OJAnes  Vol.2 No.3 , July 2012
Effectiveness of an Underbody Forced Warm-Air Blanket during Coronary Artery Bypass Surgery in the Prevention of Postoperative Hypothermia: A Prospective Controlled Randomized Clinical Trial
Abstract: Introduction: Perioperative hypothermia in cardiac surgery is associated with adverse outcome. The aim of this investigation was to study whether an underbody forced-air warming blanket during coronary artery bypass graft surgery with normothermic cardiopulmonary bypass can prevent postoperative hypothermia. Methods: After Medical Ethics Committee approval, 60 low-risk cardiac surgery patients at random were assigned into a group that received standard thermal care management (control group n = 30) and a group that received the underbody forced-air warming system plus the standard thermal care (intervention group n = 30). Results: The temperature after-drop from the end of cardiopulmonary bypass to arrival in the ICU was less in the intervention group versus control group (0.4°C ± 0.3°C vs 0.6°C ± 0.4°C; P = 0.027). Out of the intervention group, 27 patients arrived in the ICU with a bladder temperature ? 36°C (90%) as compared to 14 patients (46.7%) from the control group (P < 0.001). The peripheral temperature was significantly higher in the intervention group as compared to the control group (P < 0.001). Conclusions: A full underbody forced-air warming blanket prevents postoperative hypothermia in normothermic coronary artery bypass graft surgery patients.
Cite this paper: J. Teodorczyk, J. Heijmans, W. Mook, D. Bergmans and P. Roekaerts, "Effectiveness of an Underbody Forced Warm-Air Blanket during Coronary Artery Bypass Surgery in the Prevention of Postoperative Hypothermia: A Prospective Controlled Randomized Clinical Trial," Open Journal of Anesthesiology, Vol. 2 No. 3, 2012, pp. 65-69. doi: 10.4236/ojanes.2012.23016.

[1]   D. I. Sessler, “Temperature Monitoring and Perioperative Thermoregulation,” Anesthesiology, Vol. 109, No. 2, 2008, pp. 318-338. doi:10.1097/ALN.0b013e31817f6d76

[2]   D. J. Buggy and A. W. Crossley, “Thermoregulation, Mild Perioperative Hypothermia and Postanaesthetic Shivering,” British Journal of Anaesthesia, Vol. 84, No. 5, 2000, pp. 615-628. doi:10.1093/bja/84.5.615

[3]   D. I. Sessler, “Complications and Treatment of Mild Hypothermia,” Anesthesiology, Vol. 95, No. 2, 2001, pp. 531543.

[4]   A. W. Crossley, “Peri-Operative Shivering,” Anaesthesia, Vol. 47, No. 3, 1992, pp. 193-195. doi:10.1111/j.1365-2044.1992.tb02114.x

[5]   S. Rajagopalan, E. Mascha, J. Na and D. I. Sessler, “The Effects of Mild Perioperative Hypothermia on Blood Loss and Transfusion Requirement,” Anesthesiology, Vol. 108, No. 1, 2008, pp. 71-77.

[6]   C. K. Hofer, M. Worn, R. Tavakoli, L. Sander, M. Maloigne, R. Klaghofer and A. Zollinger, “Influence of Body Core Temperature on Blood Loss and Transfusion Requirements during Off-Pump Coronary Artery Bypass Grafting: A Comparison of 3 Warming Systems,” Journal of Thoracic and Cardiovascular Surgery, Vol. 129, No. 4, 2005, pp. 838-843.

[7]   A. Kurz, D. I. Sessler and R. Lenhardt, “Perioperative Normothermia to Reduce the Incidence of Surgical-Wound Infection and Shorten Hospitalization,” New England Journal of Medicine, Vol. 334, No. 19, 1996, pp. 1209-1215.

[8]   S. M. Frank, L. A. Fleisher, M. J. Breslow, M. S. Higgins, K. F. Olson, S. Kelly and C. Beattie, “Perioperative Maintenance of Normothermia Reduces the Incidence of Morbid Cardiac Events. A Randomized Clinical Trial,” Journal of the American Medical Association, Vol. 277, No. 14, 1997, pp. 1127-1134.

