Non-battery powered dual-stage fluid warmer for battlefield transfusion

Hemorrhage is the leading and potentially preventable cause of battlefield mortality. Timely and balanced resuscitation with blood components known as damage control resuscitation (DCR) leads to increased survival by achieving hemostasis as quickly as possible. 65% of all surgical patients experience hypothermia mainly due to the use of anesthetics and cold intravenous fluids. Blood components used for pre-hospital transfusion as a rapid bolus (cold fluids) can lead to a drop of up to 1.3░C in the core body temperature. The potential for casualties to develop hypothermia and secondary coagulopathy makes adequate fluid warming an important function in preparation for and during pre-hospital resuscitation. Blood products are typically warmed using in-line battery powered warmers to avoid transfusion induced hypothermia. The in-field, portable warmers are complex instruments that are dependent on access to electricity (battery or grid).MaxQ and USAISR in a collaborative effort developed a non-battery powered portable bulk warming and in-line warming devices (MaxExoTM) for warming freeze-dried plasma (FDP) at the point of injury for treating casualties to extend the æGolden WindowÆ. The device uses chemically activated heating element along with phase change chemical layer resulting in an in-situ thermoregulation system (iTS) that can provide necessary thermal energy to warm blood components from room temperature to prerequisite transfusion safe temperature. MaxQ has completed proof of concept (breadboard prototype) validation in lab and relevant environments receiving critical end user feedback from experienced combat medics at USAISR. In this proposed work, MaxQ aims to improve performance of MaxExo warmer based on feedback from the field tests by combining bulk warming for an initial period followed by warming of the transfusion line to reduce the overall warming time to less than 6 minutes. The proposed solution will be a non-battery powered, compact, high flow rate and versatile blood and fluid warmer for pre-hospital transfusion.