Rapid Fluid and Blood Delivery Systems

Definition

Rapid fluid and blood delivery (RFBD) devices are used when IV fluid or blood must be delivered at rates greater than those attainable with free-flow or IV pressure bag devices. Contemporary RFBD devices allow for flows of 1000 mL/min, with the ability to “dial in” flow rates. In addition to high flow, they allow one to select or set the temperature of the infusate.

High flows are provided by pressure. RFBD pressurization can be achieved by two methods: external pneumatic pressurization and occlusive roller pumps. Heating is provided by either water bath conduction heat exchange or a magnetic induction heater.

In addition to delivering high-volume flow rates and heating the fluids, RFBD devices must be able to detect or vent air. Air traps are able to extract small volumes of entrained air, but larger volumes may exceed the capacity of the trap. Many commercially available RFBD devices include safety mechanisms to prevent delivery of air to the patient by shutting off flow if air is detected.

Potential complications associated with the use or malfunction of RFBD devices include the following:

• Air embolism

• Hypervolemia or overtransfusion (transfusion-associated circulatory overload)

• Overheating of fluids

• Hypothermia

• Hemolysis

• Electrical shock