KYAMBOGO UNIVERSITY

FACULTY OF ENGINEERING

DEPARTMENT OF MECHATRONICS AND BIOMEDICAL

ENGINEERING

DESIGN AND IMPLEMENTATION OF A LOW COST

BLOOD INFUSION WARMER

MAKAFU JOSEPH JAMES

19/U/BIO/178/GV

A PROJECT PROPOSAL SUBMITTED TO KYAMBOGO UNIVERSITY

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
AWARD OF A BACHELORS DEGREE IN MECHATRONICS AND
BIOMEDICAL ENGINEERING

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TABLE OF CONTENTS
BACKGROUND ......................................................................................................................................... 3
PROBLEM STATEMENT............................................................................................................................ 3
OBJECTIVES ............................................................................................................................................. 4
Main objective .................................................................................................................................... 4
Specific objectives ............................................................................................................................... 4
JUSTIFICATION ........................................................................................................................................ 4
SIGNIFICANCE.......................................................................................................................................... 5
SCOPE ...................................................................................................................................................... 5
LITERATURE REVIEW ............................................................................................................................... 6
METHODOLOGY ...................................................................................................................................... 9
The Design........................................................................................................................................... 9
Electrical Circuitry ............................................................................................................................. 10
TOOLS USED .......................................................................................................................................... 11
BUDGET ................................................................................................................................................. 12
TIMELINES ............................................................................................................................................. 12
CONCLUSIONS ....................................................................................................................................... 13
REFERENCES .......................................................................................................................................... 13

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BACKGROUND

Blood is infused into the body through the blood vessels that take blood to the heart. This in
turn causes the blood to circulate throughout the body. Blood is stored in a flexible plastic
container at about 1–5 °C. The normal body temperature is 37 °C and blood is usually required
to be warmed to this temperature or slightly above 37 °C before it is infused into the patient’s
body in order to prevent hypothermia and other related health complications. According to the
world health organisation, 1.7 million deaths occur annually due to hypothermia during blood
transfusions (WHO 2022).

According to a study in the hospitals located in developing regions in Uganda, there are several
methods of warming blood that are used such as putting bags in warm water or leaving the
blood bags under running tap water. These methods are risky, inefficient and time consuming.
There are standard blood warmers available on market but they are very expensive and
unaffordable for the hospitals in the developing regions of Uganda.

Therefore we intend to design and implement a low cost, efficient and safe blood warming
device to address the above problems in hospitals in the developing regions in Uganda.

PROBLEM STATEMENT

In ordinary medical practice, blood, which is stored at a temperatures of 1- 5°C, is required to

be warmed to 37°C before transfusion but this is unaffordable in low income settings where
the local methods of warming blood are used but less effective. Therefore our system is
intended to be of a low cost, portable, easily accessible and effective mechanism of providing
warm blood to patients during blood transfusion in low income setting.

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OBJECTIVES

Main objective

• To Design and implement a Blood infusion warmer for developing regions.

Specific objectives

• To research about the existing blood warmers available on market.

• To design a highly efficient and user friendly device.

• To design a device that is safe for both the user and the environment.

• To design a portable device that occupies little space and it’s easy to move around.

• To ensure the preservation of blood integrity after warming.

• To design an affordable device with low cost of maintenance.

JUSTIFICATION

Blood transfusions often require warmed blood to prevent complications such as hypothermia
in the recipient. A low cost blood infusion warmer can help maintain the appropriate
temperature of the blood ensuring safety during transfusions.

Making blood transfusion warmers more affordable and accessible will improve health care
access in remote and underserved areas this will help save lives by ensuring that the patients in
these areas have access to warm blood transfusions when needed.

The affordable blood infusion warmer will enable the healthcare workers to administer blood
products safely and accurately, which will improve the patient care outcomes.

The manual methods which are used are time consuming, error prone and risky. A low cost
blood infusion device will provide a more reliable and standardized method for administering
blood to a patient which will reduce the likelihood of errors and complications.

In emergency situations the need for blood transfusions is a lot. Having access to a low cost
blood transfusion device will help the healthcare facilities to effectively respond to the
emergencies.

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SIGNIFICANCE

The cost-effectiveness of the blood infusion warmer will be beneficial for healthcare providers,
especially those operating with limited budgets. By reducing the cost of the device, the
healthcare facilities can allocate their resources more efficiently, allowing for increased
availability of critical medical equipment and services.

Blood transfusions are critical medical interventions, and maintaining the appropriate
temperature of the transfused blood is crucial for patient safety and optimal outcomes. The
low-cost blood infusion warmer will ensure that patients receive warmed blood hence reducing
the risk of complications such as hypothermia and improving the success of transfusions.

Healthcare facilities in developing regions will be able to gain access to an essential medical
device at an affordable price. This will improves the overall quality of care in these facilities
will help bridge the healthcare access gap between different regions

The device will have a warming time less than 15 minutes which is shorter compared to the
traditional improvised methods that take 45 minutes or more.

