Forced‐air warming maintains normothermia during orthotopic liver ransplantation

Abstract

We evaluated the efficacy of forced-air warming to maintain normothermia during liver transplantation. In a prospective, clinical trial 20 patients were randomly assigned to routine thermal management (circulating-water mattress set at 42 degrees C, intravenous fluid warming to 37 degrees C and passive insulation) or routine management with additional forced-air warming of head, chest, and arms. Core temperature was measured in the pulmonary artery. Morphometric and demographic characteristics were similar in each group, as was total administered fluid volume replacement. Core temperatures in each group decreased by about 0.6 degrees C during the first 70 min of anaesthesia and then by 0.9 degree C within 90 to 120 min in the patients given routine thermal management, but only by 0.4 degree C in those warmed with forced-air. Subsequently, core temperatures in the control group increased to only 35.7, SD 0.25 degree C whereas those in the patients given forced-air warming increased to 36.5, SD 0.2 degree C. Despite the relatively high ambient temperature, patients warmed only with a circulating-water mattress and passive insulation became hypothermic during surgery. In contrast, when forced-air warming was added to this routine thermal management, patients were normothermic at the end of surgery. Forced-air warming prevented intra-operative hypothermia during liver transplantation.

Comparison of forced‐air warming systems with lower body blankets using a copper manikin of the human body

“…Forced‐air warming has been studied for various perioperative situations in the clinical setting (1,8–11). Compared with these studies manikin investigations offer the advantage of controlled environmental and steady state conditions (12).…”

Differences among forced‐air warming systems with upper body blankets are small. A randomized trial for heat transfer in volunteers

“…The efficacy of different measures for the prevention of perioperative hypothermia can be studied in clinical studies (14, 16, 17). In these studies core temperature changes are taken as the measure of efficacy.…”

Thermal softening of tracheal tubes: an unrecognized hazard of the Bair Hugger active patient warming system

“…Active patient warming using a forced-air mattress system is a widely used and well documented technique for routine theatre purposes. [1][2][3] The system is relatively new and research has focused largely on comparison with existing or alternative warming techniques. 1 4 Apart from routine manufacturer's warnings, we were unable to find any published data on potential hazards.…”