Literature DB >> 9702617

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

C E Smith1, R Desai, V Glorioso, A Cooper, A C Pinchak, K F Hagen.   

Abstract

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.

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Year:  1998        PMID: 9702617     DOI: 10.1016/s0952-8180(98)00049-x

Source DB:  PubMed          Journal:  J Clin Anesth        ISSN: 0952-8180            Impact factor:   9.452


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