A Randomized Controlled Trial of the Arctic Sun?? Temperature Management System Versus Conventional Methods for Preventing Hypothermia During Off-Pump Cardiac Surgery

Grocott, Hilary P.; Mathew, Joseph P.; Carver, Elizabeth H.; Phillips-Bute, Barbara; Landolfo, Kevin P.; Newman, Mark F.

doi:10.1213/01.ane.0000096242.06561.c0

Cited by 45 publications

(34 citation statements)

References 19 publications

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“…9 Furthermore, a single hour of preoperative skin surface warming has been reported to reduce the rate at which core hypothermia developed during the first hour of anesthesia. 33 Our analysis shows that the no-warming group is at significant risk of developing perioperative hypothermia, which in turn can give rise to significant perioperative morbidity.…”

Section: Discussionmentioning

confidence: 86%

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The role of perioperative warming in surgery: a systematic review

et al. 2009

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OBJECTIVE: The objective of this review was to systematically analyze the trials on the effectiveness of perioperative warming in surgical patients. METHODS:A systematic review of the literature was undertaken. Clinical trials on perioperative warming were selected according to specific criteria and analyzed to generate summative data expressed as standardized mean difference (SMD). RESULTS:Twenty-five studies encompassing 3,599 patients in various surgical disciplines were retrieved from the electronic databases. Nineteen randomized trials on 1785 patients qualified for this review. The no-warming group developed statistically significant hypothermia. In the fixed effect model, the warming group had significantly less pain and lower incidence of wound infection, compared with the no-warming group. In the random effect model, the warming group was also associated with lower risk of post-anesthetic shivering. Both in the random and the fixed effect models, the warming group was associated with significantly less blood loss. However, there was significant heterogeneity among the trials.CONCLUSION: Perioperative warming of surgical patients is effective in reducing postoperative wound pain, wound infection and shivering. Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy. Perioperative warming may be given routinely to all patients of various surgical disciplines in order to counteract the consequences of hypothermia. RESUMOOBJETIVO: O objetivo desta revisão é analisar sistematicamente os ensaios sobre a eficácia do aquecimento perioperatório em pacientes cirúrgicos. MÉTODOS:Uma revisão sistemática da literatura foi realizada. Ensaios clínicos sobre aquecimento perioperatório foram selecionados segundo critérios específicos e analisados para gerar dados sumativo expresso na diferença média padronizada (standardized mean difference, SMD). RESULTADOS:Vinte e cinco estudos englobando 3.599 pacientes de várias disciplinas de cirurgia foram obtidos a partir de bases de dados eletrônicas.Dezenove ensaios aleatórios em 1.785 pacientes qualificados para esta revisão. Nenhum grupo de aquecimento desenvolveu estatisticamente significativa hipotermia. No modelo de efeito fixo, grupo de aquecimento tiveram significativamente menos dor e menor incidência de infecção na ferida quando comparado com o grupo de não-aquecimento. No modelo de efeito aleatório, grupo de aquecimento também foi associado a um menor risco de tremores pós-anestesia. Em ambos os modelos de efeitos fixos e aleatórios, o aquecimento foi significativamente associado com menor perda de sangue. No entanto, houve significativa heterogeneidade entre os ensaios.CONCLUSÃO: O aquecimento perioperatório de pacientes cirúrgicos é eficaz na redução da dor pós-operatória ferida, infecção ferida, e tremores. O aquecimento sistêmico do paciente cirúrgico também está associado com menor perda de sangue no perioperatório prevenindo hipotermia e induzindo coagulopatia. O ...

