US3590215A - Clinical fluid warmer - Google Patents

Clinical fluid warmer Download PDF

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Publication number
US3590215A
US3590215A US810976A US3590215DA US3590215A US 3590215 A US3590215 A US 3590215A US 810976 A US810976 A US 810976A US 3590215D A US3590215D A US 3590215DA US 3590215 A US3590215 A US 3590215A
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United States
Prior art keywords
sac
heating element
heater
heater plates
plate
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Expired - Lifetime
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US810976A
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English (en)
Inventor
Cleophas E Anderson
Darrle D Moore
William J Walsh
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Manufacturers Hanover Trust Co
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THERMOLYNE CORP
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Assigned to MANUFACTURERS HANOVER TRUST COMPANY reassignment MANUFACTURERS HANOVER TRUST COMPANY ASSIGNMENT OF ASSIGNORS INTEREST. Assignors: BARNSTEAD COMPANY, BOTHNIA HOLDINGS, INC., ERIE SCIENTIFIC COMPANY, KERR MANUFACTURING COMPANY, MEXOSERV COMPANY, NALGE COMPANY, ORMCO CORPORATION, SAC/BARNSTEAD, INC., SAC/CK, INC., SAC/ERIE, INC., SAC/KERR, INC., SAC/NALGE, INC., SAC/ORMCO, INC., SAC/RESIDUAL, INC., SAC/THERMO-BARN, INC., SAC/THERMOLYNE, INC., THERMOLYNE CORPORATION, THERMOLYNE HOLDINGS, INC.
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/44Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests having means for cooling or heating the devices or media
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/36General characteristics of the apparatus related to heating or cooling
    • A61M2205/3653General characteristics of the apparatus related to heating or cooling by Joule effect, i.e. electric resistance

