> So three questions...
> 1. Can giving sets be damaged by long term (one week) prewarming
No idea, but I gravely doubt it. When I first started as a Consultant, the pharmacy had decreed that each bag of fluid
could only be put in a warmer once for a week. The result was that the Unit was cluttered with hundreds of 'unwarmable'
bags of fluid that had done their week. I got chapter and verse on this, and pointed out that many tropical countries
would have fluid stored at temperatures > 30 deg C for months without apparent ill effect. So we now keep our fluids
warmed for 6 months at a time, with no apparent degradation. I appreciate that your question relates to the plastic of the
tubing, which may be different from that of the bag. However, the same tropical rules apply.
> 2. Is there heat loss through a giving set
Yes. The magnitude depends on the rate of flow, and the effect on the patient is of course inversely proportional to this.
So unless it freezes in the giving set I wouldn't worry.
> 3. Is there evidence for 'non warmed' infusions affecting patient
> outcome positively.
Yes, and there is quite a lot of interest in this; hypothermia has of course been used therapeutically for years in cardiac
surgery, but the Houston experiments on cooling of brain injured patients have I understand been unimpressive. It
should be considered SERNIP C only at present (as should permissive hypotension in trauma, but I'm fighting a losing
battle on that one, I feel.)
Best wishes,
Rowley Cottingham
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