scholarly journals Impact of Parylene Coating On Heating Performance of Intravenous Fluid Warmer: A Bench Study

2021 ◽  
Author(s):  
Danielle K. Bayoro ◽  
Herman Groepenhoff ◽  
Daniel Hoolihan ◽  
Edward A. Rose ◽  
Michael J. Pedro ◽  
...  
Keyword(s):  
Perioperative Complications ◽  
Age Groups ◽  
Intravenous Fluid ◽  
Low Flow ◽  
Fluid Temperature ◽  
Target Temperature ◽  
Flow Rates ◽  
Fluid Warmer ◽  
Increased Risk ◽  
The Impact

Abstract Background Perioperative hypothermia is a common occurrence, particularly with the elderly and pediatric age groups. Hypothermia is associated with an increased risk of perioperative complications. One method of preventing hypothermia is warming the infused fluids given during surgery. The enFlow™ intravenous fluid warmer has recently been reintroduced with a parylene coating on its heating blocks. In this paper, we evaluated the impact of the parylene coating on the new enFlow’s fluid warming capacity. Methods Six coated and six uncoated enFlow cartridges were used. A solution of 10% propylene glycol and 90% distilled H2O was infused into each heating cartridge at flow rates of 2, 10, 50, 150, and 200 ml/min. The infused fluid temperature was set at 4°C, 20°C, and 37°C. Output temperature was recorded at each level. Data for analysis was derived from 18 runs at each flow rate (six cartridges at three temperatures). Results The parylene coated fluid warming cartridge delivered very stable output of 40°C temperatures at flow rates of 2, 10, and 50 ml/min regardless of the temperature of the infusate. At higher flow rates, the cartridges were not able to achieve the target temperature with the colder fluid. Both cartridges performed with similar efficacy across all flow rates at all temperatures. Conclusions At low flow rates, the parylene coated enFlow cartridges was comparable to the original uncoated cartridges. At higher flow rates, the coated and uncoated cartridges were not able to achieve the target temperature. The parylene coating on the aluminum heating blocks of the new enFlow intravenous fluid warmer does not negatively affect its performance compared to the uncoated model.

scholarly journals Influence of flow rate, fluid temperature, and extension line on Hotline and S-line heating capability: an in vitro study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hosu Kim ◽  
Tae Kyong Kim ◽  
Sukha Yoo ◽  
Jin-Tae Kim
Keyword(s):  
Flow Rate ◽  
Room Temperature ◽  
In Vitro Study ◽  
High Flow ◽  
High Flow Rate ◽  
Low Flow ◽  
Fluid Temperature ◽  
Flow Rates ◽  
Fluid Warmer

Abstract Background A fluid warmer can prevent hypothermia during the perioperative period. This study evaluated the heating capabilities of Hotline and Barkey S-line under different flow rates and initial fluid temperatures, as well as after the extension line installation. Methods We measured the temperature of a 0.9% sodium chloride solution at the fluid warmer outlet (TProx) and the extension line end (TDistal) with three different initial fluid temperatures (room, warm, and cold) and two flow rates (250 ml/hr and 100 mL/hr). Results At a 250 ml/hr flow rate, the TProx and TDistal values were observed to be higher in Hotline than in S-line when using room-temperature or cold fluid. Administering of the warm fluid at the same flow rate significantly increased the TProx and TDistal values in S-line more than the cold and room-temperature fluids. At flow rates of 100 ml/hr, TDistal values were significantly lower than TProx values in both devices regardless of the initial fluid temperature. Conclusions Hotline outperformed S-line for warming fluids at a high flow rate with cold or room-temperature fluids. Administering warm fluid in S-line prevented a decrease in the fluid temperature at a high flow rate. However, at a low flow rate, the fluid temperature significantly decreased in both devices after passing through an extension line.

scholarly journals Influence of flow rate, fluid temperature, and extension line on Hotline and S-line heating capability: an in vitro study

2020 ◽  
Author(s):  
Hosu Kim ◽  
Tae Kyong Kim ◽  
Sukha Yoo ◽  
Jin-Tae Kim
Keyword(s):  
Flow Rate ◽  
Room Temperature ◽  
In Vitro Study ◽  
High Flow ◽  
High Flow Rate ◽  
Low Flow ◽  
Fluid Temperature ◽  
Flow Rates ◽  
Fluid Warmer

