Delayed forced air warming prevents hypothermia during abdominal aortic surgery

Abstract

We have evaluated the efficacy of the delayed forced air warming during abdominal aortic surgery in 18 patients. Patients were allocated randomly to one of two groups: the control group (n = 9) received no intraoperative warming device; the Bair-Hugger group (n = 9) had active skin surface warming with an upper body cover. The device was activated when core temperature decreased to less than 36 degrees C. The reduction in core temperature was 0.6 degrees C during the first hour after induction and 0.4 degrees C during the second hour in both groups. In the control group, core temperature continued to decrease until the end of surgery, whereas in the Bair-Hugger group, the reduction in core temperature stopped after 1 h of warming, and then rewarming began. At the end of surgery, core temperature in the Bair-Hugger group was similar to core temperature before induction, and was higher than core temperature in the control group (P < 0.003).

Core temperature changes during open and laparoscopic colorectal surgery

“…In randomized trials, they have been shown to prevent hypothermia in this setting [7,11]. A significant decrease in the incidence of hypothermia, as shown in this series, when a forced-air warming device is used during laparoscopic colorectal surgery has not been previously reported.…”

Heating and humidifying of carbon dioxide during pneumoperitoneum is not indicated

“…However, the etiology of hypothermia is obviously multifactorial, and known to be affected by cold irrigation and intravenous fluids, anesthetic agents that alter thermoregulatory control, ambient operating room temperature, and length of procedure [10,18,27]. In open and laparoscopic abdominal surgery, it has been shown that the application of external warming blankets helps to prevent reduction in core temperature [11,16].…”

Effect of heated and humidified carbon dioxide gas on core temperature and postoperative pain

“…Hypothermia is a potential complication after open abdominal surgery [5]. A major factor contributing to intraoperative hypothermia is radiant heat loss from the exposure of skin surfaces and abdominal viscera to the ambient environment.…”

“…During open abdominal surgery, an external warming blanket has been shown to prevent reduction of core temperature [5]. In a trial comparing surgical patients randomized to receive routine intraoperative thermal care or additional warming with an external warming blanket, Kurz et al [7] demonstrated that maintaining intraoperative normothermia decreased infectious complications and shortened hospitalization.…”