The device will help to avoid possible contamination associated with using water as a warming
medium by using dry heat

The device will have a power protection system that prevents damage to the device in the case
of power surges, which is common in resource-limited settings.

The device will be portable and therefore will occupy little space in a hospital where congestion
is a problem

The device will be easy to use with a short user learning time and this will be through the
simplified interfaces and intuitive controls

SCOPE

• Conducting thorough market research to identify the target audience and understand the
specific needs and requirements. This will include studying existing blood transfusion
device, analyzing healthcare trends and gathering information from the healthcare
professionals and patients.

• Developing a cost effective design for the blood transfusion warmers that meets the
safety, accuracy and compatibility standards. This will involve designing the

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 mechanical, electronic and software components to ensure a seamless and reliable
operation.

• Identifying and selecting the appropriate materials that strike a balance between quality,
performance and cost effectiveness. This will ensure the durability and longevity of the
device while keeping the production costs low.

• Building a prototype of the blood infusion warmer to validate the design and
functionality.

• Conducting various tests to ensure safety accuracy and reliability under various
conditions.

LITERATURE REVIEW

Currently fluid warming for emergency situations in remote locations is being done by a variety
of methods which have limitations and have potential dangers. Using warm water to heat fluid
bags may take too long to succeed in the specified temperature and carries a risk of bacterial
contamination.

The current blood infusion warmers basically use dry heating and water bath methods and these
include:

Reusable silicone ring Nuova Blood Warmers: it is controlled by a microcontroller with low
and high temperature alarms. [1]

Aluminium free and portable Buddy Lite Blood Warmer: it is portable and it used globally
by civilians and military medical personnel to prevent hypothermia during fluid administration.
Allows emergency personnel and fast responder to spend more time attending to the critical
status of the patient instead of focusing on the device and that helps in life saving efforts. [2]

Quantum blood warmers: the system consists of unique thermal administration set that
incorporate sensing elements with an integrated heating system that does not disrupt the fluid
flow. [3]

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 Figure 1: Effect of the surrounding environment over blood bags

One of the critical issues with the current blood infusion techniques is that the blood bag is
directly exposed to the environment during the procedure, resulting in convection heating of
the blood, which causes the temperature of the blood to fall below or increase over the needed
rating. As illustrated, when the ambient temperature is high, it attempts to heat the blood bag,
raising the fluid’s temperature. When the ambient temperature is low, the blood bag is cooled
by extracting its heat, resulting in a temperature drop.

The patient’s body becomes cold during treatment for various causes, including anaesthetic
medications, diabetes, and low blood pressure, among others. The ideal blood temperature of
the human body is 37 °C, and infusion of cold blood can create a temperature change in the
body, which may result in hypothermia, coagulation, and other medical crises. It is potentially
fatal since the body generates less heat than it loses. This situation becomes serious in new-
born babies, severe patients, and older adults since their body is not adaptable to this
temperature transition. The human body can tolerate temperatures up to 40 °C (which can be
delivered safely) [4]. Caution must be taken for mixing cold fluid with blood. [5]

Charles E. Smith et al [6] compared blood warming to convective warming using hot air. They
discovered that if both heating techniques were used on the patient throughout anaesthesia and
the procedure, the patient would be normthermic, or not hypothermic. They conclude that
warming blood may be advantageous for individuals undergoing medical diagnostics or
treatment.

In a comparison study, Yokoyama et al [7] compared the effects of over-warmed and unarmed
blood on caesarean birth patients. It was observed that preheating blood results in a higher
Apgar score. The greater the score, the more healthy the new-born is.

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Lyng. J.et al [8] demonstrated that patients with hypothermia or trauma might benefit
significantly from warm blood infusion. In addition, he concluded from his research that the
warming device must be less time-consuming and cost-effective to be recommended for use
with the blood infusion system.

Glenn Farieset al [9] studied the variation of Blood temperature in children at various flow
rates and tubing lengths. They determined that the Blood flow rate is lower in children and that
heat loss is significant, resulting in a decrease in Blood temperature. A warming device must
be attached for fluid infusion treatment to be effective.

Richard B. Schwartz et al [10] devised a portable heat exchanger composed of sodium acetate
that, when activated, can reach around 54 °C in temperature. This hermetically sealed heat
exchanger was inserted into the blood tubing to rewarm the fluid. It may be employed in
military situations when a reliable power supply is unavailable. In the research comparing
commercially available Blood warmers enFLOWTM and buddy liteTM.

Giang Le HaMTM et al [11] found that enFLOWTM is more consistent than buddy liteTM. It
was observed that most of the warmers were based on heating the disposable component to
heat the fluid, which may generate a significant amount of disposable trash. Additionally, it
raises the cost of the warmer and cannot be reused.