Abstract Background A fluid warmer can prevent hypothermia during the perioperative period. This study evaluated the heating capabilities of Hotline and Barkey S-line under different flow rates and initial fluid temperatures, as well as after the extension line installation. Methods We measured the temperature of a 0.9% sodium chloride solution at the fluid warmer outlet (TProx) and the extension line end (TDistal) with three different initial fluid temperatures (room, warm, and cold) and two flow rates (250 ml/hr and 100 mL/hr). Results At a 250 ml/hr flow rate, the TProx and TDistal values were observed to be higher in Hotline than in S-line when using room-temperature or cold fluid. Administering of the warm fluid at the same flow rate significantly increased the TProx and TDistal values in S-line more than the cold and room-temperature fluids. At flow rates of 100 ml/hr, TDistal values were significantly lower than TProx values in both devices regardless of the initial fluid temperature. Conclusions Hotline outperformed S-line for warming fluids at a high flow rate with cold or room-temperature fluids. Administering warm fluid in S-line prevented a decrease in the fluid temperature at a high flow rate. However, at a low flow rate, the fluid temperature significantly decreased in both devices after passing through an extension line.

scholarly journals Influence of flow rate, fluid temperature, and extension line on Hotline and S-line heating capability: an in vitro study

2020 ◽  
Author(s):  
Hosu Kim ◽  
Tae Kyong Kim ◽  
Sukha Yoo ◽  
Jin-Tae Kim
Keyword(s):  
Flow Rate ◽  
Room Temperature ◽  
In Vitro Study ◽  
High Flow ◽  
High Flow Rate ◽  
Low Flow ◽  
Fluid Temperature ◽  
Flow Rates ◽  
Fluid Warmer

Abstract Background A fluid warmer can prevent hypothermia during the perioperative period. This study evaluated the heating capabilities of Hotline and Barkey S-line under different flow rates and initial fluid temperatures, as well as after the extension line installation. Methods We measured the temperature of a 0.9% sodium chloride solution at the fluid warmer outlet (TProx) and the extension line end (TDistal) with three different initial fluid temperatures (room, warm, and cold) and two flow rates (250 ml/hr and 100 mL/hr). Results At a 250 ml/hr flow rate, the TProx and TDistal values were observed to be higher in Hotline than in S-line when using room-temperature or cold fluid. Administering of the warm fluid at the same flow rate significantly increased the TProx and TDistal values in S-line more than the cold and room-temperature fluids. At flow rates of 100 ml/hr, TDistal values were significantly lower than TProx values in both devices regardless of the initial fluid temperature. Conclusions Hotline outperformed S-line for warming fluids at a high flow rate with cold or room-temperature fluids. Administering warm fluid in S-line prevented a decrease in the fluid temperature at a high flow rate. However, at a low flow rate, the fluid temperature significantly decreased in both devices after passing through an extension line.

scholarly journals Influence of Flow Rate, Fluid Temperature, and Extension Line on Hotline and S-Line Heating Capability: an in Vitro Study

2020 ◽  
Author(s):  
Hosu Kim ◽  
Tae Kyong Kim ◽  
Sukha Yoo ◽  
Jin-Tae Kim
Keyword(s):  
Flow Rate ◽  
Room Temperature ◽  
In Vitro Study ◽  
High Flow ◽  
High Flow Rate ◽  
Low Flow ◽  
Fluid Temperature ◽  
Flow Rates ◽  
Fluid Warmer

Abstract Background A fluid warmer can prevent hypothermia during the perioperative period. This study evaluated the heating capabilities of Hotline and Barkey S-line under different flow rates and initial fluid temperatures, as well as after the extension line installation. Methods We measured the temperature of a 0.9% sodium chloride solution at the fluid warmer outlet (TProx) and the extension line end (TDistal) with three different initial fluid temperatures (room, warm, and cold) and two flow rates (250 ml/hr and 100 mL/hr). Results At a 250 ml/hr flow rate, the TProx and TDistal values were observed to be higher in Hotline than in S-line when using a room-temperature fluid; similar results were observed for the cold fluid. Administration of the warm fluid was observed to significantly increase the TProx and TDistal values in S-line at rates of 250 ml/hr more than the administration of the cold and room-temperature fluids. At flow rates of 100 ml/hr, TDistal values were significantly lower than TProx values in both devices regardless of the initial fluid temperature. Conclusions Hotline outperformed S-line for warming fluids at a high flow rate with cold or room-temperature fluids. The administration of the initially warm fluid prevented a decrease in the fluid temperature at a high flow rate in S-line. However, at a low flow rate, the fluid temperature significantly decreased in both devices after passing through an extension line.

