A comparison of flow rates and warming capabilities of the level 1 and rapid Infusion System with various-size intravenous catheters

• Published in: Anesthesia and analgesia Vol. 97; no. 2; pp. 358 - 363
• Main Authors: BARCELONA, Sandra L, VILICH, Fatima, COTE, Charles J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.08.2003
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Transfusion - instrumentation; Catheterization; Emergency and intensive care: techniques, logistics; In Vitro Techniques; Infusions, Intravenous - instrumentation; Intensive care medicine; Isotonic Solutions - administration & dosage; Medical sciences; Perfusions. Catheterizations. Hyperbaric oxygenotherapy; Rheology; Ringer's Lactate; Temperature; Warming; Delivery system; Flow rate; Ringer lactate; Intravenous administration; Crystalloid solution; Perfusion; Size; Catheter; In vitro; Comparative study; Technical equipment
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1213/01.ANE.0000070235.67887.5C

Cases involving massive blood transfusion may require the use of specialized blood warmers, such as the Level 1 (L-1) (Level 1 Technologies, Inc., Rockland, MA) or the Rapid Infusion System (RIS) (Haemonetics Corp., Braintree, MA). In this in vitro study, we compared the infusion and warming capabilities of the L-1 (model 1000) versus the RIS using pediatric- and adult-sized IV catheters. The time to infuse 2 L of lactated Ringer's solution and the end temperature after infusion through 20-, 18-, 16-, and 14-gauge catheters, and 4-, 5-, 6-, 7-, and 8.5-French catheters using both the L-1 and RIS were measured. The flow rates of both systems were similar for 18- and 20-gauge catheters; however, the flow rates with the RIS were progressively faster than the L-1 as catheter size increased to >18 gauge. The heating capabilities of the RIS were superior to the L-1 for all catheters >or=16 gauge. We conclude that the RIS was superior to the L-1 for both flow rates and warming capacity for all IV catheters >18 gauge, i.e., those used for cases with massive blood loss. The RIS provided no advantage (with regard to heating and flow) when used with typical pediatric-sized catheters. The rapid infusion system is superior to the Level 1 for warming and flow of crystalloid for IV catheters >18 gauge in vitro. The rapid infusion system provides no advantage with catheters typically used in small children (<or=18 gauge). Safety and cost are additional factors to be considered when choosing one system over the other.