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 METHODOLOGY

OBJECTIVE METHODOLOGY

To design a highly efficient and  Employ a user centred design approach by involving
user friendly device healthcare professionals in the design process

 Implement clear labels and visual indicators to guide users

through the setup and operation of the device

To design an device that is safe  Conduct a comprehensive risk assessment to identify

for both the user and the potential hazards and implement appropriate safety
environment measures.

To design a portable device that  Prioritize light weight and compact design elements to
occupies little space and easy to enhance portability
move around
 Utilize materials that are both durable and light weight, such
as high strength plastics.

To ensure the preservation of  Test the rate of heat exchange between the blood, heating
blood integrity after warming unit and the device boundaries

 Test feasibility of the design concept using SIMULINK

To develop an fully functional  Assembling the different parts in order to achieve a fully
operating system functional blood warmer with the appropriate temperature

Design

• We intend to use computer aided design (CAD) software for the design. The device will
be designed to minimize heat loss to the environment by the insertion of a lagging
material in between its double wall.

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 Cold Warm
Blood Blood
Contactless
Blood Patient
heating system

Figure 2: Proposed Working of the Infusion Warmer

Electrical Circuitry

The electrical and electronic components such as

• Heating element

• Temperature control module

• AC/DC converter

• Temperature sensor

• Thermal Regulator: This is a device that controls the heat within the warming
chamber, when the device is in operation. It monitors the temperature within the
warming chamber and initiates the appropriate response. The thermal regulator controls
the energy supplied to the heating unit by breaking the circuit if the preset temperature
in the warming chamber (80°C) is reached.

• Heat Distribution System (Blood Paddle): This component ensures the even
distribution of heat within the blood bag.

• Temperature Measuring Device: This is a component of the device that measures the
temperature within the warming basket and displays it to the user.

• Device Protector: This is a component that controls the power and protects the device
from damage.

• Timer: This is a component that switches off the device when the warming process is
complete. In its operation, the user will make an input by selecting a desired warming
time using the timer switch. Some amount of thermal energy will be delivered to the

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 blood during the preset time. The timer device will be wired to a mechanical bell that
serves as an alert system to indicate the end of operation.

• Warming Basket: The device will have a container that holds the blood. Chilled blood
in a standard blood bag is put into the warming basket that functions to support the
blood bag and promotes the effective distribution of heat around the blood bag during
the warming process.

FEEDBACK TO
CONTROLLER
FROM
TEMPERATURE
SENSOR

AC TEMPERATURE FABRIC JACKET

POWER AC/DC
CONTROL WITH HEATING
SOURCE CONVERTER
MODULE ELEMENT

Figure 3: Proposed Block Diagram

TOOLS USED

• Power Socket

• Screw drivers

• Matlab Simulink

• Proteus

• Heating element

• Bolts and nuts

• Relay switch

• Timer switch

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 BUDGET

UGX 300,000

75% 15% 10%

Material resources Travel costs Human resources

TIMELINES

MONTH JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER

PROJECT

PROJECT PROPOSAL

BACKGROUND
RESEARCH

PROPOSAL
PRESENTATION

DESIGN

IMPLEMETATION

SOURCING OF
REQUIRED
PARTSSIMULATION
AND ASSEMBLY OF
PROTOTYPE

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CONCLUSION

A cost effective and efficient blood-warming device will be intended for health care institutions
in developing regions in Uganda and it will be designed, fabricated from readily available
materials and tested on blood and other available IV fluids.

REFERENCES

[1] “Reusable Pressure Curfs. Nuova GmbH medical division- (2018), Nuova Warmers.
https://www.nouva.de/en/druckmanschetten.php,” [Online].

[2] “https://belmontmedtech.com/portable-iv-pump,” [Online].

[3] Rescue., “https://www.narescue.com/quantum-blood-fluid-warming-system.html,” [Online].

[4] Fildes J, Effects of short heat exposure on human red and white blood cells, 2000.

[5] Campbell G, Warming of intravenous and irrigation fluids for preventing inadvertent, Cochrane
Database of Systematic Reviews, 2015.

[6] Smith C E, “Preventing hypothermia: convective and intravenous fluid,” Journal of Clinical
Anesthesia, pp. 380 - 385, 1998.

[7] Yokoyama K, “Effect of administration of pre-warmed intravenous,” Clinical Anesthesia, 2009.

[8] Lyng J, heat loss from IVfluids during the administration of pre-warmed normal saline, 2009.

[9] Faries G, “Temperature relationship to distance and flow rate of warmed IVfluids,” Annals of
Emergency Medicine, vol. 20.

[10] Schwartz R B, “Use of an improvised portable reusable heat exchanger for warming IVfluids,”
Prehospital Emergency Care, vol. 8, pp. 97 -97, 2007.

[11] G. K. L. a. L. J. Le H, “Warmed IVfluids to neonates,” Air Medical Journal, vol. 41, pp. 26-27,
2022.

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