High Performance Blood Warmers

​There are numerous blood warmers available.  However, most are limited to low or moderate flow rates and warming capacity.  For routine surgical cases they are adequate.

High performance blood warmers are needed for surgical cases in which rapid blood or fluid replacement is critical. For this discussion, we define "high performance" as having four specific performance characteristics:

  1. Ability to deliver blood or crystalloid fluid warmed to >35°C at 500ml/min when the inlet fluid temperature is 10°C
  2. Capable of removing air from warmed fluid to prevent gas embolism (e.g. by use of hydrophobic membrane)
  3. Able to sense air in system if air removal ability (of 2 above) is overwhelmed, and
  4. To respond to air in system by stopping flow (e.g. by solenoid pinch valve) and sounding alarm until problem is remedied.



Only three currently marketed devices meet the "high performance" criteria listed above.

The MMED High Performance Blood Warmer will be the fourth such device, and can feature much lower costs of both the device and disposables.

​
1. 
Smiths Medical Level 1® Fast Flow 1200
This is a device that has been around for some time, employing a heated water reservoir warming blood by pumping 42°C heated water through a counter-flow heat exchanger. It has a limited gas removal capacity (a small area hydrophobic membrane) but does detect air and stops flow to prevent air from reaching the patient. It also includes two pressure infusers. One report noted that at high flow rates, outlet temperature decreases with time.

This blood warmer is quite expensive—about $8,000. Disposables are also costly, in the $50-100 range.


View Level 1® H-1200 Fast Flow Fluid Warmer.
2. 
Belmont® FMS 2000
Belmont Instrument Corp., Billerica, MA
This is a fluid warmer which warms the fluid by electromagnetic induction as it passes through a special disposable. It differs from other blood warmers also in using a computer-controlled, semi-occlusive roller pump to control flow rate (bag pressurizers not needed). Also, it has 2 air detectors, and stops flow if air in line is detected.

The Belmont® FMS 2000 is also very expensive—about $18,000. Its disposables are expensive, approaching $100 or more.


View Belmont® FMS 2000, 
Disposable (p.16), and Brochure.
3. 
Smisson-Cartledge ThermaCor® 1200
A third "high performance blood warmer"—the Smisson-Cartledge ThermaCor® 1200—​purports to warm over 500 ml/min to a temperature change of 35°C. Thus, if input temperature is 10°C, it should be able to warm 500 ml/min to 45°C. Heater power is unspecified, but to deliver a 35°C temperature rise 1250w (delivered to fluid) would be required.

It does claim to remove air from line, and employs a computer-controlled pump to control flow (no pressurizer needed).

The ThermaCor® 1200 is very expensive—$39,000.

The disposable cassette looks very complicated, and its price of $225 or more reflects that complication. Priming volume for the cassette is listed as ​< 200ml (quite high).


View Smisson-Cartledge ThermaCor® 1200.