Intra‐operative rewarming with Hot Dog^® resistive heating and forced‐air heating: a trial of lower‐body warming

Abstract

SummaryResistive heating is an alternative to forced-air warming which is currently the most commonly used intra-operative warming system. We therefore tested the hypothesis that rewarming rates are similar with Hot Dog Ò (Augustine Biomedical) resistive and Bair Hugger Ò (Arizant) forced-air heating systems. We evaluated 28 patients having major maxillary tumour surgery. During the establishment of invasive monitoring, patients became hypothermic, dropping their core temperature to about 35°C. They were then randomly assigned to rewarming with lower-body resistive (n = 14) or forced-air (n = 14) heating, with each system set to 'high'. Our primary outcome was the rewarming rate during active heating over a core temperature range from 35 to 37°C. Morphometric characteristics were comparable in both groups. Temperature increased at twice the rate in patients assigned to forced-air warming, with an estimated mean (SE) slope of 0.49 (0.03)°C.h )1 vs 0.24 (0.02)°C.h )1 (p < 0.001). Resistive heating warmed at half the rate of forced air.

Comparing Forced-Air to Resistive-Polymer Warming for Perioperative Temperature Management: A Retrospective Study

“…As a method of rewarming patients who met hypothermic criteria at the start of the case, FAW was associated with a lower proportion of those patients that had a final temperature of <36°C (p = .023). This evidence is consistent with the work of Röder et al (2011) and Engelen et al (2011). Both of these studies found that the use of FAW to be superior to RHB when used as a means to rewarm hypothermic patients.…”

“…Active warming has been standard perioperative care for years as a means to prevent and treat inadvertent perioperative hypothermia (Hooper et al, 2010;NICE, 2008;Guiliano & Hendricks, 2017). Forced-air warming has been in use since the late 1980s with positive results well-documented in the literature (Hynson & Sessler, 1992;Röder et al, 2011, Engelen et al, 2011Hooper et al, 2010). Resistive-polymer heating blankets have gained in popularity in the temperature management of surgical patients and have also also been supported by the literature (Brandt et al, 2010;Nieh & Su, 2016).…”

“…After placement of invasive monitoring, patient temperatures were allowed to drop to 35°C before being randomly assigned to the RHB or FAW group. The RHB rewarmed the patients at about half the rate of FAW (p < .001), and the RHB group had a mean final core temperature below 36.0°C (Röder et al, 2011). Comparing 129 patients on cardiopulmonary bypass, Engelen et al (2011) found that FAW was superior to RHB and passive interventions to rewarm the patient at the end of bypass (p < .001).…”

“…Two studies have found FAW to be superior to RHB when intraoperative rewarming was studied. Röder et al (2011) studied 28 patients undergoing maxillary tumor surgery. After placement of invasive monitoring, patient temperatures were allowed to drop to 35°C before being randomly assigned to the RHB or FAW group.…”

Inadvertent Perianesthetic Hypothermia in Small Animal Patients

“…4,36,43 Resistive polymer electric blankets have been demonstrated to be both equally and less effective compared with forced warm air blankets. 44,45 Forced warm air blankets can be placed over or under a patient with the direction of the air flow toward the patient. Circulating warm water pads and resistive polymer electric blankets can be placed over or under a patient as well; in addition, because of their flexibility, they can be wrapped around the patient.…”