Warrior & Warrior AC VS Competing Hospital Warming Solutions
| Warrior AC | Warrior | buddy lite AC™ | enFlow™ | Hotline® | Ranger® | |
|---|---|---|---|---|---|---|
| Max Delivery Rate at 4°C input [1] | 290 ml/min | 200 ml/min [2] | 50 ml/min at 10°C per user manual. See conflicting data in note [3] | <100 ml/min per independent study. See note [4] | 83 ml/min (5 liter/hour) | - Pediatric: 100 ml/min - Standard: 150 ml/min - High Flow: TBD (contact manufacturer) |
| Max Delivery Rate at 20°C input [1] | 500 ml/min | 290 ml/min | 80 ml/min per user manual. See note [3] | <200 ml/min per independent study. See note [4] | 83 ml/min (5 liter/hour) | - Pediatric: TBD (contact manufacturer) - Standard: TBD (contact manufacturer) - High Flow: 500 ml/min |
| Warming Speed | Within seconds | Within seconds | Per manufacturer, "within seconds". See conflicting data in note [3] | 30 - 60 seconds | 4 minutes | 2 minutes |
| Warming with Intense Push/Pull Resuscitation Techniques [5] | Performance validated | Performance validated | See note [6] | See note [7] | See note [8] | See note [9] |
| Priming Volume | 19 ml | 19 ml | 7.5 ml [10] | 4 ml [11] | 20 ml | - Pediatric: 20 ml - Standard: 39-44 ml - High Flow: 150 ml |
| Location of Warming Element vis-a-vis Patient [12] | Close to patient | Close to patient | Close to patient | Close to patient | Closest to patient | Remote from patient [13] |
| Set Temperature | 38°C, with tolerances | 38°C, with tolerances | 38°C, with tolerances | 40°C, with tolerances | 37°C, with tolerances | 41°C, with tolerances [13] |
| The Disposable Unit Can Be Easily Disconnected from One Device and Reconnected to the Next Device [14] | Yes, within seconds | Yes, within seconds | N/A | N/A | N/A | N/A |
| Number of Administration Sets | 1 | 1 | 1 | 1 | 1 | 3 |
| Battery Option | Yes | (N/A; battery operated) | Yes | No | No | No |
| Aluminum Free | Yes | Yes | Yes | Warming element contains aluminum [15] | Yes | Yes |
| Dry / Wet Warming Technology | Dry warming technology | Dry warming technology | Dry warming technology | Dry warming technology | Wet warming technology | Dry warming technology |
| Service Requirements | Inspection in 5 years | Inspection in 5 years | TBD (contact manufacturer for details) | Yearly inspection | Monthly / yearly disinfection | Twice a year |
| Disposable Price | $60 ($15-30 coming soon) [16] | $60 ($15-30 coming soon) [16] | $15-30 [17] | $15-30 [17] | $15-30 [17] | $15-64 [18] |
Notes:
[1] The term “Max Delivery Rate” means “the maximum flow rate in which target temperature – typically 38°C — will be reached”.
[2] “At an input temperature of 20°C and a flow rate of 50 mL/min, the Warrior warmed over 3.5 L to an average temperature of 37.8°C. Flow rates of 100 and 200 mL/min increased total heated volume with small effect on the output temperature (4.3 and 4.8 L at 37.1°C and 36.1°C, respectively). This behaviour persists at an input temperature of 10°C—warming 2.6, 2.9 and 3.3 L to 36.9°C, 35.9°C and 34.4°C at flow rates of 50, 100 and 200 mL/min, respectively.” (Lehavi A, Yitzhak A, Jarassy R, et al. Emergency Med Journal, doi:10.1136/ emermed-2017-207112).
