Effectiveness of Resistive Heating Compared With Passive Warming in Treating Hypothermia Associated With Minor Trauma: A Randomized Trial

Kober, Alexander; Scheck, Thomas; Fülesdi, Béla; Lieba, Frank; Vlach, W.; Friedman, Alexander; Sessler, Daniel I.

doi:10.4065/76.4.369

Cited by 41 publications

(33 citation statements)

References 49 publications

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“…In four recent studies, minor trauma victims [15], patients with lower back pain [16], patients with renal colic [17] and cholelithiasis pain [18] were assigned to passive insulation or carbon-fibre warming: The warmed patients had improved thermal comfort, less pain, and were significantly less anxious.…”

Section: Discussionmentioning

confidence: 99%

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

2007

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SummarySkin surface warming of patients not only improves thermal comfort, but has been shown to reduce anxiety in a pre-hospital setting. We tested the hypothesis that pre-operative warming can reduce pre-operative anxiety as effectively as a conventional dose of intravenous midazolam in patients undergoing neurosurgery. We randomly allocated 80 patients to four groups in the pre-operative holding area. Treatment was applied for 30-45 min with (1) passive insulation and placebo; (2) passive insulation and intravenous midazolam (30 lg.kg )1 ); (3) warming with forced-air and placebo; and (4) warming with forced-air and intravenous midazolam (30 lg.kg )1 ). Thermal comfort levels (VAS 0-100 mm) and anxiety levels (VAS 0-100 mm, Spielberger State-Trait Anxiety Inventory) were assessed twice: before the designated treatment was started and before induction of anaesthesia. In the midazolam and the midazolam ⁄ warming groups, anxiety VAS and Spielberger state anxiety scores decreased by ) 19 (95% CI: ) 29 to ) 9, p < 0.01) and ) 10 (95% CI: ) 14 to ) 6, p < 0.01), respectively. In the warming and the combined groups, thermal VAS increased by + 26 (95% CI: 17-34, p < 0.01). [7], and prolonged hospitalisation [5]. Pre-operative warming before induction can prevent redistribution hypothermia and can improve thermal comfort by keeping the patient warm during the preoperative period [8,9]. This benefit of pre-operative warming has been demonstrated in several studies during regional [10] and general anaesthesia [8,11,12]. The administration of pre-operative warming has even been shown to abolish completely the need for any additional intra-operative warming in certain patient populations [13,14].There is, however, another potential benefit of preoperative warming: it may reduce anxiety. In four recent studies, minor trauma victims [15], patients with lower back pain [16], patients with renal colic [17] and cholelithiasis pain [18] were assigned to passive insulation or carbon-fibre warming: The warmed patients had improved thermal comfort, less pain, and were significantly less anxious.For the reduction of pre-operative anxiety, patients typically receive medications such as oral or intravenous benzodiazepines, yet these medications are not always effective and can be associated with respiratory depression and delayed discharge [19][20][21][22][23]. Thus, several non-pharmacological methods to reduce pre-operative anxiety have been considered, including music therapy [24,25], supply of in-depth information with leaflets [26] or videos

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Section: Discussionmentioning

confidence: 99%

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

2007

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“…Unsurprisingly, when compared against passive insulation [90] or no warming [41,91], resistive heating achieves significantly higher patient core temperatures. Furthermore, when evaluated against forced-air warming, an early non-clinical investigation with healthy volunteers showed that the heat transfer achieved from resistive heating was significantly greater [92].…”

Section: Resistive Heatingmentioning

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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“…electric blankets). Unsurprisingly, resistive heating is more effective than passive insulation [8,9]. Various over-the-body resistive heating systems have been compared to forced-air, with some studies concluding that both methods maintain normothermia [10][11][12][13] but at least one concluding that resistive heating is less effective [14].…”

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confidence: 99%

Intra‐operative rewarming with Hot Dog^® resistive heating and forced‐air heating: a trial of lower‐body warming

Röder

Sessler

Schopper³

et al. 2011

Anaesthesia

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SummaryResistive heating is an alternative to forced-air warming which is currently the most commonly used intra-operative warming system. We therefore tested the hypothesis that rewarming rates are similar with Hot Dog Ò (Augustine Biomedical) resistive and Bair Hugger Ò (Arizant) forced-air heating systems. We evaluated 28 patients having major maxillary tumour surgery. During the establishment of invasive monitoring, patients became hypothermic, dropping their core temperature to about 35°C. They were then randomly assigned to rewarming with lower-body resistive (n = 14) or forced-air (n = 14) heating, with each system set to 'high'. Our primary outcome was the rewarming rate during active heating over a core temperature range from 35 to 37°C. Morphometric characteristics were comparable in both groups. Temperature increased at twice the rate in patients assigned to forced-air warming, with an estimated mean (SE) slope of 0.49 (0.03)°C.h )1 vs 0.24 (0.02)°C.h )1 (p < 0.001). Resistive heating warmed at half the rate of forced air.

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Effectiveness of Resistive Heating Compared With Passive Warming in Treating Hypothermia Associated With Minor Trauma: A Randomized Trial

Cited by 41 publications

References 49 publications

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

Peri‐operative warming devices: performance and clinical application

Intra‐operative rewarming with Hot Dog^® resistive heating and forced‐air heating: a trial of lower‐body warming

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Effectiveness of Resistive Heating Compared With Passive Warming in Treating Hypothermia Associated With Minor Trauma: A Randomized Trial

Cited by 41 publications

References 49 publications

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

Peri‐operative warming devices: performance and clinical application

Intra‐operative rewarming with Hot Dog® resistive heating and forced‐air heating: a trial of lower‐body warming

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Product

Resources

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Intra‐operative rewarming with Hot Dog^® resistive heating and forced‐air heating: a trial of lower‐body warming