scholarly journals Quit Experiences among Primary Care Patients Enrolled in a Smoking Cessation Pilot RCT Early in the COVID-19 Pandemic

2021 ◽  
Vol 18 (3) ◽  
pp. 1011
Author(s):  
Andrea A. Joyce ◽  
Grace M. Styklunas ◽  
Nancy A. Rigotti ◽  
Jordan M. Neil ◽  
Elyse R. Park ◽  
...  
Keyword(s):  
Primary Care ◽  
Text Messaging ◽  
Risk Perceptions ◽  
Environmental Changes ◽  
Age Groups ◽  
Text Messages ◽  
Increased Risk ◽  
Primary Care Patients ◽  
The Impact ◽  
At Home

The impact of the COVID-19 pandemic on US adults’ smoking and quitting behaviors is unclear. We explored the impact of COVID-19 on smoking behaviors, risk perceptions, and reactions to text messages during a statewide stay-at-home advisory among primary care patients who were trying to quit. From May–June 2020, we interviewed smokers enrolled in a 12-week, pilot cessation trial providing text messaging and mailed nicotine replacement medication (NCT04020718). Twenty-two individuals (82% white, mean age 55 years), representing 88% of trial participants during the stay-at-home advisory, completed exit interviews; four (18%) of them reported abstinence. Interviews were thematically analyzed by two coders. COVID-19-induced environmental changes had mixed effects, facilitating quitting for some and impeding quitting for others. While stress increased for many, those who quit found ways to cope with stress. Generally, participants felt at risk for COVID-19 complications but not at increased risk of becoming infected. Reactions to COVID-19 and quitting behaviors differed across age groups, older participants reported difficulties coping with isolation (e.g., feeling disappointed when a text message came from the study and not a live person). Findings suggest that cessation interventions addressing stress and boredom are needed during COVID-19, while smokers experiencing isolation may benefit from live-person supports.

scholarly journals Impact of Cirrhosis on Morbidity and Mortality After Spinal Fusion

2019 ◽  
Vol 10 (7) ◽  
pp. 851-855
Author(s):  
Young Lu ◽  
Charles C. Lin ◽  
Hayk Stepanyan ◽  
Andrew P. Alvarez ◽  
Nitin N. Bhatia ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Resource Utilization ◽  
Perioperative Complications ◽  
Perioperative Outcomes ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Nationwide Inpatient Sample Database ◽  
Increased Risk ◽  
Cirrhotic Patients ◽  
The Impact

Study Design: Retrospective large database study. Objective: To determine the impact of cirrhosis on perioperative outcomes and resource utilization in elective spinal fusion surgery. Methods: Elective spinal fusion hospitalizations in patients with and without cirrhosis were identified using ICD-9-CM codes between the years of 2009 and 2011 using the Nationwide Inpatient Sample database. Main outcome measures were in-hospital neurologic, respiratory, cardiac, gastrointestinal, renal and urinary, pulmonary embolism, wound-related complications, and mortality. Length of stay and inpatient costs were also collected. Multivariable logistic regressions were conducted to compare the in-hospital outcomes of patients with and without cirrhosis undergoing spinal fusion. Results: A total of 1 214 694 patients underwent elective spinal fusions from 2009 to 2011. Oh these, 6739 were cirrhotic. Cirrhosis was a significant independent predictor for respiratory (odds ratio [OR] = 1.43, confidence interval [CI] 1.29-1.58; P < .001), gastrointestinal (OR = 1.72, CI 1.48-2.00; P < .001), urinary and renal (OR = 1.90, CI 1.70-2.12; P < 0.001), wound (OR = 1.36, CI 1.17-1.58; P < 0.001), and overall inpatient postoperative complications (OR = 1.43, CI 1.33-1.53; P < .001). Cirrhosis was also independently associated with significantly greater inpatient mortality (OR = 2.32, CI 1.72-3.14; P < .001). Cirrhotic patients also had significantly longer lengths of stay (5.35 vs 3.35 days; P < .001) and inpatient costs ($36 738 vs $29 068; P < .001). Conclusions: Cirrhosis is associated with increased risk of perioperative complications, mortality and greater resource utilization. Cirrhotic patients undergoing spinal fusion surgeries should be counseled on these increased risks. Current strategies for perioperative management of cirrhotic patients undergoing spinal fusion surgery need improvement.