[3] “At an input temperature of 20°C and flow of 50 mL/min, the Buddy Lite warmed over 3 L to above 35°C, an energy transfer of more than 44 watt hour (Wh). As the flow increased to 100 mL/min, the Buddy Lite warmed intermittently for 30 min before stabilising at a peak temperature of 33°C, heating the first 3 L by only 5°C–8°C, with a maximal temperature exceeding 35°C, achieved after more than 30 min, and lasting for a prolonged period. This translated into low initial energy transfer for the initial 3 L, but equated to heat transfer of greater than 38 Wh when more than 5 L were infused. As flow rate increased to 200 mL/min, the Buddy Lite performance pattern worsened: it consisted of short heating attempts, without stabilising at an appropriate output temperature, providing minimal energy transfer (1.5 Wh). This behaviour persisted at an input temperature of 10°C, regardless of the flow rate. The Buddy Lite was unable to sustain stable, appropriate output temperature and at flow rates of 50, 100 and 200 mL/min it heated fluid by only 1°C–2°C, with minimal heat transfer (6.7, 2.8 and 2.0 Wh, respectively). In this study, this device was only delivering body temperature fluids at 20°C input and 50 ml/min” (Lehavi A, Yitzhak A, Jarassy R, et al. Emergency Med Journal, doi:10.1136/ emermed-2017-207112). Note: the study tested the battery version of the product, not the AC version
[4] “At an input temperature of 20°C and a flow rate of 50 mL/min, the enFlow warmed over 2.4 L to above 36°C before depleting the battery, over 2.8 L at 100 mL/min with minimal decrease in output temperature and over 3.3 L at 200 mL/min with average output temperature of 34.2°C. At an input temperature of 10°C and a flow of 50 mL/min, the enFlow warmed over 1.6 L to above 36°C, with an increase in total heated volume and a substantial decrease in output temperature as the flow rate increased to 100 and 200 mL/min (1.8 and 2.3 L, at 33.7°C and 25.7°C, respectively)”. (Lehavi A, Yitzhak A, Jarassy R, et al. Emergency Med Journal, doi:10.1136/ emermed-2017-207112). Note: the study tested the battery version of the product, not the AC version
[5] E.g. hand pump; LifeFlow-like devices, etc.
[6] Based on manufacturer’s published data, and as reflected in the independent study results mentioned above, warming efficiency may not suffice for very intense bolus flows. Further, the cassette’s resiliency to sustain the extreme pressure that is often generated by intense push-pull resuscitation techniques need to be validated. It is recommended to consult with the manufacturer.
[7] Based on manufacturer’s published data, and as reflected in the independent study results mentioned above, warming efficiency may not suffice for very intense bolus flows. It is recommended to consult with the manufacturer.
[8] Based on manufacturer published data, the device cannot warm blood or near freeze fluids in flow rates exceeding 83ml/min. Therefore, high flows generated by push-pull resuscitation techniques may be difficult for the device to handle. It is recommended to consult with the manufacturer.
[9] The cassette’s resiliency to sustain the extreme pressure that is often generated by intense push-pull resuscitation techniques need to be validated. It is recommended to consult with the manufacturer.
[10] 4ml without tubing, 7.5ml with valves and tubing at the input and output.
[11] Optional IV extension set: 0.5 ml.
[12] The longer the distance, the more likely that fluids will get colder as they travel towards the patient, especially at low flows.
[13] Most probably 41°C output intended to compensate for long distance from the warming element to the patient.
[14] To facilitate warming during interfacility and intra-facility transports.
[15] Product on global recall due to aluminum toxicity concerns.
[16] Rounded price at high volume. Coming soon – lower-cost option ($15-30)
[17] QinFlow’s estimate based on its market research; the stated prices have not been confirmed by the manufacturer
[18] QinFlow’s estimate based on its market research; the highest price is for the high-flow set; the stated prices have not been confirmed by the manufacturer
[1] The term “Max Delivery Rate” means “the maximum flow rate in which target temperature – typically 38°C — will be reached”.
[2] “At an input temperature of 20°C and a flow rate of 50 mL/min, the Warrior warmed over 3.5 L to an average temperature of 37.8°C. Flow rates of 100 and 200 mL/min increased total heated volume with small effect on the output temperature (4.3 and 4.8 L at 37.1°C and 36.1°C, respectively). This behaviour persists at an input temperature of 10°C—warming 2.6, 2.9 and 3.3 L to 36.9°C, 35.9°C and 34.4°C at flow rates of 50, 100 and 200 mL/min, respectively.” (Lehavi A, Yitzhak A, Jarassy R, et al. Emergency Med Journal, doi:10.1136/ emermed-2017-207112).