Definitions

  • a dry heat clinical blood warmer comprising first and second heater plates, pivotally mounted relative to each other; a thin, flat, channeled sac, having an inlet and an outlet spaced from each other, is mounted between the plates, the sac contacting both plates when the plates are closed.
  • the electrical heater elements for the plates are effectively tapered, by positioning or by power relationships, from inlet end to outlet end, in proportion to the diminishing rate of heat absorption of blood or other fluid flowing through the sac.
  • Continuous blood heating devices have been proposed, using a liquid heating bath and a heat transfer coil immersed in the bath, the blood being heated by passage through the coil.
  • Devices of this kind tend to produce substantial overheating or underheating of the blood depending upon the rate of flow of the blood.
  • a blood warmer should be able to supply blood for use in a quite restricted temperature range despite large variations in flow rate.
  • the blood warmer of the aforesaid Pins U.S. Pat. No. 3,475,590 affords a controlled temperature output for the blood over a practical range of flow rates from to 150 cubic centimeters per minute. That is, the Pins blood warmer assures a supply of blood at a temperature within an acceptable rang for transfusion purposes, starting with blood refrigerated to 4 C. or even lower, even though the flow rate may be changed from a maximum of 150 cc. per minute to a complete stop at any time during the transfusion procedure.
  • the Pins device does present some difficulties with respect of cleaning and accessibility and is susceptible of some improvement with respect to the precise control of the blood temperature.
  • Another object of the invention is to provide a new and improved dry heat clinical blood warmer which is readily and conveniently cleaned, even in those instances in which an accident may occur and some spillage of blood or other transfusion fluid may take place.
  • Another principal object of the invention is to afford a new an improved dry heat clinical blood warmer in which thermal control is made more effective by precise proportioning of the electrical heater elements in accordance with the diminishing rate of heat absorption of the blood or other fluid flowing through the heater.
  • the invention relates to a dry heat clinical fluid warmer for use in warming refrigerated blood and other fluids to a safe, usable transfusion temperature, at any flow rate from zero to a given maximum rate.
  • the warmer of the invention comprises first and second thermally conductive heater plates and means for mounting those plates for pivotal movement between a closed position in which the plates are in closely spaced parallel relation and an open position in which the plates are rather widely spaced from each other.
  • the warmer further comprises support means for removably supporting a thin, flat, channelled fluid-conducting sac on one of e heater plates, the sac having inlet and outlet openings at opposite ends thereof. When the heater plates are in closed position and the sac is filled with fluid, the opposed sides of the sac contact the first and second heater plates, respectively.
  • First and second heating elements are provided for the first and second heater plates, respectively.
  • Each heating element is tapered from the inlet end to the outlet end so that the heat output diminishes in proportion to the diminishing rate of heat absorption of fluid moving from the sac inlet to the sac outlet.
  • Precision thermal control means are provided for controlling the operation of the heating elements in accordance with the temperature of one of the heater plates.
  • FIG. 1 is a front perspective view of a clinical fluid warmer constructed in accordance with one embodiment of the present invention
  • FIG. 2 is a detail sectional view of a part of the fluid warmer of FIG. 1 illustrating the engagement of the heater plates with the sac that carries fluid through the warmer;
  • FIG. 3 is a perspective view of the clinical fluid warmer of FIG. 1 with the door nearly closed and with a door cover removed to show the thermostatic controls;
  • FIG. 4 is a schematic diagram of the heating elements and electrical controls for the clinical fluid warmer of FIGS. 1-3;
  • FIG. 5 is a schematic illustration of the heating elements for a different embodiment of the invention.
  • FIGS. 1-4 illustrate a dry heat clinical fluid warmer 10, for use in warming refrigerated blood and other fluids to a safe usable transfusion temperature, constituting a first embodiment of the present invention.
  • the clinical fluid warmer 10 comprises a base 11 and an upwardly extending stationary frame 12.
  • Base 11 projects forwardly of the frame 12 and, at the upper end of 'the frame, there is a forwardly projecting housing 13.
  • a first thermally conductive heater plate 21 is fixedly mounted on frame 12. Heater plate 21 is formed in two sections, a lower section 21A and an upper section 21B. A second thermally conductive heater plate 22 is included in fluid warmer 10. Like heater plate 21, plate 22 is constructed in two sections, a lower section 22A and an upper section 22B. Heater plate 22 is mounted upon door 14 that is pivotally mounted upon the base and frame 11-13 of the fluid warmer device. Thus, heater plates 211 and 22 are pivotally movable, relative to each other, between an open position (FIG. 1) and a closed position; in the closed position the two heater plates are disposed in closely spaced parallel relation to each other (FIG. 2).
  • Warmer 10 further comprises support means for removably supporting a thin, flat channelled fluid-conducting sac 16 in predetermined position upon heater plat 21.
  • This support means comprises four pins 15A, 15B, 15C and 15D mounted on frame 12 and positioned to project through four corresponding apertures in sac 16. Pins 15A-15D are aligned with four corresponding apertures 17A-17D in heater plate 22.
  • the support means for the fluid-conducting sac 16 further comprises individual slots 18A and 188 in heater plates 21A and 22A, respectively, for receiving an inlet opening tube 18 that is a part of sac 16. Corresponding slots 19A and 1913 in heater plate sections 2113 and 22B, respectively, receive the outlet tube 19 of the sac.