[9]   R. Lenhardt, E. Marker, V. Goll, H. Tschernich, A. Kurz, D. I. Sessler, et al., “Mild Intraoperative Hypothermia Prolongs Postanesthetic Recovery,” Anesthesiology, Vol. 87, No. 6, 1997, pp. 1318-1323.

[10]   J. Heijmans, G. V. Mastrigt, J. Maessen and P. Roekaerts, “Shortening ICU Stay after Coronary Artery Surgery,” In: J. H. Heijmans, Eds., Introducing Short-Stay Intensive Care after Coronary Artery Surgery, Datawyse/Universitaire Pers, Maastricht, 2007, pp. 119-133.

[11]   S. R. Insler, M. H. Bakri, F. Nageeb, E. Mascha, T. Mihaljevic and D. I. Sessler, “An Evaluation of a Full-Access Underbody Forced-Air Warming System during NearNormothermic, On-Pump Cardiac Surgery,” Anesthesia & Analgesia, Vol. 106, No. 3, 2008, pp. 746-750.

[12]   S. Engelen, D. Himpe, S. Borms, J. Berghmans, P. Van Cauwelaert, J. E. Dalton and D. I. Sessler, “An Evaluation of Underbody Forced-Air and Resistive Heating during Hypothermic, On-Pump Cardiac Surgery,” Anaesthesia, Vol. 66, No. 2, 2011, pp. 104-110.

[13]   A. Rajek, R. Lenhardt, D. I. Sessler, A. Kurz, G. Laufer, R. Christensen, T. Matsukawa and M. Hiesmayr, “Tissue Heat Content and Distribution during and after Cardiopulmonary Bypass at 31?C and 27?C,” Anesthesiology, Vol. 88, No. 6, 1998, pp. 1511-1518.

[14]   D. I. Sessler, E. H. Rubinstein and A. Moayeri, “Physiologic Responses to Mild Perianesthetic Hypothermia in Humans,” Anesthesiology, Vol. 75, No. 4, 1991, pp. 594610.

[15]   A. Kurz, D. I. Sessler, E. Narzt, A. Behar, R. Lenhardt, G. Huemer and F. Lachner, “Postoperative Hemodynamic and Thermoregulatory Consequences of Intraoperative Core Hypothermia,” Journal of Clinical Anesthesia, Vol. 7, No. 5, 1995, pp. 359-366. doi:10.1016/0952-8180(95)00028-G

[16]   S. M. Frank, M. S. Higgins, M. J. Breslow, L. A. Fleisher, R. B. Gorman, J. V. Sitzman, et al., “The Catecholamine, Cortisol, and Hemodynamic Responses to Mild Perioperative Hypothermia, a Randomized Clinical Trial,” Anesthesiology, Vol. 82, No. 1, 1995, pp. 83-93.

[17]   M. S. Vaughan, R. W. Vaughan and R. C. Cork, “Postoperative Hypothermia in Adults: Relationship of Age, Anesthesia, and Shivering to Rewarming,” Anesthesia & Analgesia, Vol. 60, No. 10, 1981, pp. 746-751.

[18]   A. Kurz, O. Plattner, D. I. Sessler, G. Huemer, G. Redl, and F. Lackner, “The Threshold for Thermoregulatory Vasoconstriction during Nitrous Oxide/Isoflurance Anesthesia Is Lower in Elderly than in Young Patients,” Anesthesiology, Vol. 79, No. 3, 1993, pp. 465-469.

[19]   D. Galante, “Intraoperative Hypothermia. Relation between General and Regional Anesthesia, Upperand Lower-Body Warming: What Strategies in Pediatric Anesthesia?” Pediatric Anesthesia, Vol 17, No. 9, 2007, pp. 821-823. doi:10.1111/j.1460-9592.2007.02248.x