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Prewarming patients

He Ma, Bingjie Lai, Shanshan Dong, Xinyu Li, Yunfeng Cui, Qianchuang Sun, Wenhua Liu, Wei Jiang, Feng Xu, Hui Lv, Hongyu Han, Zhenxiang Pan
BACKGROUND: This prospective, randomized, and controlled study was performed to determine the benefits of prewarmed infusion in elderly patients who underwent bilateral hip replacement. METHODS: Between September 2015 and April 2016, elderly patients who underwent bilateral hips replacement that met the inclusion and exclusion criteria were included in this study. After inclusion, patients were randomized into one of the study groups: in the control group, patients received an infusion of fluid kept at room temperature (22-23°C); in the warming infusion group, patients received an infusion of fluid warmed using an infusion fluid heating apparatus (35°C)...
March 2017: Medicine (Baltimore)
E-P Horn, E Klar, J Höcker, A Bräuer, B Bein, H Wulf, A Torossian
To improve perioperative quality and patient safety, the German S3 guideline should be consistently implemented to avoid perioperative hypothermia. Perioperative normothermia is a quality indicator and should be achieved by anesthesiologists and surgeons. To detect hypothermia early during the perioperative process, measuring body temperature should be started 1-2 h preoperatively. Patients should be actively warmed for 20-30 min before starting anesthesia. Prewarming is most effective and should be included in the preoperative process...
January 9, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Tobias Werk, Imke S Ludwig, Hanns-Christian Mahler, Joerg Luemkemann, Joerg Huwyler, Mathias Hafner
Reconstitution time of dried products is influenced by various factors including formulation, process, and reconstitution method itself. This manuscript describes factors affecting reconstitution in a dual chamber syringe using highly concentrated human monoclonal antibody and bovine serum albumin model formulations. Freezing and drying conditions had only minor impact on the reconstitution time, whereas the primary container and thus the geometry of the lyophilization cake played a major role. Prewarmed diluent and agitation decreased reconstitution time...
November 2016: PDA Journal of Pharmaceutical Science and Technology
Matthias Görges, Nicholas C West, Simon D Whyte
BACKGROUND: Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management...
March 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Alexander Torossian, Elke Van Gerven, Karin Geertsen, Bengt Horn, Marc Van de Velde, Johan Raeder
STUDY OBJECTIVE: Incidence of inadvertent perioperative hypothermia is still high; therefore, present guidelines advocate "prewarming" for its prevention. Prewarming means preoperative patient skin warming, which minimizes redistribution hypothermia caused by induction of anesthesia. In this study, we compared the new self-warming BARRIER EasyWarm blanket with passive thermal insulation regarding mean perioperative patient core body temperature. DESIGN: Multinational, multicenter randomized prospective open-label controlled trial...
November 2016: Journal of Clinical Anesthesia
Zohaib Akhtar, Brian D Hesler, Alexa N Fiffick, Edward J Mascha, Daniel I Sessler, Andrea Kurz, Sabry Ayad, Leif Saager
STUDY OBJECTIVE: To test the primary hypothesis that forced-air prewarming improves patient satisfaction after outpatient surgery and to evaluate the effect on core temperature and thermal comfort. DESIGN: Prospective randomized controlled trial. SETTING: Preoperative area, operating room, and postanesthesia care unit. PATIENTS: A total of 115 patients aged 18 to 75 years with American Society of Anesthesiologists status <4 and body mass index of 15 to 36kg/m(2) who were undergoing outpatient surgery (duration <4 hours)...
September 2016: Journal of Clinical Anesthesia
Clarissa Tjoakarfa, Vikram David, Atlas Ko, Raphael Hau
BACKGROUND: The use of forced air warming devices in the operating room has been shown to cause disruption of laminar airflow and a potential for increase in surgical site contamination. In contrast, conductive warming devices such as reflective blankets do not disrupt airflow and therefore have no potential for this increase in surgical site infection. However, some studies have shown them to be inferior to forced air warming devices in maintaining normothermia. We tested the hypothesis that the use of reflective blankets is as effective as forced air warming devices in maintaining intraoperative normothermia after adequate prewarming...