  • heater plate 22 is disposed at a relatively wide angle with respect to heater plate 21. Complete accessibility is thus provided for mounting or demounting the plastic fluid-conducting sac 16 in device 10.'But when door 14 is closed, the two heater plates 21 and 22 are disposed in closely aligned parallel spaced relation to each other, as shown by the detail sectional view of FIG. 2. Thus, when door 14 is closed and the heater plates are in their closed positions, relative to each other, the opposite sides of the channelled sac 16 contact heater plates 21 and 22 respectively. This provides for a rapid and efficient heat transfer from the heater plates to the fluid in sac 16.
  • Heater plates 21 and 22 are each provided with electrical heating elements.
  • the positioning and alignment of the heating elements for warmer 10, in relation to the heater plates, is best illustrated in FIG. 4.
  • heater plate sections 21A and 21B are provided with individual electrical resistance heaters 25A and 25B, respectively.
  • the heating elements 25A and 25B are each effectively tapered from the bottom of the heating element to the top of the heating element so that the heat output diminishes in an upward direction across the face of heater plate 21.
  • the heating elements are effectively tapered so that the heat output diminishes gradually from that portion of the heater plate that is adjacent to the inlet end 18 of the sac 16 to the outlet end 19 of the sac, in proportioned to the diminishing rate of heat absorption of fluid moving through the sac from its inlet to its outlet.
  • the flood or other lid gradually increases in temperature as it traverses the sac from the bottom inlet 18 to the top outlet 19.
  • the rate of heat absorption of the fluid is proportional to the temperature differential between the blood and the heater plates 21, 22.
  • the heater plates are of high thermal conductivity (relatively heavy cast aluminum is preferred) and hence generally uniform in temperature. Consequently, the fluid absorbs less heat near the outlet end of the sac 16 than near the inlet end because the temperature difference is much smaller at the outlet end of the sac.
  • first or lower horizontal segment 25A1 of heating element 25A is centered in a relatively small area A1 of heater plate section 21A. Note that this area A1 is aligned with the inlet 18.
  • the next horizontal segment 25A2 of the same heating element is centered in a somewhat wider segmental area A2 of the heater plate.
  • the next segmental area, in which the heating element segment 25A3 is centered is still wider, and the widest of the segmental areas of the heater plate 25A is the uppermost area A4 containing the last heating element segment 25A4.
  • the same distribution pattern is utilized for each of the heating element sections 25B, 26A and 2613.
  • the electrical control for device is shown in FIGS. 3 and 4. It comprises four thermostats 31, 32 33 and 34 mounted in cover 14 on the rear surfaces of heater plate 21, as shown in FIG. 3.
  • Thermostat 31 is a principal control thermostat for the electrical heating elements A and 26A.
  • Thermostat 33 is a main control thermostat for the heating elements 258 and 26B.
  • Thermostats 32 and 34 are limiting thermostats for controlling an alarm system.
  • heating element section 25B is connected across to the corresponding heating element section 2.68 in the other heater plate and the latter is returned to the other line terminal 42.
  • the control circuit for the lower heating element sections 25A and 26A is similar but is made specifically different to handle higher currents.
  • the energizing circuit for heating element sections 25A and 26A beginning at line terminal 41, again extends through the two series-connected therelements of device 10 are energized for a conventional AC supply having terminals 41 and 42.
  • One line terminal 41 is mostats 32 and 34.
  • the circuit extends to the input electrode of a triac 36, the output electrode of the triac being connected to heating element section 25A, which is connected in series with heating element section 26A back to line terminal 42.
  • the control thermostat at 31 is connected, in series with a current-limiting resistor 37, between the input electrode of triac 36 and the gate electrode of the triac.
  • thermostat 33 which is mounted on the upper heated plate section 21B (FIG. 3) directly controls the energization and deenergization of the two series-connected upper heating element sections 258 and 26B.
  • Thermostat 34 is also mounted upon the upper heater plate section 218, but does not serve a primary control function for the upper heating elements. It serves only as an limit control to actuate an alarm 38 in the event of some failure on the part of thermostat 33 or some other malfunction of the warmer that leads to substantial overheating of the plate section 218.
  • thermostat 32 does not perform a major control function with respect to either heating element section 25A or section 26A, although it is mounted on heater plate section 21A.
  • thermostat 32 is set for a temperature slightly above the desired operating temperature for the heater plated and functions only in the event that the main control for heating element sections 25A and 26A 31 and triac 36) fails to perform properly.
  • the alarm 38 which may comprise an audible, visual or other type of alarm, is connected in parallel with thermostats 32 and 34. The alarm being normally shunted by the two thermostats, does not operate unless one of the two thermostats is heated beyond its setting, opening and allowing energization of the alarm.
  • warmer 10 provides two pairs of heater plate sections, each controlled by a single thermostat mounted don one of the plate sections.
  • the input to the entire heating surface of each pair of heater plate sections is controlled in accordance with the conditions of thermal equilibrium at only one point. If the heat supply preceeds or falls below the rate of heat absorption at some other point, on either pair of heater plate sections, an undesirable temperature variation can result.
  • the design of the heating elements cannot be optimized for more than one flow rate unless the heater plates are subdivided into minute incremental areas, each with its own heating element and control. But good results can be obtained with two equalized heating areas, separately controlled as in device 10. That is, the heating elementsof the two sections of the heater plated can be so proportioned that the heat supply equal the heat demand over each area at some maximum rate of flow.
