Pre-induction skin-surface warming minimizes intraoperative core hypothermia

Camus, Y.; Delva, E.; Sessler, Daniel I.; Lienhart, A.

doi:10.1016/0952-8180(95)00051-i

Cited by 92 publications

(40 citation statements)

References 31 publications

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“…In contrast, it is well established that prewarming reduces redistribution hypothermia 22,26,27 by warming peripheral tissues to nearly core temperature. 28 Without a thermal gradient, the second Law of Thermodynamics specifies that there can be no flow of heat — and thus no redistribution hypothermia.…”

Section: Discussionmentioning

confidence: 97%

Intraoperative Core Temperature Patterns, Transfusion Requirement, and Hospital Duration in Patients Warmed with Forced Air

et al. 2015

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Background Core temperature patterns in patients warmed with forced-air remain poorly characterized. Also unknown is the extent to which transient and mild intraoperative hypothermia contributes to adverse outcomes in broad populations. Methods We evaluated esophageal (core) temperatures in 58,814 adults having surgery lasting >60 min who were warmed with forced air. Independent associations between hypothermic exposure and transfusion requirement and duration of hospitalization was evaluated. Results In every percentile subgroup, core temperature decreased during the first hour and subsequently increased. The mean lowest core temperature during the first hour was 35.7 ± 0.6°C. Sixty-four percent of the patients reached a core temperature threshold of <36°C 45 min after induction; 29% reached a core temperature threshold of <35.5°C. Nearly half the patients had continuous core temperatures <36°C for more than an hour, and 20% of the patients were <35.5°C for more than an hour. Twenty percent of patients had continuous core temperatures <36°C for more than 2 h, and 8% of the patients were below 35.5°C for more than 2 h. Hypothermia was independently associated with both transfusion and duration of hospitalization, although prolongation of hospitalization was small. Conclusions Even in actively warmed patients, hypothermia is routine in the first hour of anesthesia. Thereafter, average core temperatures progressively increase. Nonetheless, intraoperative hypothermia was common, and often prolonged. Hypothermia was associated with increased transfusion requirement which is consistent with numerous randomized trials.

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Section: Discussionmentioning

confidence: 97%

Intraoperative Core Temperature Patterns, Transfusion Requirement, and Hospital Duration in Patients Warmed with Forced Air

et al. 2015

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“…173 Either amount should be suffi cient to minimize redistribution. The benefi ts of prewarming have been demonstrated in both volunteers 174 and surgical patients 138,175,176 (Figure 8-10). Assuming intraoperative forced-air warming is anticipated, there is no additional patient cost to prewarming because the same disposable cover can be used before and during surgery.…”

Section: Thermal Managementmentioning

confidence: 97%

mentioning

confidence: 99%

Shivering: scores and protocols

Badjatia

2012

Crit Care

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“…Loss of body heat during induction of anesthesia can be averted by actively warming patients before anesthesia, 92 although in practice this is rarely done. Intraoperative warming to prevent hypothermia is now quite common.…”

Section: Preventionmentioning

confidence: 99%