Alexander Torossian1, Elke Van Gerven2, Karin Geertsen3, Bengt Horn4, Marc Van de Velde2, Johan Raeder5. 1. Department of Anesthesiology and Critical Care, University Hospital Marburg and Medical Faculty, Philipps-University of Marburg, Germany. Electronic address: alexander.torossian@med.uni-marburg.de. 2. Department Cardiovascular Sciences and Department of Anesthesiology, KU Leuven, University Hospitals Leuven, Belgium. 3. Department of Operative and Intensive Care, Hallands sjukhus Varberg, Sweden. 4. Department of Orthopedics, Aleris Specialistvård, Motala Hospital, Sweden. 5. Department of Anesthesiology, Oslo University Hospital and Medical Faculty, University of Oslo, Norway.
Abstract
STUDY OBJECTIVE: Incidence of inadvertent perioperative hypothermia is still high; therefore, present guidelines advocate "prewarming" for its prevention. Prewarming means preoperative patient skin warming, which minimizes redistribution hypothermia caused by induction of anesthesia. In this study, we compared the new self-warming BARRIER EasyWarm blanket with passive thermal insulation regarding mean perioperative patient core body temperature. DESIGN: Multinational, multicenter randomized prospective open-label controlled trial. SETTING: Surgical ward, operation room, postanesthesia care unit at 4 European hospitals. PATIENTS: A total of 246 adult patients, American Society of Anesthesiologists class I to III undergoing elective orthopedic; gynecologic; or ear, nose, and throat surgery scheduled for 30 to 120 minutes under general anesthesia. INTERVENTIONS: Patients received warmed hospital cotton blankets (passive thermal insulation, control group) or BARRIER EasyWarm blanket at least 30 minutes before induction of general anesthesia and throughout the perioperative period (intervention group). MEASUREMENTS: The primary efficacy outcome was the perioperative mean core body temperature measured by a tympanic infrared thermometer. Secondary outcomes were hypothermia incidence, change in core body temperature, length of stay in postanesthesia care unit, thermal comfort, patient satisfaction, ease of use, and adverse events related to the BARRIER EasyWarm blanket. MAIN RESULTS: The BARRIER EasyWarm blanket significantly improved perioperative core body temperature compared with standard hospital blankets (36.5°C, SD 0.4°C, vs 36.3, SD 0.3°C; P<.001). Intraoperatively, in the intervention group, hypothermia incidence was 38% compared with 60% in the control group (P=.001). Postoperatively, the figures were 24% vs 49%, respectively (P=.001). Patients in the intervention group had significantly higher thermal comfort scores, preoperatively and postoperatively. No serious adverse effects were observed in either group. CONCLUSIONS: Perioperative use of the new self-warming blanket improves mean perioperative core body temperature, reduces the incidence of inadvertent perioperative hypothermia, and improves patients' thermal comfort during elective adult surgery.
RCT Entities:
STUDY OBJECTIVE: Incidence of inadvertent perioperative hypothermia is still high; therefore, present guidelines advocate "prewarming" for its prevention. Prewarming means preoperative patient skin warming, which minimizes redistribution hypothermia caused by induction of anesthesia. In this study, we compared the new self-warming BARRIER EasyWarm blanket with passive thermal insulation regarding mean perioperative patient core body temperature. DESIGN: Multinational, multicenter randomized prospective open-label controlled trial. SETTING: Surgical ward, operation room, postanesthesia care unit at 4 European hospitals. PATIENTS: A total of 246 adult patients, American Society of Anesthesiologists class I to III undergoing elective orthopedic; gynecologic; or ear, nose, and throat surgery scheduled for 30 to 120 minutes under general anesthesia. INTERVENTIONS:Patients received warmed hospital cotton blankets (passive thermal insulation, control group) or BARRIER EasyWarm blanket at least 30 minutes before induction of general anesthesia and throughout the perioperative period (intervention group). MEASUREMENTS: The primary efficacy outcome was the perioperative mean core body temperature measured by a tympanic infrared thermometer. Secondary outcomes were hypothermia incidence, change in core body temperature, length of stay in postanesthesia care unit, thermal comfort, patient satisfaction, ease of use, and adverse events related to the BARRIER EasyWarm blanket. MAIN RESULTS: The BARRIER EasyWarm blanket significantly improved perioperative core body temperature compared with standard hospital blankets (36.5°C, SD 0.4°C, vs 36.3, SD 0.3°C; P<.001). Intraoperatively, in the intervention group, hypothermia incidence was 38% compared with 60% in the control group (P=.001). Postoperatively, the figures were 24% vs 49%, respectively (P=.001). Patients in the intervention group had significantly higher thermal comfort scores, preoperatively and postoperatively. No serious adverse effects were observed in either group. CONCLUSIONS: Perioperative use of the new self-warming blanket improves mean perioperative core body temperature, reduces the incidence of inadvertent perioperative hypothermia, and improves patients' thermal comfort during elective adult surgery.