Preventing hypothermia: convective and intravenous fluid warming versus convective warming alone.

Autor: Smith CE; Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA., Desai R, Glorioso V, Cooper A, Pinchak AC, Hagen KF
Jazyk: angličtina
Zdroj: Journal of clinical anesthesia [J Clin Anesth] 1998 Aug; Vol. 10 (5), pp. 380-5.
DOI: 10.1016/s0952-8180(98)00049-x
Abstrakt: Study Objective: To test the hypothesis that warming intravenous (i.v.) fluids in conjunction with convective warming results in less intraoperative hypothermia (core temperature < 36.0 degrees C) than that seen with convective warming alone.
Design: Prospective, randomized study.
Setting: University affiliated tertiary care teaching hospital.
Patients: 61 ASA physical status, I, II, and III adults undergoing major surgery and general anesthesia with isoflurane.
Interventions: All patients received convective warming. Group 1 patients received warmed fluids (setpoint 42 degrees C). Group 2 patients received room temperature fluids (approximately 21 degrees C).
Measurements and Main Results: Lowest and final intraoperative distal esophageal temperatures were higher (p < 0.05) in Group 1 (mean +/- SEM: 35.8 +/- 0.1 degrees C and 36.6 +/- 0.1 degrees C) versus Group 2 (35.4 +/- 0.1 degrees C and 36.1 +/- 0.1 degrees C, respectively). Compared with Group 1, more Group 2 patients were hypothermic at the end of anesthesia (10 of 26 patients, or 38.5% vs. 4 of 30 patients, or 13%; p < 0.05). After 30 minutes in the recovery room, there were no differences in temperature between groups (36.7 +/- 0.1 degrees C and 36.5 +/- 0.1 degrees C in Groups 1 and 2, respectively). Intraoperative cessation of convective warming because of core temperature greater than 37 degrees C was required in 33% of Group 1 patients (vs. 11.5% in Group 2; p = 0.052).
Conclusions: The combination of convective and fluid warming was associated with a decreased likelihood of patients leaving the operating room hypothermic. However, average final temperatures were greater than 36 degrees C in both groups, and intergroup differences were small. Care must be taken to avoid overheating the patient when both warming modalities are employed together.
Databáze: MEDLINE
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