3M: Maintaining normothermia - Key to optimal patient blood management

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Australia has one of the safest blood supplies in the world. However, the transfusion of blood and blood products is not without risk and can lead to complications and adverse outcomes for patients. The NSQHS in Standard 7 recognises the importance of managing blood and blood products, specifically the process used to deliver blood or blood products to achieve positive patient outcomes.ⁱ

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The benchmark in patient blood management
Integral to health care organisations complying with the Standard are Australia’s National Blood Authority (NBA) Patient Blood Management Guidelines. ⁱⁱ
Patient Blood Management is recognised as improving patient outcomes by improving a patient’s medical and surgical management. A key recommendation of the NBA, in a series of evidence-based guidelines, is the importance of maintaining normothermia to achieve optimal patient outcomes.
Meta-analyses undertaken by the NBA indicates that use of hypothermia prevention strategies, which include forced air patient warming and fluid warming, result in significant reductions in transfusion incidence (22%) and blood loss (14%).
These findings led the NBA to make a Grade A recommendation that ‘In patients undergoing surgery, measures to prevent hypothermia should be used’. The NBA also recognises that in most situations maintaining normothermia also reduces the incidence of wound infection.
Maintaining normothermia and the adjunct role of blood warming
During the perioperative journey of a surgical patient, there are key actions that in combination, can positively impact patient outcomes.
Forced-air warming pre, intra and postoperatively is widely accepted as the way to reduce risk of hypothermia in patients. In patients requiring a transfusion however, it is the combination of forced-air warming and blood warming that enables normal intraoperative core temperatures to be maintained. ⁱⁱⁱ
Even where patient warming is utilised, not warming fluids prior to transfusion will lower patient temperatures and increase the risk of hypothermia - each litre of fluid infused at ambient temperature (or blood at 4°C) can decrease the mean body temperature by about 0.25°C. ^iv
Blood warming guidelines
To reduce risk of contamination associated with fluid and blood warming techniques, Australian guidelines for the Administration of Blood products stipulate use of dry heat blood warming equipment, such as the 3M™ Ranger™ Blood and Fluid Warming System.
The Ranger™ Blood and Fluid Warming System is integral to 3M’s offering, supporting health care organisations to improve patient outcomes through meeting NSQHS Standards.
All Australian hospitals and day procedure services must now comply with new National Safety and Quality Health Service Standards. These 10 mandatory Standards were developed by the Australian Commission on Safety and Quality in Health Care (NSQHS) and their outcome will have an effect on each health care organisation’s accreditation.
One of the Standards developed by the Commission is specific to Blood and Blood Products. The aim of Standard 7 is to ensure safe, appropriate, effective and efficient blood management systems are in place.
References
i Australian Commission on Safety and Quality in Health Care (ACSQHC) (September 2011), National Safety and Quality Health Service Standards
ii The National Blood Authority’s Patient Blood Management Guideline: Module 2 – Perioperative
iii Sessler DI. Current concepts: Mild Perioperative Hypothermia. New Engl J Med. 1997;336(24):1730-1737
iv Sessler DI. Consequences and treatment of perioperative hypothermia. Anesth Clin N Am. 1994. 12(3):425-426
v Guidelines for the Administration of Blood Products, 2nd edition, 2011, Australian and New Zealand Society of Blood Transfusion Ltd and Royal College of Nursing Australia.
3M™ Ranger™ Blood/Fluid Warming System with Smartheat Technology
For more information about the 3M™ Ranger™ Blood and Fluid Warming and Bair Hugger™ patient warming please contact your 3M Sales Representative or call 3M Customer Service on 1300 363 878.