Fluido | FAQ
This is a list of Frequently Asked Questions about the Fluido product line. If you need more information, or if you need any other support, please visit our contact page.
1. Why should I consider fluid warming?
One of the contributing factors to unintended hypothermia is the intravenous (IV) delivery of cold fluids. Each liter of IV crystalloid solution administered at room temperature (21ºC) infused into adult patients, or each unit of blood infused at 4°C, decreases the mean temperature approximately 0.25°C.1
A study of Smith et al. has shown that fluid warming improves the likelihood of maintaining normothermia when used in conjunction with convection warming.2
According to Sessler and Kurz in “Mild Perioperative Hypothermia,” patients lose up to 1.5°C during the first hour of anaesthesia and the infusion of 1 liter at room temperature can consume up to 24% of a person’s warming capacity. The same study also infers that it is better to maintain normothermia, rather than try to rewarm a hypothermic patient.
1 Sessler, Daniel I. MD, “Mild Perioperative Hypothermia”, New England Journal of Medicine. 336 (24):1730 1737, June 1997
2 Smith C.E., Desai R., Glorioso V., Cooper A., Pinchak A.C., Hagen K.F., “Preventing hypothermia: convective and intravenous fluid warming versus convective warming alone”, J. Clin Anesth. 1998 Aug; 10 (5):380-5
2. Is it possible to connect a stop-cock or extension line?
Yes, it is possible to connect any stop-cock or extension line you prefer.
3. What evidence exists that Fluido Compact is safe to warm blood?
The Fluido Compact has been tested successfully for hemolysis at the Dutch National Blood Bank Sanquin in Amsterdam. Tests have shown that use of the Fluido Compact does not cause any damage to red blood cells during warming. Reports available upon request.
4. What is the shelf life of the Fluido Compact Standard Set?
The shelf life of the sterile Fluido Compact Standard Set will be 5 years and is indicated on the label of the pouch:
5. For how long can I use the disposable?
The disposable can be used for 24 hours in compliance with local hospital policies.
6. How many sensors does Fluido Compact have and what is the purpose?
The flexible heater of the Warming Module has 11 temperature sensors to control accurate heating. Three fluid sensors are used to control the fluid temperature and seven heater sensors to monitor the condition of the heater. Next to that one temperature sensor to control the housing temperature. All together these temperature sensors enable maximum patient safety and accurate & safe warming for your daily blood and fluid warming.
7. How does the Fluido Compact System protect against overheating?
The embedded software enables maximum patient safety through an independent control system and 11 temperature sensors. If a temperature limit is reached the device stops warming and does not start again until the temperature lowered sufficiently. If the normal control system fails to control the temperature below certain limits the independent safety controller will stop the heating. When the temperature reaches the high temperature limit of 45ºC an audible alarm is given according to ASTM F2172-02 (2011). This makes Fluido Compact unique and very safe against overheating.
8. How should the disposable be placed?
Open the slider of the Warming Module and put the disposable in the Warming Module. The disposable fits in only one way, see below picture:
9. Can I use Fluido pressure chambers in combination with Fluido Compact?
Yes, you can use Fluido Pressure Chambers in combination with Fluido Compact. Pressure shall not exceed 300 mmHg. In case you use a (manually operated) pressure device without a pressure indicator, pressure should not exceed 300 mmHg.
10. How much is the maximum flow rate?
The maximum achievable free flow rate with pressure at 300 mmHg is ≥ 400 ml/min, without a catheter attached. Please note the maximum achievable free flow rate depends on the intravenous catheter size.
11. How does the heat exchange take place at the Warming Module?
The spring in combination with a slider mechanism in the Warming Module provides an optimal heat exchange between the warming interface and the coated aluminum plate of the cassette. The very thin rigid coated aluminum material of the cassette has a low thermal resistance and generates a high heat conductivity.
12. Why is the aluminum cassette parylene coated?
The aluminum plate is parylene coated to be sure the cassette is biocompatible with body fluids.
13. How does Fluido Compact control the temperature?
The flow algorithm calculates the internal environment and uses temperature and flow information from multiple temperature sensors in the heater for controlling the target temperature.
14. How do you recommend positioning Fluido Compact Warming Module?
The Fluido Compact Warming Module can be positioned near the patient by using a clamp. The Warming Module can also be placed in the Warming Module holder that can be mounted to either an IV pole or a bed rail. See the manual for detailed instructions.
15. How long is the limited warranty time?
The limited warranty time is 2 years. For a complete overview of warranty provisions, please refer to the website www.the37company.com
16. What does the ‘Set point indicator’ mean?
The set point indicator indicates if the derived fluid temperature at the outlet of the disposable cassette have reached the target temperature (39 ± 2ºC) or not.