scholarly journals The impact of fresh gas flow on wash-in, wash-out time and gas consumption for sevoflurane and desflurane, comparing two anaesthesia machines, a test-lung study.

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1997 ◽  
Author(s):  
Fredrik Leijonhufvud ◽  
Fredrik Jöneby ◽  
Jan G. Jakobsson
Keyword(s):  
Gas Flow ◽  
Anaesthetic Agent ◽  
Point Of View ◽  
Low Flow ◽  
Test Lung ◽  
Minimal Alveolar Concentration ◽  
Flow Rates ◽  
Optimal Flow ◽  
Gas Consumption ◽  
The Impact

Low-flow anaesthesia is considered beneficial for the patient and the environment, and it is cost reducing due to reduced anaesthetic gas consumption. An initial high-flow to saturate the circle system ( wash-in) is desirable from a clinical point of view. We measured the wash-in and wash-out times (time to saturate and to eliminate the anaesthetic agent, AA), for sevoflurane and desflurane, in a test-lung with fixed 3 MAC vaporizer setting at different fresh gas flow (FGF) and calculated the consumption of AA. We tried to find an optimal flow rate for speed and gas consumption, comparing two anaesthesia machines (AMs): Aisys and Flow-i. Time to reach 1 minimal alveolar concentration (MAC) (wash-in) decreased (p<0.05) at higher flow rates (1 – 2 – 4) but plateaued at 4-4.8 l/min. The consumption of AA was at its lowest around 4-4.8 l/min (optimal flow) for all but the Aisys /desflurane group. Wash-out times decreased as FGF increased, until reaching plateau at FGF of 4-6 l/min. Aisys had generally shorter wash-in times at flow rates < 4 l/min as well as lower consumption of AA. At higher flow rates there were little difference between the AMs. The “optimal FGF” for wash-out, elimination of gas from the test-lung and circle system, plateaued with no increase in speed beyond 6 l/min. A fresh gas flow of 4 l/min. seems “optimal” taking speed to reach a 1 MAC ET and gas consumption into account during wash-in with a fixed 3 MAC vaporizer setting, and increasing fresh gas flow beyond 6 l/min does not seem to confirm major benefit during wash-out.

scholarly journals Early breast cancer: why does obesity affect prognosis?

2018 ◽  
Vol 77 (4) ◽  
pp. 369-381 ◽  
Author(s):  
A. Heetun ◽  
R. I. Cutress ◽  
E. R. Copson
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Treatment Effectiveness ◽  
Management Strategies ◽  
Age Groups ◽  
Obese Patients ◽  
Chemotherapy Drugs ◽  
Increased Risk ◽  
The Impact ◽  
High Bmi

High BMI is associated with an increased risk of breast cancer in post-menopausal women but poorer outcomes in all age groups. The underlying mechanism is likely to be multi-factorial. Patients with a high BMI may present later due to body habitus. Some studies have also indicated an increased incidence of biologically adverse features, including a higher frequency of oestrogen receptor (ER negative) tumours, in obese patients. Obese patients have a higher frequency of surgical complications, potentially delaying systemic therapies, and reports suggest that chemotherapy and endocrine therapy are less effective in patients with BMI ≥30 kg/m2.High BMI is generally interpreted as excess adiposity and a World Cancer Research Fund report judged that the associations between BMI and incidence of breast cancer were due to body fatness. However, BMI cannot distinguish lean mass from fat mass, or characterise body fat distribution. Most chemotherapy drugs are dosed according to calculated body surface area (BSA). Patients with a similar BSA or BMI may have wide variations in their distribution of adipose tissue and skeletal muscle (body composition); however, few studies have looked at the effect of this on chemotherapy tolerance or effectiveness. Finally, adjuvant treatments for breast cancer can themselves result in body composition changes.Research is required to fully understand the biological mechanisms by which obesity influences cancer behaviour and the impact of obesity on treatment effectiveness and tolerance so that specific management strategies can be developed to improve the prognosis of this patient group.

