;
3. Sufficient Priming Volume: sufficient priming volume is required in order to warm the rapid flows and yet ensure safe (i.e. incremental and relaxed) heat transfer process to the fluids/blood; and
4. Robust Mechanical Structure: robust mechanical structure is required in order to address the elevated pressure that these techniques often generate.

To the best of our knowledge, the Warrior line is the only technology in the market nowadays that can effectively address these aggressive intermittent flows:

1. Real-Time Sensing: a sensor array embedded on the Warrior’s disposable unit measures fluids/blood temperature hundreds of times per second and the system adjusts the heating distribution accordingly so as to ensure 38°C ±2°C output;
2. High Delivery Rate / High Efficiency: with its high battery capacity and nearly 100% warming efficiency (patented technology), the Warrior line is capable of delivering up to 180 (Warrior lite with Extra Power battery) and 200 (Warrior and Warrior EXTREME) ml/min for 4°C fluids/blood. With AC power source, the Warrior can deliver up to 290 ml/min for 4°C fluids/blood (Warrior AC);
3. Sufficient Priming Volume: comfortable 19ml priming volume facilitate the warming of the rapid flows while ensuring safe heat exchange process; and
4. Robust Mechanical Structure: the Warrior consumable was validated to withstand the elevated pressure generated through rapid intermittent flows without leaking or breaking.

To sum up: prevailing warmers cannot warm fluids/blood delivered intermittently, in rapid flows. In some cases, the cassette may even break due to the elevated pressure. As a result, your sickest patients may receive cold blood/fluids! This abnormality is now fixed by the Warrior line!

NEW ADVANCES TO THE WARRIOR LINE?

As of August, 2021 –
All Warrior Base Units (i.e Warrior lite, Warrior, and Warrior EXTREME base units) delivered from our factory include tightened performance specifications, designed to effectively warm rapid intermittent flows. The performance of the systems with constant flows remains top notch.
The warming performance of the Warrior line when intermittent flows are applied is second to none even prior to introducing the tightened performance specifications; however, wider tolerances may be observed.
Recent and successful validation studies were performed with the methods listed above, and predominantly with the LifeFlow® and LifeFlow PLUS® infusers.

WHAT WARMING PERFORMANCE CAN BE EXPECTED?

As indicatively shown in the figure below, set temperature of 38°C ±2°C will be maintained also when rapid intermittent flows rates are applied. The figure provides an indicative performance of the Warrior device with the LifeFlow® PLUS device, when cold fluids (4°C input) are delivered intermittently in rapid flows (approximately 200ml delivered in one minute). The Warrior’s fast adjustments to the rapid flow fluctuations is reflected by the minor tolerances (±2°C) around the device’s target temperature (38°C). The warming is maintained within spec (38±2°C).
Please note that restrictions apply; therefore, contact us for more details.

INDICATIVE WARRIOR PERFORMANCE WITH INTERMITTENT FLOWS

INTERESTED TO LEARN MORE?

Contact us for more details.
Thank you,
Team QinFlow