In high-altitude areas, unique geographical and climatic conditions present significant challenges to trauma care. Hypoxia increases blood viscosity and reduces flow velocity, while cold ambient temperatures cause a marked temperature gap between stored intravenous fluids and the human body. Infusion of cold fluids can induce shivering, hypothermia, and limb discomfort, aggravating patient distress. Moreover, cold fluid may trigger vasoconstriction and lumen narrowing, slowing infusion rates and compromising resuscitation efforts.

A study on warmed infusion for trauma patients in high-altitude settings offers valuable insights into addressing these issues.

1. Study Subjects

Pan Lijie from Qinghai Red Cross Hospital [1] conducted an observational study starting in February 2008, involving 52 trauma patients in a high-altitude region. Subjects were randomly assigned to an observation group and a control group, with no statistically significant differences in age or sex between the two groups, ensuring comparability. In the observation group, all intravenous fluids, wound irrigation fluids, and body-cavity irrigation fluids were warmed to 37–38°C before, during, and up to 48 hours after surgery. The control group received fluids stored at room temperature.

2. Results

The observation group demonstrated excellent tolerance to warmed fluids, with markedly reduced or eliminated shivering and discomfort. No abnormal postoperative temperature elevation occurred, and the differences compared to the control group were statistically significant (see table below).

These findings indicate that warmed infusion effectively alleviates limb discomfort induced by cold fluids, improves patient comfort, and reduces the risk of complications related to heat loss, thus promoting postoperative recovery.

3. Recommendations for Clinical Application

Warmed infusion represents a simple and effective adjunct in high-altitude trauma care. Practical considerations include:

(1) Properly connecting the power supply and performing safety checks;

(2) Setting the temperature to 37–38°C;

(3) Monitoring device operation throughout use;

(4) Maintaining infusion rates at or below 6 L/h to ensure stable fluid temperature.

It is worth emphasizing that a fluid temperature of 37.8°C does not cause thermal injury to the vascular intima or red blood cell deformation. However, temperatures exceeding 42°C may reduce erythrocyte deformability, so precise temperature control is essential.

In conclusion, this study provides valuable evidence for trauma management in high-altitude regions. Warmed infusion – a simple and feasible intervention – significantly improves patient experience and clinical outcomes, and deserves broader adoption in plateau and similar environments. Let us join efforts to address the needs of trauma patients in high-altitude regions and safeguard their health and recovery.

Reference:

1. Pan Lijie. Observation on the effect of warmed infusion in trauma patients in high‑altitude areas[J]. Journal of Preventive Medicine of Chinese People's Liberation Army, 2010, 28(4): 147.

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