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Section: Discussionmentioning

confidence: 86%

“…Nineteen randomized controlled trials [11][12]14,18-32 on 1,785 patients qualified for this review in accordance with the inclusion criteria (Figure 1). Six trials 16,17,[33][34][35][36] were excluded for the reasons mentioned in Figure 1. The characteristics of the trials included are given in Table 1.…”

Section: Resultsmentioning

confidence: 99%

The role of perioperative warming in surgery: a systematic review

et al. 2009

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“…Although equivalence has been shown between water garments and the combination of posterior water mattress heating with anterior forced-air warming [118], the former is arguably a more practical warming strategy. Newer temperature management systems incorporating energy transfer pads containing circulating water also offer flexibility in patient warming sites and have been shown to be more effective than forced-air warming (Table 6) [119,120]. These are, however, more expensive than other warming methods [108].…”

Section: Circulating Water Devicesmentioning

confidence: 99%

Peri‐operative warming devices: performance and clinical application

2014

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SummarySince the adverse consequences of accidental peri-operative hypothermia have been recognised, there has been a rapid expansion in the development of new warming equipment designed to prevent it. This is a review of peri-operative warming devices and a critique of the evidence assessing their performance. Forced-air warming is a common and extensively tested warming modality that outperforms passive insulation and water mattresses, and is at least as effective as resistive heating. More recently developed devices include circulating water garments, which have shown promising results due to their ability to cover large surface areas, and negative pressure devices aimed at improving subcutaneous perfusion for warming. We also discuss the challenge of fluid warming, looking particularly at how devices' performance varies according to flow rate. Our ultimate aim is to provide a guide through the bewildering array of devices on the market so that clinicians can make informed and accurate choices for their particular hospital environment.

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“…Only one clinical trial (28) included in this review tested the energy transfer pads. Even though we did find, during the search for primary studies, another study (37) testing this system, it was not a randomized controlled trial and had to be excluded, though its results also suggest that energy pads are more effective than the forced-air warming system.…”

Section: N Type Of Surgery Type Of Anesthesia Resultsmentioning

confidence: 99%

Active cutaneous warming systems to prevent intraoperative hypothermia: a systematic review

Poveda

Martinez

Galvão

2012

Rev. Latino-Am. Enfermagem

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This study analyzed the evidence available in the literature concerning the effectiveness of different active cutaneous warming systems to prevent intraoperative hypothermia. This is a systematic review with primary studies found in the following databases: CINAHL, EMBASE, Cochrane Register of Controlled Trials and Medline. The sample comprised 23 randomized controlled trials. There is evidence in the literature indicating that the circulating water garment system is the most effective in maintaining patient body temperature. These results can support nurses in the decision-making process concerning the implementation of effective measures to maintain normothermia, though the decision of health services concerning which system to choose should also take into account its cost-benefit status given the cost related to the acquisition of such systems. Métodos activos de calentamiento cutáneo para la prevención de hipotermia en el período intraoperatorio: revisión sistemáticaLa finalidad del estudio fue analizar las evidencias disponibles en la literatura acerca de la efectividad de los diferentes métodos activos de calentamiento cutáneo para la prevención de hipotermia en el período intraoperatorio. Para esto, la revisión sistemática fue usada como método de revisión. La búsqueda de los estudios primarios fue efectuada en las bases de datos CINAHL, EMBASE, Cochrane Register of Controlled Trials y Medline.La muestra de la revisión abarcó 23 ensayos clínicos aleatorios controlados. La literatura ofrece evidencias que indican que el sistema de circulación de agua calentada es el método más efectivo en la manutención de la temperatura corporal. Los resultados evidenciados pueden subsidiar la toma de decisión del enfermero en la implementación de medidas efectivas para la manutención de la temperatura corporal. Sin embargo, considerando los costos de adquisición de los sistemas investigados, la elección del sistema en cada servicio de salud debería ser basada en el análisis de costo-beneficio.

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A Randomized Controlled Trial of the Arctic Sun?? Temperature Management System Versus Conventional Methods for Preventing Hypothermia During Off-Pump Cardiac Surgery

Abstract: The Arctic Sun Temperature Management System was more effective than conventional methods in preventing hypothermia during off-pump coronary artery bypass graft surgery.

Cited by 45 publications

References 19 publications

The role of perioperative warming in surgery: a systematic review

The role of perioperative warming in surgery: a systematic review

Peri‐operative warming devices: performance and clinical application

Active cutaneous warming systems to prevent intraoperative hypothermia: a systematic review

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