July 21, 2016: Journal of Arthroplasty
Youn Joung Cho, Seo Yun Lee, Tae Kyong Kim, Deok Man Hong, Yunseok Jeon
BACKGROUND: General anesthesia may induce inadvertent hypothermia and this may be related to perioperative cardiovascular complications. Microvascular reactivity, measured by the recovery slope during a vascular occlusion test, is decreased during surgery and is also related to postoperative clinical outcomes. We hypothesized that microvascular changes during surgery may be related to intraoperative hypothermia. To evaluate this, we conducted a randomized study in patients undergoing off-pump coronary artery bypass surgery, in which the effect of prewarming on microvascular reactivity was evaluated...
2016: PloS One
Jeremy S Pollock, Ryan D Hollenbeck, Li Wang, Benjamin Holmes, Michael N Young, Matthew Peters, E Wesley Ely, John A McPherson, Eduard E Vasilevskis
BACKGROUND: Mild therapeutic hypothermia is recommended for comatose patients resuscitated from cardiac arrest. However, the prevalence of delirium and its associated risk factors have not been assessed in survivors of cardiac arrest treated with therapeutic hypothermia. OBJECTIVE: To determine the prevalence of and risk factors for delirium among survivors of cardiac arrest who were treated with therapeutic hypothermia. METHODS: A retrospective observational study of patients treated with therapeutic hypothermia after cardiac arrest from 2007 through 2014...
July 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Matthias Görges, Nicholas C West, Wesley Cheung, Guohai Zhou, Firoz Miyanji, Simon D Whyte
BACKGROUND: Underbody forced air warming is a method commonly used for intraoperative temperature maintenance in children. We previously reported that preoperative forced air warming of children undergoing spinal surgery substantially reduces the incidence and duration of intraoperative hypothermia (<36°C). OBJECTIVE: The aim of this study was to evaluate the effects of preoperative warming before spinal deformity surgery on surgical site infection rate, length of hospitalization, and bleeding (estimated blood loss and incidence of cell salvaged and/or allogeneic packed red blood cell transfusions)...
September 2016: Paediatric Anaesthesia
M Menzel, R Grote, D Leuchtmann, C Lautenschläger, C Röseler, A Bräuer
BACKGROUND: Perioperative hypothermia is defined as a core temperature below 36 °C. The literature shows that perioperative hypothermia is a frequent but potentially preventable complication of the surgical process. The risk of experiencing perioperative hypothermia is inherent for all anesthetized patients, independent of the type of surgery. Unless preventative measures are taken, perioperative hypothermia occurs in 50 to 70 % of all surgical patients. In Germany and Austria the guideline "Preventing inadvertent perioperative hypothermia" has been published...
June 2016: Der Anaesthesist
Alexander Emmert, Robert Franke, Ivo Florian Brandes, Marc Hinterthaner, Bernhard C Danner, Martin Bauer, Anselm Bräuer
Background Perioperative hypothermia is frequent during thoracic surgery. After approval by the local ethics committee and written informed consent from patients, we examined the efficiency of prewarming and intraoperative warming with a convective warming system and conductive warming system to prevent perioperative hypothermia during video-assisted thoracic surgery (VATS). Methods We randomized 60 patients with indication for VATS in two groups (convective warming with an underbody blanket vs. conductive warming with an underbody mattress and additional warming of the legs)...
May 13, 2016: Thoracic and Cardiovascular Surgeon
Madeleine Kok, Casper Mihl, Babs M F Hendriks, Sibel Altintas, Nienke G Eijsvoogel, Bas L J H Kietselaer, Joachim E Wildberger, Marco Das
PURPOSE: Pain sensation and extravasation are potential drawbacks of contrast media (CM) injection during computed tomographic angiography. The purpose was to evaluate safety and patient comfort of higher flow rates in different CM protocols during coronary computed tomographic angiography. METHODS: Two hundred consecutive patients of a double-blind randomized controlled trial (NCT02462044) were analyzed. Patients were randomized to receive 94 mL of prewarmed iopromide 240 mg I/mL at 8...
December 2016: Investigative Radiology
Jai Darvall, Rukman Vijayakumar, Kate Leslie
PURPOSE: Prewarming prior to surgery is effective in preventing perioperative hypothermia. There is a paucity of evidence, however, regarding the hemodynamic effects of prewarming. We hypothesized that the nadir mean arterial pressure during anesthesia induction would be higher after prewarming than after no prewarming. METHODS: We randomized 32 patients prior to elective neurosurgery to receive either one hour of forced-air convective warming at 46°C or routine care (full body blanket with convective warmer attached but not turned on)...
