I have spent some time trying to find the regulations related to blood warming infusion equipment. My biomed department has factory calibration guidelines indicating the blood warmers used at our facility be set to operate at 41.9 degrees C. The warmers are the sort that have the infusion line surrounded by a heated solution to maintain even temperature to the patient infusion connection. My question is the limitations we use when thawing frozen units limit the temperature to 37 C. Allowing the warmer to operate at a higher temperature seems inconsistant with the handling in blood bank. Are their regs detailing temperature limits applied to blood components during infusion? If so someone help me with a reference. Thanks in advance.

I can't help you with a reference . . . my experience has been that that is the norm for warmers. It seems the blood is only heated indirectly by the warming solution. The blood itself does not exceed the allowable temp. These devices are FDA approved for warming components. A good thing to check is to see what components it is approved for. This should be found in the operational directions. If not, the device cannot be used for blood products no matter what the sales rep says. Speaking of devices, it is also interesting to check on what products your infusion pumps are approved for. Many are only approved for red cells, not plasma or plts.

Yes, I agree with David. Even the regs were changed from a specific temp to say something like "a temp that does not cause hemolysis". So make sure it is FDA approved, then look at the insert to see what their running temp is and what they consider "over temp" and make sure your BioMed dept is properly testing it.

I have another question regarding warmer use. A member of anesthesia was at a recent seminar where the recommendation was made to transfuse all blood through a warmer. I guess I could see the reason in the surgical suite where the temperature is kept lower, but for every single transfusion I am not sure this is appropriate. Thoughts and references appreciated.

Denny, ask your anesthesia person for the reference. If this was at a conference, the reference should be readily available. BTW, I have seen literature about using warmers for ALL fluids in surgery--is this what he/she is talking about?