Prevention of hypothermia in children under combined epidural and general anesthesia: a comparison between upper‐ and lower‐body warming

Shorrab, Ahmed A.; ElSawy, M.E.; Othman, Mahmoud M.; Hammouda, Golinar E.

doi:10.1111/j.1460-9592.2006.02006.x

Cited by 13 publications

(13 citation statements)

References 22 publications

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“…The electric blanket setting was as same as in group E, and the forced-air warming system was controlled at 38 °C during the rewarming process. [10] …”

Section: Methodsmentioning

confidence: 99%

Effect of an electric blanket plus a forced-air warming system for children with postoperative hypothermia

Shi²,

Ren³

et al. 2017

Medicine

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Background:Postoperative hypothermia in children in postanesthesia care unit (PACU) is a well-known serious complication as it increases the risk of blood loss, wound infections, and cardiac arrhythmias. We conducted this prospective randomized controlled trial to evaluate the effect of an electric blanket plus a forced-air warming system on rewarming in children with postoperative hypothermia.Methods:We recruited 346 children (aged < 3 years) who were admitted to a PACU after surgery and diagnosed with hypothermia between March and August 2016. They were randomly divided into 3 groups: group C (n = 108, rewarmed with only a regular blanket), group E (n = 123, rewarmed with a regular blanket plus an electric blanket), and group EF (n = 115, rewarmed with an electric blanket plus a forced-air warming system). From the beginning of rewarming, the rectal temperature was recorded every 5 minutes for the first half hour, then every 10 minutes up to when the patient left the PACU. The primary outcome was the rewarming time of children (from the beginning of rewarming to recovery of normothermia). The rewarming rate, increase in temperature (compared with the beginning of rewarming), hemodynamics, recovery time, and incidences of adverse effects were recorded.Results:There were no significant differences among the 3 groups in terms of the baseline clinical characteristics, use of narcotic drugs, intraoperative temperature, and hemodynamics (P > .05). Compared with the children in groups C and E, both the heart rate and mean arterial pressure of those in group EF were significantly increased after 10 minutes of arriving at the PACU (P < .05). Children in the EF group had the shortest rewarming time (35.61 ± 16.45 minutes, P < .001) and highest rewarming efficiency (0.028 ± 0.001 °C/min, P < .001), while there was no evidence of a difference in increased rectal temperature among the 3 groups. Children in the EF group had lower incidences of arrhythmia, shivering, nausea, and vomiting (P < .05).Conclusion:The combination of an electric blanket and a forced-air warming system was shown to be an effective rewarming method for children with postoperative hypothermia.

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“…The electric blanket setting was as same as in group E, and the forced-air warming system was controlled at 38 °C during the rewarming process. [10] …”

Section: Methodsmentioning

confidence: 99%

Effect of an electric blanket plus a forced-air warming system for children with postoperative hypothermia

Shi²,

Ren³

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…The smaller the temperature gradient between the highest and the lowest temperatures provided by the blanket, the better its efficiency 12 . A study by Shorrab et al 13 that included data from pediatric epidural and general anesthesia surgeries suggests that there is similar heat loss between lower and upper body blankets of equal surface areas. Because of this, both upper body blankets and lower body blankets were effective in preventing intraoperative hypothermia; the choice between a lower body blanket and an upper body blanket depends mainly on the surgical site and procedure 13 …”

Section: Level Of Evidence In This Article According To the National mentioning

confidence: 99%

“…Although the topic of hypothermia is included in most surgical textbooks, results of studies indicate that there is inadequate knowledge among surgical team members about the implementation of warming techniques and about which warming techniques work best or are most cost effective for surgical patients 1,13 . Perioperative educators must highlight the risks of hypothermia for staff members and provide education to fill knowledge gaps about hypothermia, techniques to effectively warm patients, and instructions for using warming devices.…”

Section: Level Of Evidence In This Article According To the National mentioning

confidence: 99%

The Safe and Efficient Use of Forced‐Air Warming Systems

Wu¹

2013

AORN Journal

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Maintaining perioperative normothermia is important to ensure that a patient does not experience inadvertent hypothermia and its consequences, such as increased blood loss, cardiac abnormalities, prolonged recovery, and increased risk for wound infection. Many clinical guidelines recommend the use of forced-air warming as one of several techniques to prevent inadvertent perioperative hypothermia. Safe use of forced-air warming devices includes choosing the right device, assessing the patient for risks, protecting the patient from burn injuries, appropriately maintaining the patient's body temperature, and using the device as directed by the manufacturer's recommendations. Staff members should receive education on hypothermia and warming technology on a regular basis.

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“…Nevertheless, the approved conventional forced‐air warmers are not always capable of preventing severe perioperative hypothermia in neonates and children throughout the intraoperative period or when used as the sole device , and Barker et al ., for example, recommend a combination of different warming methods to maintain normthermia , as we have stated in our manuscript .…”

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confidence: 99%

Reply to the comment on: Witt L, Dennhardt N, Eich C et al. Prevention of intraoperative hypothermia in neonates and infants: results of a prospective multicentre observational study with a new forced‐air warming system with increased warm air flow. Pediatr Anesth 2013; 23: 469–474

Witt

Sümpelmann

Bräuer

2013

Pediatric Anesthesia

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Prevention of hypothermia in children under combined epidural and general anesthesia: a comparison between upper‐ and lower‐body warming

Abstract: Lower body warming is as effective as UBW in prevention of hypothermia in children subjected to combined epidural and general anesthesia.

Cited by 13 publications

References 22 publications

Effect of an electric blanket plus a forced-air warming system for children with postoperative hypothermia

Effect of an electric blanket plus a forced-air warming system for children with postoperative hypothermia

The Safe and Efficient Use of Forced‐Air Warming Systems

Reply to the comment on: Witt L, Dennhardt N, Eich C et al. Prevention of intraoperative hypothermia in neonates and infants: results of a prospective multicentre observational study with a new forced‐air warming system with increased warm air flow. Pediatr Anesth 2013; 23: 469–474

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