17. What does the ‘Repair required’ LED mean?
When the ‘Repair required’ LED turns continuously yellow, it means:
- the interface cable is not correctly positioned or
- the safety circuit of the device has measured a too high temperature. The 'Overtemperature indicator' LED turns continuously yellow (see question 24) or
- an error is detected. The device cannot be used and needs to be replaced. When the system is warming an audible alarm (repeating beep) is also active.
18. What does the 'Overtemperature indicator' LED mean?
When the 'Overtemperature indicator' LED turns continuously yellow it means that the safety circuit of the device has measured a too high temperature. An audible alarm (repeating beep) is also active. To reset the device, disconnect the power supply cord, wait a few seconds and reconnect the power supply cord.
19. How do I clean the Control Module and Warming Module?
To clean the outer surface of the device, use a soft cloth lightly dampened with a solution of hand warm water and a mild detergent or a non-staining hospital disinfectant. Use one of the following cleaning solutions:
- 90% (or 70%) isopropyl alcohol
- mild detergent solution
- diluted chlorine bleach (30 ml/l water)
- ammonia based cleaners
- glutaraldehyde-based cleaners 2.4% hydrogen peroxide
The Control Module is protected against falling water and classified with IPX1 according to IEC 60529.
The Warming Module is protected against splashing of water and classified with IPX4 according to IEC 60529.
20. What does international guidelines recommend when administrating fluid?
There are a few national and international guidelines for temperature management:
1. In 1998, a guideline appeared that was drawn up by the American Society of PeriAnesthesia Nurses (ASPAN). This guideline, the "Clinical Practice Guideline for the prevention of unplanned peri-operative hypothermia", recommends to administer fluids (intravenous and irrigants) when the patient’s temperature is below 36ºC during the intra- and post-operative phase.3
2. The NICE (National Institute for Health and Clinical Excellence) guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales. These guidelines advices that all administered intravenous fluids (500 ml or more) and blood products should be warmed to at least 37ºC using a fluid warming device.4
3. The S3 Guideline, Avoidance of perioperative hypothermia (Germany, 2014) include the following advice: 5
a. Active warming if anaesthesia duration is longer than 30 minutes
b. Warm patients who are receiving > 500 ml/h of fluid or procedures of an hour or longer
c. Additionally it is also cost efficient to warm intravenous infusions for patients with general or regional anaesthesia, even if only minor operations are involved. This applies even assuming that in smaller operations the rate of accidental perioperative hypothermia is only 50% of the rate in major operations.
3 ASPAN: American Society of PeriAnesthesia Nurses, “Clinical guideline for the prevention of unplanned peri-operative hypothermia”
4 NICE clinical guideline, “Inadvertent perioperative hypothermia, the management of inadvertent perioperative hypothermia in adults”, National Institute for Health and Clinical Excellence, April 2008
5 S3 Guideline, “Avoidance of perioperative hypothermia”, April 2014
21. I want to know more of the benefits maintaining normothermia. Where can I learn more?
To learn more about the clinical value of maintaining normothermia, please refer to Virtual37. This unique simulation tool offers an innovative and easy way to understand the warming balance impact of warming decisions taken in different patients and surgeries.
22. Can I use the same disposable after being used with blood/plasma?
Yes, you can use the same disposable. Once finished giving blood / plasma, please flush the system and continue using the set.
23. How long does the Fluido self test take?
The self test takes 4 seconds to achieve.
24. Where should the Fluido disposable be positioned during the self test?
It should be placed on the table and remain in the packaging.
25. How should the cassette be placed?
To place the cassette, slide it inside the Fluido with the reflecting side towards the logo.
26. How do you remove the cassette from the Fluido?
To remove the cassette from the Fluido, you have to push the eject button.
27. What should be the first step when priming the disposable?
Before priming the disposable, you have to close all clamps.
28. What type of syringe do you need to de-aerate the chamber?
We advice to use a Luer syringe and a Luer Lock syringe to de-aerate the chamber.
29. What are the differences between the Fluido Standard and the Trauma set?
The differences between the Fluido Standard and the Trauma set are the maximum flow range, the Y-administration set and the drugs administration port.
30. What will be displayed when you push the ML button on the Fluido twice?
The display shows the ml/min and litres and will change every 5 seconds.
31. What is the default temperature of the Fluido?
The default temperature of the Fluido is 37° C.
32. With what flow rate at the end of line will the set temperature not be reached?
The set temperature will not be reached at a flow rate below 20 ml/min.
33. What does the Fluido measure to calculate the heat compensation?
To calculate the heat compensation, the Fluido will measure the flow and the temperature of the fluid.
34. How will the total volume be reset?
You can reset the total volume after 1) switching of electricity and starting back up, 2) after 15 minutes in standby or 3) by pressing the ml and – button.
35. What can you use to clean the Fluido?
Wipe down the Fluido with standard cleaning agents: a moist cloth or alcohol tissues.
36. When does the Fluido definitely needs service?
Once a year or after 2000 hours the Fluido needs service.