May 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Ernst-Peter Horn, Berthold Bein, Ole Broch, Timo Iden, Ruwen Böhm, Svea-Kristina Latz, Jan Höcker
BACKGROUND: Epidural analgesia (EDA) is known to be an independent risk factor for perioperative hypothermia and its many known adverse effects. Combined general and epidural anaesthesia decreases intraoperative core temperature more rapidly than general anaesthesia alone. Hence, adequate warming procedures are needed for these patients. OBJECTIVE: We evaluated the effects of active skin-surface warming before and/or after initiation of EDA during general anaesthesia as a procedure to prevent perioperative hypothermia...
May 2016: European Journal of Anaesthesiology
Casper Mihl, Madeleine Kok, Joachim E Wildberger, Sibel Altintas, David Labus, Estelle C Nijssen, Babs M F Hendriks, Bas L J H Kietselaer, Marco Das
PURPOSE: Aim of this study was to test the hypothesis that peak injection pressures and image quality using low concentrated contrast media (CM) (240 mg/mL) injected with high flow rates will be comparable to a standard injection protocol (CM: 300 mg/mL) in coronary computed tomographic angiography (CCTA). MATERIAL AND METHODS: One hundred consecutive patients were scanned on a 2nd generation dual-source CT scanner. Group 1 (n=50) received prewarmed Iopromide 240 mg/mL at an injection rate of 9 mL/s, followed by a saline chaser...
November 2015: European Journal of Radiology
Jun Shen, Qin Wang, YuXia Zhang, Xuan Wang, Peng Shi
BACKGROUND: Postoperative hypothermia in the postanesthesia care unit (PACU) in neonates and infants is a well-known serious complication as it can increase the risk of blood loss, wound infections, and cardiac arrhythmias. AIM: To identify an effective rewarming method for neonates and infants in China with postoperative hypothermia, an open-label, randomized, and controlled study was performed to compare the effects of three different rewarming methods. METHODS: Neonates and infants (<1 year) admitted to the PACU after surgery between June 2011 and November 2012 in a local hospital were investigated...
November 2015: Paediatric Anaesthesia
R M Waeschle, S G Russo, B Sliwa, F Bleeker, M Russo, M Bauer, A Bräuer
BACKGROUND: Improvement of quality of care and patient safety while decreasing costs are major challenges in healthcare systems. This challenge includes the avoidance of perioperative hypothermia to reduce the associated adverse effects, length of stay and treatment costs. Due to the medical and economic relevance the national S3 guidelines for the prevention of perioperative hypothermia were recently published. AIM: This study presents and analyses the reality of utilization of thermal management in German hospitals depending on the size of the hospital, which is based on the number of beds...
August 2015: Der Anaesthesist
Anne Erdling, Anders Johansson
Unplanned perioperative hypothermia is a well-known complication to anesthesia. This study compares esophageal and nasopharyngeal temperature measured in the same patient for a period of 210 minutes of anesthesia. Forty-three patients undergoing colorectal surgery were randomly assigned in 2 groups, with or without a prewarming period (group A = prewarming [n = 21] or group B = no prewarming [n = 22]). Demographics were similar in both groups. Mean temperatures at 210 minutes were statistically different between the groups at both sites of measurement...
April 2015: AANA Journal
Alexander Torossian, Anselm Bräuer, Jan Höcker, Berthold Bein, Hinnerk Wulf, Ernst-Peter Horn
BACKGROUND: 25-90% of all patients undergoing elective surgery suffer from inadvertent postoperative hypothermia, i.e., a core body temperature below 36°C. Compared to normothermic patients, these patients have more frequent wound infections (relative risk [RR] 3.25, 95% confidence interval [CI] 1.35-7.84), cardiac complications (RR 4.49, 95% CI 1.00-20.16), and blood transfusions (RR 1.33, 95% CI 1.06-1.66). Hypothermic patients feel uncomfortable, and shivering raises oxygen consumption by about 40%...
March 6, 2015: Deutsches Ärzteblatt International
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