Laboratory study on the kinetics of the warming of cold fluids-A hot topic

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• 作者：Alexandre Mendibil^a ; ^{alexandre.mendibil@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Daniel Jost^a ; Auré ; lien Thiry^b ; Delphine Garcia^b ; Julie Trichereau^a ; Benoit Frattini^a ; Pascal Dang-Minh^a ; Olga Maurin^a ; Sylvie Margerin^c ; Laurent Domanski^a ; Jean-Pierre Tourtier^a
• 关键词：Induced hypothermia ; Cold saline ; Postresuscitation care ; Temperature ; Laboratory
• 刊名：Anaesthesia Critical Care & Pain Medicine
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：35
• 期：5
• 页码：337-342
• 全文大小：795 K

文摘

In case of mild therapeutic hypothermia after an out-of-hospital cardiac arrest, several techniques could limit the cold fluid rewarming during its perfusion. We aimed to evaluate cold fluid temperature evolution and to identify the factors responsible for rewarming in order to suggest a prediction model of temperature evolution.

Equipment and methods

This was a laboratory experimental study. We measured temperature at the end of the infusion line tubes (ILT). A 500 ml saline bag at 4 °C was administered at 15 and 30 ml/min, with and without cold packs applied to the cold fluid bag or to the ILT. Cold fluid temperature was integrated in a linear mixed model. Then we performed a mathematical modelization of the thermal transfer across the ILT.

Results

The linear mixed model showed that the mean temperature of the cold fluid was 1 °C higher (CI 95%: [0.8–1.2]) with an outflow rate of 15 versus 30 ml/min (P < 0.001). Similarly, the mean temperature of the cold fluid was 0.7 °C higher (CI 95%: [0.53–0.9]) without cold pack versus with cold packs (P < 0.001). Mathematical modelization of the thermal transfer across the ILT suggested that the cold fluid warming could be reduced by a shorter and a wider ILT. As expected, use of CP has also a noticeable influence on warning reduction. The combination of multiple parameters working against the rewarming of the solution should enable the infusion of a solute with retained caloric properties.

Conclusions

By limiting this “ILT effect,” the volume required for inducing mild therapeutic hypothermia could be reduced, leading to a safer and a more efficient treatment.