An evaluation of induced failure modes in the belmont® rapid infuser

Richard B. Boyer, Kyle M. Hocking, Garrett S. Booth, James M. Berry, Travis W. Spain, Damon R. Michaels, Warren S. Sandberg, Michael A. Pilla

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Rapid infusers are vital tools during massive hemorrhage and resuscitation. Sporadic reports of overheating and shutdown of the Belmont® Rapid Infuser, a commonly used system, have been attributed to 1-sided clot blockage of the fluid path. We investigated multiple causes of failure of this device. METHODS: Packed red blood cells and thawed fresh frozen plasma with normal saline solution were used as base fluids for serial 10-minute trials using standard disposable sets in 2 Belmont devices. Possible contributors to device failure, including calcium-containing solutions and external leakage currents, were evaluated. Thermographic images of the heater and disposable cartridges were recorded. The effects of complete unilateral clotting were modeled by sealing half of the disposable cartridge with epoxy. RESULTS: Clotting on the surface of the heat exchanger coil increased with calcium concentration and was only observed at calcium concentrations >12.0 mmol/L (P < 0.0001) in a 1:1 plasma:red blood cell mixture, resulting in high-pressure downstream occlusion alarms and interruption of flow. CONCLUSIONS: Clot-based occlusion can be induced in the Belmont Rapid Infuser under unrealistic conditions. In the absence of complete unilateral flow blockage, we did not observe any significant overheating of the infuser under extreme operating conditions.

Original languageEnglish (US)
Pages (from-to)1062-1069
Number of pages8
JournalAnesthesia and Analgesia
Volume122
Issue number4
DOIs
StatePublished - Apr 1 2016

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Equipment Failure
Calcium
Erythrocytes
Sodium Chloride
Resuscitation
Hot Temperature
Hemorrhage
Pressure
Equipment and Supplies

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Boyer, R. B., Hocking, K. M., Booth, G. S., Berry, J. M., Spain, T. W., Michaels, D. R., ... Pilla, M. A. (2016). An evaluation of induced failure modes in the belmont® rapid infuser. Anesthesia and Analgesia, 122(4), 1062-1069. https://doi.org/10.1213/ANE.0000000000001110

An evaluation of induced failure modes in the belmont® rapid infuser. / Boyer, Richard B.; Hocking, Kyle M.; Booth, Garrett S.; Berry, James M.; Spain, Travis W.; Michaels, Damon R.; Sandberg, Warren S.; Pilla, Michael A.

In: Anesthesia and Analgesia, Vol. 122, No. 4, 01.04.2016, p. 1062-1069.

Research output: Contribution to journalArticle

Boyer, RB, Hocking, KM, Booth, GS, Berry, JM, Spain, TW, Michaels, DR, Sandberg, WS & Pilla, MA 2016, 'An evaluation of induced failure modes in the belmont® rapid infuser', Anesthesia and Analgesia, vol. 122, no. 4, pp. 1062-1069. https://doi.org/10.1213/ANE.0000000000001110
Boyer, Richard B. ; Hocking, Kyle M. ; Booth, Garrett S. ; Berry, James M. ; Spain, Travis W. ; Michaels, Damon R. ; Sandberg, Warren S. ; Pilla, Michael A. / An evaluation of induced failure modes in the belmont® rapid infuser. In: Anesthesia and Analgesia. 2016 ; Vol. 122, No. 4. pp. 1062-1069.
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