|
|
October 16-20, 2010 San Diego, CA Home Abstract Archive Search Abstracts 2010 Session Grid 2010 Meeting Website Policy Statements ASA Website Feedback 
Visit Anesthesiology.org |
| Previous Abstract | Next Abstract |
| Printable Version |
|
A1280
October 20, 2009 2:00 PM - 4:00 PM Room Area M |
| Comparable Core Temperature with Circulating-Water Garment vs. Forced-Air/Circulating-Water Mattress |
|
**
Silvia E. Perez-Protto, M.D., Edward Mascha, Ph.D., Luke Reynolds, M.S., Mohamed Bakri, M.D., Daniel I. Sessler, M.D. Department of Outcomes Research, The Cleveland Clinic, Cleveland, Ohio |
|
Background
: A recent heat-balance study in volunteers suggested that greater efficacy of circulating water garments results largely from increased heat transfer across the posterior skin surface since heat transfer across the anterior skin surface was similar with circulating-water and forced-air. We thus tested the hypothesis that the combination of a circulating-water mattress and forced-air warming prevents temperature reduction during major abdominal surgery as well as a circulating-water garment does.
Methods : 50 adult patients aged between 18 and 85 years old, undergoing major abdominal surgery, were randomly assigned to intraoperative warming with a combination of forced-air and a circulating-water mattress (CWM) or with a circulating-water garment (CWG) (Allon ThermoWrap). Core temperature was measured in the distal esophagus. Non-inferiority of the CWM to the CWG on change from baseline to median intraoperative temperature was assessed multivariably by first adjusting for the observed imbalance in continuous baseline covariables using analysis of covariance, and then applying a one-tail student t test with an equivalency buffer of 0.5°C. Results : Data analysis was restricted to 16 CWG and 20 CWM patients who completed the protocol. Core temperature increased in both groups during the initial hours of surgery.[figure1]We had sufficient evidence (multivariable P < 0.001), to conclude that the combination of a circulating-water mattress and forced-air warming is no worse than (i.e., non-inferior to, and actually superior to) a circulating-water garment in preventing temperature reduction, with mean (95% CI) difference in the temperature change between the CWM and the CWG groups (CWM minus CWG) of 0.49ºC (95% CI: 0.03ºC, 0.95ºC). Conclusions : The combination of a circulating-water mattress and forced-air warming is as effective ( i.e. , significantly non-inferior) in maintaining core temperature and less expensive than a circulating-water garment; the combination thus appears preferable to a circulating-water garment alone. Key words: Anesthesia. Temperature. Thermoregulation. Circulating-water. Forced-air. Heat. From Proceedings of the 2009 Annual Meeting of the American Society Anesthesiologists. |
Figure 1
 |