Hypothermia/Warming Protocols: Why Are They Not Widely Used in the OR?

Weirich, Tara Lynn

doi:10.1016/j.aorn.2007.08.021

Cited by 65 publications

(96 citation statements)

References 15 publications

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“…Forced-air warming has been used on millions of patients and has been shown to be effective for managing unintended peri-operative hypothermia. The choice of warming device depends on a number of factors including the evidence base for the technology, cost, noise and even complaints from surgeons that they themselves become too warm [23]. Disruption of laminar flow should be one further objective factor guiding the proper choice.…”

Section: Discussionmentioning

confidence: 99%

Effect of forced‐air warming on the performance of operating theatre laminar flow ventilation*

2012

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SummaryForced-air warming exhaust may disrupt operating theatre airflows via formation of convection currents, which depends upon differences in exhaust and operating room air temperatures. We investigated whether the floor-to-ceiling temperatures around a draped manikin in a laminar-flow theatre differed when using three types of warming devices: a forced-air warming blanket (Bair Hugger TM ); an over-body conductive blanket (Hot Dog TM ); and an under-body resistive mattress (Inditherm TM ). With forced-air warming, mean (SD) temperatures were significantly elevated over the surgical site vs those measured with the conductive blanket (+2.73 (0.7)°C; p < 0.001) or resistive mattress (+3.63 (0.7)°C ; p < 0.001). Air temperature differences were insignificant between devices at floor (p = 0.339), knee (p = 0.799) and head height levels (p = 0.573). We conclude that forced-air warming generates convection current activity in the vicinity of the surgical site. The clinical concern is that these currents may disrupt ventilation airflows intended to clear airborne contaminants from the surgical site. . However, patient warming systems also release excess heat into the operating theatre that may generate convection currents even within a laminar flow system. It is possible that convection currents could disrupt the intended ceilingto-floor theatre airflows and therefore impede the ventilation system's ability to clear contaminants from the surgical site.There are two distinct categories of patient warming technology, forced-air and conductive heating. Forcedair devices deliver a heated airflow to a disposable coverlet that vents the hot air over the patient's body [6]. Conductive heating devices employ an electrically heated pad in contact with the patient's body [7]. Both types of devices appear to be comparably effective for the prevention of accidental peri-operative hypothermia [8][9][10][11][12][13][14], although forced-air devices are less efficient in transferring the applied heat to the patient than conductive devices [15]. Therefore, we might expect forced-air devices to generate a greater excess heat load on the ventilation system.

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Section: Discussionmentioning

confidence: 99%

Effect of forced‐air warming on the performance of operating theatre laminar flow ventilation*

2012

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“…Maintaining body temperature has been established to decrease postoperative length of hospital stay by as much as 40% and has been shown to decrease the risk of surgical site infections by 64% (Weirich, 2008). So this study aimed to evaluate the effect of applying warming measures on prevention hypothermia among parturient women during caesarean delivery.…”

Section: Significance Of the Studymentioning

confidence: 99%

Applying Warming Measures on prevention Hypothermia among Parturient Women during Caesarean Delivery

Khedr¹,

eldeen²

2017

IOSR JNHS

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Decrease body temperature during caesarean Section (CS)is happened due to administered intravenous fluids and thermoregulation mechanism disorders it will lead to increase in oxygen consumption, heart rate, blood pressure, pain. The study aimed to evaluate the effect of applying warming measures on prevention hypothermia among parturient women during caesarean delivery. Methods:A quasi-experimental design was conducted on 60 parturient women candidates for elective cesarean delivery at Obstetrics Operating Room in Mansoura University Hospital from February to July 2016, divided randomly into two groups, the intervention group were (Appling warming measures), and control group were (received routine measures). Data were collected by two tool ( A structured Interviewing Questionnaire , Scale of Shivering and record to follow temperature.Results : revealed that the baseline temperature were stable in both group but it decreased within 30 min of starting the cesarean section in control group and it was highly statistically significant differences, with P-value <0.001. frequency of shivering as considered via Wrench's scale was 27(90%) of women in the intervention group had no shivering at score zero compared to 18(60 %) of women in the control group during the time spent in the recovery room. Conclusion:The study concluded that intra-operative warmed measures prevent hypothermia and shivering in parturient women undergoing cesarean delivery .

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“…It is an invasive procedure that should not be recommended for patients only subjected to regional anesthesia, who may feel discomfort during its placement and maintenance; furthermore, if the tip of the sensor is positioned in the distal third of the esophagus, the temperature of inhaled gases may interfere with the patient's body temperature measurement (1,10) . Tympanic temperature measurement would be a less invasive method of measuring core temperature, and it would reflect the temperature of the external carotid artery by using a device located near the tympanic membrane (8) .…”

Section: Introductionmentioning

confidence: 99%

“…Body temperature can be obtained in several places of the body, such as the axilla, nasopharynx, esophagus, rectum, tympanic membrane, temporal artery, pulmonary artery and bladder; however, only the measurements performed on the tympanum, esophagus, nasopharynx and pulmonary artery can more accurately portray the temperature referred to as core temperature (1,4) . It should be noted that some of these forms of measurement are not indicated for intraoperative surgical patients due to the specific needs of subjects subjected to anestheticsurgical procedures who are often exposed to intubation, manipulation of organs and spaces or to specific positions to ensure the success of the surgery (8)(9) .…”

Section: Introductionmentioning

confidence: 99%

“…Intraoperative hypothermia, defined as body temperature lower than 36°C during an anesthetic-surgical procedure, should be a constant concern of the multiprofessional team due to its high frequency and association with several complications that affect patient recovery, among them being: alteration of drug metabolism; increase in the metabolic demand promoted by the occurrence of postoperative chills; and predisposition to changes in the coagulation cascade and platelet function (1)(2)(3) . In order to prevent the occurrences mentioned above, scientific literature has explored the need for continuous and systematic use of warming measures during the perioperative period (4)(5)(6) ; however, in order to ensure patient safety regarding the adopted measures, a precise body temperature measurement is needed.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative body temperature control: esophageal thermometer versus infrared tympanic thermometer

Poveda

Nascimento

2016

Rev. esc. enferm. USP

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Objective:To verify the correlation between temperature measurements performed using an infrared tympanic thermometer and an esophageal thermometer during the intraoperative period. Method: A longitudinal study of repeated measures was performed including subjects aged 18 years or older undergoing elective oncologic surgery of the digestive system, with anesthesia duration of at least 1 hour. Temperature measurements were performed simultaneously by a calibrated esophageal thermometer and by a calibrated infrared tympanic thermometer, with laboratory reading precision of ±0.2°C. The operating room temperature remained between 19 and 21°C. Results: The study included 51 patients, mostly men (51%), white (80.4%). All patients were kept warm by a forced-air heating system, for an average of 264.14 minutes (SD = 87.7). The two temperature measurements showed no different behavior over time (p = 0.2205), however, tympanic measurements were consistently 1.24°C lower (p<0.0001). Conclusion: The tympanic thermometer presented reliable results but reflected lower temperatures than the esophageal thermometer. DESCRIPTORS

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Hypothermia/Warming Protocols: Why Are They Not Widely Used in the OR?

Cited by 65 publications

References 15 publications

Effect of forced‐air warming on the performance of operating theatre laminar flow ventilation*

Effect of forced‐air warming on the performance of operating theatre laminar flow ventilation*

Applying Warming Measures on prevention Hypothermia among Parturient Women during Caesarean Delivery

Intraoperative body temperature control: esophageal thermometer versus infrared tympanic thermometer

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