  • a maximum flow rate is selected as the control criterion because the danger of shock to a patient, from blood transfused below body temperature, increases as the flow rate increases and because the temperature increase in the fluid processed by the warmer decreases as the flow rate increases. That is, by optimizing the tapering of the heating elements for the maximum permissible flow rate of the fluid warmer, the temperature increase in the blood at that rate is placed under maximum control.
  • the eat differential in warmer 10, in any comparable heat exchanger in which a liquid medium is heated in a thin thermally conductive bag sandwiched between relatively closely spaced heating plates, the eat differential can be represented by the relationship:
  • the total surface are of sac 16 is 400 sq. cm. and that the effective sac area is a total of 200 sq. cm. for each of the heater plates, the reduction being due to the channelled construction of the sac (see FIG. 2).
  • the thermal conductivity may be taken as 0.00035
  • the thickness of the sac may be assumed to be 0.0254 cm.
  • the maximum rate of flow may be taken as 150 cc. per minute 2.5 cc. per second.
  • the temperature rise T for the lower heater plate sections 21A and 22A is 22 C.
  • T' fluid temperature rise per segment A,...A, segment areas, inlet end to outlet end.
  • heating element 25B is not the same as heating element 25A because it is required to produce only one-third of the heat output of heating element 25A. That is, heating element 258 contributes only one-third of the total temperature rise that is contributed by heating element 25A.
  • heater plate section ZllA into the four segmental areas Al through Ad is a matter of practical design considerations and is not critical to the present invention. That is, the total number of transverse legs or segments to the heating element section 25A can be varied. For example, in a given construction it may be desirable to use six transverse segments or legs for the heater element, which would produce six segmental areas of progressively increasing size, form bottom to top of the heater plate section. Calculated as described above, the segmental areas would be as follows:
  • the fluid warmer to the invention is highly convenient and accessible in use. it requires but a moment to open door 14, to
  • the fluid warmer presents no sanitation problem, an im portant consideration in emergency room and like applications.
  • a dry heat clinical fluid warmer for use in warming refrigerated blood and other fluids to a safe usable transfusion temperature, at any flow rate from zero to a given maximum rate, comprising:
  • mounting means mounting said first and second heater plates for pivotal movement, relative to each other, between a closed position in which said heater plates are disposed in closely spaced parallel relation to each other and an openposition in which said heater plates are disposed at a relatively wide angle to each other;
  • a thin, flat, disposable fluid sac having inlet and outlet openings at opposite ends thereof;
  • support means for removgbly supporting said sac in predetermined position on one of said heater plates, when the heater plates are in open position, opposite sides of said sac contacting said first and second heater plates, respectively, when said heater plates are in closed position and said sac is filled with fluid;
  • each of said heating elements being effectively tapered from the end thereof adjacent the sac inlet to the end adjacent the sac outlet so that the heat output of said heating elements gradually diminishes form the inlet end of said sac to the outlet end thereof in direct proportion to the diminishing rate of heat absorption by fluid moving from the sac inlet to the sac outlet, each heating element comprising at least two sections, arranged in sequence between the sac inlet and the sac outlet;
  • precision thermal control means thermally connected to at least one of said heater plates and electrically connected to said heating elements, for controlling operation of said heating elements in accordance with the temperature of said heater plate, said control means including separate thermostats for controlling the respective sections of each heating element.
  • a dry heat clinical fluid warmer according to claim 1 in which said mounting means mounts said heater plates in vertical alignment with one of said heater plates pivotally movable about a vertical axis, in which the sections of each heating element are mounted one above the other, and in which the sac inlet is located at the bottom of the heater plates and the sac outlet is located at the top of the heater plate.
  • each of said heating elements comprises a series of n transverse segments each centered in a segmental area of its associated plate, from the sac inlet end of the plate to the sac outlet end, said segmental areas of said plates being determined in accordance with the series relationship:
  • I A first segmental plate area,,at inlet end A, second segmental plate area A, last segmental plate area, at outlet end T fluid temperature rise per segment all expressed in the c.g.s. system.
  • a dry heat clinical fluid warmer in which said mounting means mounts said heater plates in vertical alignment, in which each electrical heating element comprises two sections, one above the other, with each heating element section distributed in accordance with said series relationship, and in which said precision thermal control means includes a first main thermostat for control of both of the lower heat element sections and a second main thermostat for control of both of the upper heating element sections.
  • a dry heat clinical fluid warmer in which said mounting means mounts said heater plates in vertical alignment, in which each electrical heating element comprises tow sections, one above the other, with each heating element section distributed in accordance with said series relationships, and in which said precision thermal control means includes a first main thermostat for control of both of the lower heating element sections and a second main thermostat for control of both of the upper heating element sections.

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  • Health & Medical Sciences (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • External Artificial Organs (AREA)
US810976A 1969-03-27 1969-03-27 Clinical fluid warmer Expired - Lifetime US3590215A (en)

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US81097669A 1969-03-27 1969-03-27

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DE (1) DE1954019A1 (fr)
FR (1) FR2035926A1 (fr)
GB (1) GB1276575A (fr)

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FR2035926A1 (fr) 1970-12-24
GB1276575A (en) 1972-06-01

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