scholarly journals Helminths in South Africa: management of cestode and trematode infections in humans

2020 ◽  
pp. 33-38
Author(s):  
RL van Zyl
Keyword(s):  
South Africa ◽  
South African ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Epidemiological Data ◽  
Sub Saharan Africa ◽  
The South ◽  
Increased Risk ◽  
Sub Saharan ◽  
The Impact

Sub-Saharan Africa has to contend with many challenges, including inadequate healthcare systems, lack of optimal sanitation, and clean water and food. All of these contribute to malnutrition and an increased risk of infections, including parasitism by cestodes and trematodes. Schistosomiasis is a category-2 notifiable trematode (fluke) infection, whereas cestode (tapeworm) infections need not be reported to the South African Department of Health. Epidemiological data for helminthiasis in South Africa is scant, with a paucity of publications on the South African scenario. As such, a complete picture of the impact of helminth infections on all age groups in South Africa does not exist. These parasitic diseases not only have an impact on socio economic development of a country, community and families, but also contribute to the chronic and detrimental effects on the health and nutritional status of the host, including the impaired development of children. In order to break the cycle of poverty and disease, a strong education drive is required in schools and communities to provide effective strategies and guidelines on preventative measures that result in avoidance of exposure to infective stages of Schistosoma and Taenia tapeworms. Also, it is imperative that healthcare professionals are able to recognise the signs and symptoms, so that interventions can be promptly initiated. The current anthelmintic treatments available in South Africa are effective against cestodes and trematodes, with no drug resistance having being reported. The need for compliancy when taking anthelmintic drugs must be emphasised.

scholarly journals Effect of Fluid Flow Rate on Efficacy of Fluid Warmer: An In Vitro Experimental Study

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Vorasruang Thongsukh ◽  
Chanida Kositratana ◽  
Aree Jandonpai
Keyword(s):  
Fluid Flow ◽  
Flow Rate ◽  
Room Temperature ◽  
Core Body Temperature ◽  
Infusion Pump ◽  
Outlet Temperature ◽  
Fluid Temperature ◽  
Fluid Flow Rate ◽  
Flow Rates ◽  
Fluid Warmer

Introduction. In patients who require a massive intraoperative transfusion, cold fluid or blood transfusion can cause hypothermia and potential adverse effects. One method by which to prevent hypothermia in these patients is to warm the intravenous fluid before infusion. The aim of this study was to determine the effect of the fluid flow rate on the efficacy of a fluid warmer. Methods. The room air temperature was controlled at 24°C. Normal saline at room temperature was used for the experiment. The fluid was connected to an infusion pump and covered with a heater line, which constantly maintained the temperature at 42°C. The fluid temperature after warming was measured by an insulated thermistor at different fluid flow rates (100, 300, 600, 900, and 1200 mL/h) and compared with the fluid temperature before warming. Effective warming was defined as an outlet fluid temperature of >32°C. Results. The room temperature was 23.6°C ± 0.9°C. The fluid temperature before warming was 24.95°C ± 0.5°C. The outlet temperature was significantly higher after warming at all flow rates (p<0.001). The increases in temperature were 10.9°C ± 0.1°C, 11.5°C ± 0.1°C, 10.2°C ± 0.1°C, 10.1°C ± 0.7°C, and 8.4°C ± 0.2°C at flow rates of 100, 300, 600, 900, and 1200 mL/h, respectively. The changes in temperature among all different flow rates were statistically significant (p<0.001). The outlet temperature was >32°C at all flow rates. Conclusions. The efficacy of fluid warming was inversely associated with the increase in flow rate. The outlet temperature was <42°C at fluid flow rates of 100 to 1200 mL/h. However, all outlet temperatures reached >32°C, indicating effective maintenance of the core body temperature by infusion of warm fluid.

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