Session: IMECE Undergraduate Research and Design Exposition

Paper Number: 111927

111927 - Fresh Whole Blood Transfusion in Austere Environments - Warming Devices 

For many of the United States military conflicts from World War II through the wars in Iraq and Afghanistan, blood component therapy has been used in the treatment of trauma patients in combat environments. In component therapy, fresh whole blood is separated into plasma, red blood cells, platelets, and cryoprecipitate. Studies resulting from the sporadic use of fresh whole blood transfusion in the wars in Iraq and Afghanistan demonstrated the increased survival rate associated with fresh whole blood transfusion when compared to component therapy [1]. Nowadays, the use of whole blood transfusion kits for prehospital treatment is commonplace in austere environments. However, in a recent unrelated study conducted in low-temperature, high-altitude conditions, researchers at the Naval Health Research Center (NHRC) noted severe performance degradation of an existing field-grade fresh whole-blood transfusion kit. Some of the issues reported were equipment breakage, freezing of components, and reduction in flow rates through the tubing. A research study at the United States Military Academy focuses on understanding the underlying physics behind these issues in austere environments, determining when and where these difficulties arise, and suggesting potential improvements to the kit. As part of that study, this work specifically focuses on the effects of temperature on blood flow through the transfusion kit. At low temperatures, blood viscosity increases and this leads to a decrease in blood flow rate through the transfusion kit. Further, earlier studies have shown that blood used for transfusions must be warmed to 37°C, normal body temperature, or warmer in situations where the patient is already hypothermic [2]. The current blood transfusion kit used in the field lacks the capability to prevent adverse effects of temperature. Some means to combat low ambient temperature effects are portable blood-warming devices and insulation of the intravenous (IV) tubing. This work will initially examine the performance of the existing transfusion kit at various temperatures and subsequently investigate the efficacy of using blood-warming devices and/or insulation to improve the low-temperature performance of the kit.  Analyzing the physical mechanisms of the transfusion kit in an austere environment with and without the integration of such measures will not only provide a better understanding of blood-like fluid behavior at variable temperatures but may also save lives. 

References

1.       Spinella, P. C., Perkins, J. G., Grathwohl, K. W., Beekley, A. C., & Holcomb, J. B. (2009). “Warm fresh whole blood is independently associated with improved survival for patients with combat-related traumatic injuries”. The Journal of trauma, 66(4 Suppl), S69–S76. https://doi.org/10.1097/TA.0b013e31819d85fb 

2.       Blakeman, Fowler, J., Branson, R., Petro, M., & Rodriquez, D. (2021). “Performance characteristics of fluid warming technology in austere environments”. Journal of Special Operations Medicine, 21(1), 18–24. https://doi.org/10.55460/0C2R-LNPH

Presenting Author: Drew Homan U.S. Military Academy

Presenting Author Biography: Drew Homan is a first-year cadet at the United States Military Academy, where he is pursuing a degree in Mechanical Engineering. He is involved with research in the Civil and Mechanical Engineering Department at the United States Military Academy, studying blood transfusion in austere environments alongside three instructors and two other cadets within the department. Drew is focusing on how blood warming devices can be implemented into fresh whole blood transfusion sets to mitigate the effects of low temperature on the sets’ function. His involvement in this research project is motivated by his interest in fluid mechanics and desire to save service members’ lives. Drew plans on being involved in research for the remainder of his time at the United States Military Academy before pursuing a graduate degree to further his knowledge in mechanical engineering.

Authors:

Andrea Riddle U.S. Military Academy
Drew Homan U.S. Military Academy
Ludvig Emerick U.S. Military Academy
Emine Foust U.S. Military Academy
Andrew Banko U.S. Military Academy
Rakesh Dubey U.S. Military Academy