Quantitative evaluation of warming and hemodilution as two techniques to increase the flow rate of blood during simulated massive transfusion of packed red blood cells

Massive bleeding is a leading cause of deaths in trauma, surgeries, wartime injuries, and childbirth. In these situations of ongoing blood loss, it is critical for patients to be rapidly resuscitated. Currently, patients who require major transfusions are given cold and concentrated blood from the blood bank. This blood does not flow fast due to its viscosity. Equipment for rapid resuscitation such as rapid transfusers are very costly and are not accessible everywhere. Additionally, specialized training is required to operate these machines. Therefore, it is necessary to determine simple, quick, and effective ways to increase the flow rate of blood. The flow rate can be increased by warming and hemodilution. The purpose of this study was to quantify the effects of these simple and quick methods since they can be implemented anywhere with easily accessible equipment. In this experiment, expired packed red blood cells were warmed and diluted. The time the blood took to flow through the tubing was measured and a flow rate was calculated for each trial. The research hypothesis stated that diluted blood at 39°C would have the fastest flow rate. The research hypothesis was supported and there was a 366% in flow rate by warming and diluting blood. There was a 232% increase by simply diluting the blood and a 170% increase by warming. Six t-tests were conducted for this data and they were all significant at a level of 0.001. These results indicate the significant effects of warming and diluting blood and this research could improve patient care during emergencies and massive blood loss.