[3] “At an input temperature of 20°C and flow of 50 mL/min, the Buddy Lite warmed over 3 L to above 35°C, an energy transfer of more than 44 watt hour (Wh). As the flow increased to 100 mL/min, the Buddy Lite warmed intermittently for 30 min before stabilising at a peak temperature of 33°C, heating the first 3 L by only 5°C–8°C, with a maximal temperature exceeding 35°C, achieved after more than 30 min, and lasting for a prolonged period. This translated into low initial energy transfer for the initial 3 L, but equated to heat transfer of greater than 38 Wh when more than 5 L were infused. As flow rate increased to 200 mL/min, the Buddy Lite performance pattern worsened: it consisted of short heating attempts, without stabilising at an appropriate output temperature, providing minimal energy transfer (1.5 Wh). This behaviour persisted at an input temperature of 10°C, regardless of the flow rate. The Buddy Lite was unable to sustain stable, appropriate output temperature and at flow rates of 50, 100 and 200 mL/min it heated fluid by only 1°C–2°C, with minimal heat transfer (6.7, 2.8 and 2.0 Wh, respectively). In this study, this device was only delivering body temperature fluids at 20°C input and 50 ml/min” (Lehavi A, Yitzhak A, Jarassy R, et al. Emergency Med Journal, doi:10.1136/ emermed-2017-207112). Note: the study tested the battery version of the product, not the AC version
[4] “At an input temperature of 20°C and a flow rate of 50 mL/min, the enFlow warmed over 2.4 L to above 36°C before depleting the battery, over 2.8 L at 100 mL/min with minimal decrease in output temperature and over 3.3 L at 200 mL/min with average output temperature of 34.2°C. At an input temperature of 10°C and a flow of 50 mL/min, the enFlow warmed over 1.6 L to above 36°C, with an increase in total heated volume and a substantial decrease in output temperature as the flow rate increased to 100 and 200 mL/min (1.8 and 2.3 L, at 33.7°C and 25.7°C, respectively)”. (Lehavi A, Yitzhak A, Jarassy R, et al. Emergency Med Journal, doi:10.1136/ emermed-2017-207112). Note: the study tested the battery version of the product, not the AC version
[5] E.g. hand pump; LifeFlow-like devices, etc.
[6] Based on manufacturer’s published data, and as reflected in the independent study results mentioned above, warming efficiency may not suffice for very intense bolus flows. Further, the cassette’s resiliency to sustain the extreme pressure that is often generated by intense push-pull resuscitation techniques need to be validated. It is recommended to consult with the manufacturer.
[7] Based on manufacturer’s published data, and as reflected in the independent study results mentioned above, warming efficiency may not suffice for very intense bolus flows. It is recommended to consult with the manufacturer.
[8] Based on manufacturer published data, the device cannot warm blood or near freeze fluids in flow rates exceeding 83ml/min. Therefore, high flows generated by push-pull resuscitation techniques may be difficult for the device to handle. It is recommended to consult with the manufacturer.
[9] The cassette’s resiliency to sustain the extreme pressure that is often generated by intense push-pull resuscitation techniques need to be validated. It is recommended to consult with the manufacturer.
[10] 4ml without tubing, 7.5ml with valves and tubing at the input and output.
[11] Optional IV extension set: 0.5 ml.
[12] The longer the distance, the more likely that fluids will get colder as they travel towards the patient, especially at low flows.
[13] Most probably 41°C output intended to compensate for long distance from the warming element to the patient.
[14] To facilitate warming during interfacility and intra-facility transports.
[15] Product on global recall due to aluminum toxicity concerns.
[16] Rounded price at high volume. Coming soon – lower-cost option ($15-30)
[17] QinFlow’s estimate based on its market research; the stated prices have not been confirmed by the manufacturer
[18] QinFlow’s estimate based on its market research; the highest price is for the high-flow set; the stated prices have not been confirmed by the manufacturer
DISCLAIMERS: The table above compares selected product attributes of several hospital-based blood/IV warmers, including buddy lite™ AC (a registered trademark of Belmont® Medical Technologies), enFlow® (a registered trademark of Vyaire™ Medical), Hotline® (a registered trademark of Smiths Medical, which is part of the global technology business Smiths Group plc), and Ranger™ (a registered trademark of 3M™), with those of the Warrior and Warrior AC configurations (manufactured by Quality In Flow, or QinFlow). Quality in Flow is not affiliated with any of the other manufacturers above. The benchmarking is based on publicly available information and/or the respective device’s Instructions for Use (IFU) / User Manual, where applicable. The IFU / User Manual used for this study many not be the latest version. Further, the IFUs / User Manuals used for this study may be changed by the manufacturers as the products evolve; QinFlow may not know about such updates and in any event does not undertake to update the information in the table upon such changes. Unless stated differently, the benchmark information was commissioned by QinFlow alone and not all data points were independently verified. The manufacturers above were not part of this benchmark study. Use of the Warrior is subject to QinFlow’s terms of use. This benchmark study does not intend to cover all the differences between the devices. QinFlow does not guarantee that any of the devices, including its own, will achieve the results or perform as mentioned in the benchmark study. QinFlow only warrants the information published in its IFUs (performance data points above are in accordance with the CE marks of each Warrior configuration; for FDA-cleared IFU, where applicable, contact QinFlow). Please contact the respective manufacturers for clarifications.
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