A Laboratory Evaluation of the Level 1 Rapid Infuser (H1025) and the Belmont Instrument Fluid Management System (FMS 2000) for Rapid Transfusion

Abstract

In this investigation I compared the heating capabilities, infusion rates, and air management system of the new FMS 2000 and the Level 1 infusion systems. A rollerhead pump was placed at the position of the IV bag spikes on the Level 1 disposable set and used to match the flow of the rollerhead pump of the FMS 2000. Infusate temperature was measured at 250 and 500 mL/min by using packed red blood cells (PRBC) at the infusate supply and distal end of the disposable tubing. Tubing lengths were equal for both systems. Devices were set at maximum flow while temperatures were measured as described previously. Flow was measured with a graduated cylinder and stopwatch. Air management was evaluated with a 10-mL air bolus injected proximal to the heat exchanger at maximum flow. Air passing through the system was collected and measured. At 250 mL/min, both devices provided infusate at >or=37 degrees C. At 500 mL/min, only the FMS 2000 provided PRBC at >or=37 degrees C. PRBC infusate temperature decreased over time with the Level 1 device. The FMS 2000 delivered PRBC at its maximum flow rate of 500 mL/min. The Level 1 attained a maximum flow of 575 mL/min of PRBC with a temperature of 32 degrees C. Air (10 mL) was recovered from the distal tubing of the Level 1. No air was recovered from the tubing of the FMS 2000. In this laboratory investigation, the FMS 2000 performance was superior with respect to providing PRBC at physiologic temperatures (at 500 mL/min) and with respect to air detection and elimination compared with current widely used pressure-infuser technology. The FMS 2000 and Level 1 H1025 warming capabilities were similar at metered flows of 500 mL/min. At more rapid flow rates, which are achieved by the H1025, fluid warming decreases dramatically. The air-detection and -elimination system of the FMS 2000 is superior to that of the H1025.