Comparison of Three Rewarming Methods in a Postanesthesia Care Unit

Abstract

Postoperative hypothermia is problematic because patients in postanesthesia care units (PACUs) often feel very cold, and unrecognized or prolonged postoperative hypothermia can aggravate patients' underlying cardiovascular disorders. The researchers compared three methods of rewarming PACU patients who had undergone laparotomy procedures. Patients were assigned randomly to three groups. Each patient in group one received the standard PACU rewarming intervention (ie, two warmed thermal blankets and a hospital bedspread). Each patient in group two received the standard PACU rewarming intervention plus a reflective blanket. Each patient in group three received the standard PACU rewarming intervention plus a reflective blanket and a reflective head covering. Nurses measured patients' vital signs on admission to the PACU and every 15 minutes thereafter until patients' sublingual temperatures reached 36 degrees C (96.8 degrees F). No significant temperature differences occurred among patients in the three groups, but an inverse relationship existed between patients' PACU admission temperatures and the time they required to reach normothermia.

Postoperative Rewarming: Are There Alternatives to Warm Hospital Blankets

“…Although not statistically significant, patients in the group covered with two warmed thermal blankets covered by a reflective blanket and then a hospital bedspread, reached normothermia on an average of eight minutes faster than the two other groups. 10 When comparing passive insulation with active rewarming (forced-air, warmed humidified oxygen, radiant warmers, etc), five RCTs (all Level II, Quality B) and one quasi-experimental study (Level III, Quality B) concluded that active rewarming is significantly more effective in the treatment of mild hypothermia than a standard application of cotton hospital blankets. This result clearly showed the superiority of active methods of warming over passive insulation.…”

“…Although this physiologic response contributed to faster rewarming, shivering may be detrimental for recovering patients because of the increase in oxygen consumption and carbon dioxide production. 10 In three studies, authors used meperidine 12,15 or meperidine and small doses of nondepolarizing muscular blockers 13 for the treatment of postoperative shivering. Treatment of shivering with opioids may theoretically contribute to a prolonged length of stay among PACU patients.…”

“…Patients who shivered returned to normothermia more quickly (t 5 2.27, df 5 138, P 5 .025) compared with patients who did not shiver. 10 The investigators did not address the length of stay in the PACU. They also did not mention whether shivering patients received additional treatment with opioids.…”

Preventing inadvertent hypothermia—a success story

“…Intraoperative temperature management is becoming an area of increasing focus for perioperative personnel. The importance of initiating warming interventions in the preoperative phase is gaining recognition 19 . With the pressure to contain costs and maintain positive patient outcomes, clinically efficacious systems that provide cost‐effective alternatives to traditionally higher‐cost methodologies must be considered in today's ORs.…”

Métodos De Prevenção E Reaquecimento Do Paciente Para O Perioperatório

“…Os periódicos analisados eram dois médicos e um de enfermagem. Enfermagem, v. 07, n. 03, p. 266 -272, 2005 HERSHEY et al, (1997) desenvolveram um estudo onde procuraram testar a efetividade de 3 métodos de aquecimento para a recuperação da temperatura corporal dos pacientes na SRPA, sendo eles, como controle, dois cobertores aquecidos e a colcha da cama do hospital, grupo experimental 1, o método padrão do hospital mais o cobertor de alumínio reflexivo e grupo experimental 2, o método de aquecimento padrão mais o cobertor de alumino reflexivo mais reflective head covering (touca reflexiva? ), seus resultados demonstraram não haverem diferenças estatisticamente significantes entre os grupos.…”