Effect of preoperative warming on intraoperative hypothermia: a randomized-controlled trial Warming with an underbody warming system reduces intraoperative hypothermia in patients undergoing laparoscopic gastrointestinal surgery: a randomized controlled study. Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery. Preoperative warming combined with intraoperative skin-surface warming does not avoid hypothermia caused by spinal anesthesia in patients with midazolam premedication. Forced-air warming and fluid warming minimize core hypothermia during abdominal surgery. Normothermia to Prevent Surgical Site Infections After Gastrointestinal Surgery: Holy Grail or False Idol? Use of forced-air warming during and after outpatient arthroscopic surgery. Prevention of Intraoperative Hypothermia by Preoperative Skin-Surface Warming The Effect of Forced Air Warming on Postoperative Oxygen Consumption and Temperature in Elective Orthopaedic Surgery Benefits of intraoperative skin surface warming in cardiac surgical patients. Pre-induction skin-surface warming minimizes intraoperative core hypothermia. Forced-Air Warming Decreases Vasodilator Requirement After Coronary Artery Bypass Surgery Efficacy of external warming in attenuation of hypothermia in surgical patients. Warming of intravenous fluids prevents hypothermia during off-pump coronary artery bypass graft surgery. Intraoperative Patient Warming using Radiant Warming or Forced-air Warming during Long Operations Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. Hypothermia control in elderly surgical patients in the intraoperative period: evaluation of two nursing interventions.
Purpose The purpose of this study was to evaluate the effects of preoperative forced-air warming on intraoperative hypothermia . Methods In this r and omized-controlled trial , adult patients scheduled for elective , non-cardiac surgery under general anesthesia were stratified by scheduled surgical duration ( < 2.5 hr or ≥ 2.5 hr ) and then r and omized to a pre-warming group using a BairPaws ™ forced-air warming system for at least 30 min preoperatively or to a control group with warmed blankets on request . All patients were warmed intraoperatively via convective forced-air warming blankets .  Perioperative temperature was measured using the SpotOn ™ temperature system consisting of a single-use disposable sensor applied to the participant ’s forehead . The primary outcome was the magnitude of intraoperative hypothermia calculated as the area under the time-temperature curve for core temperatures < 36 ° C between induction of general anesthesia and leaving the operating room . Secondary outcomes included surgical site infections , packed red blood cell requirements , and 24 hr postoperative opioid consumption . Results Two hundred participants were analyzed ( 101 control ; 99 pre-warmed ) . Pre-warmed participants had a lower median [ interquartile range ] magnitude of hypothermia than controls ( 0.00 [ 0.00 - 0.12 ] ° C·hr−1vs 0.05 [ 0.00 - 0.36 ] ° C·hr−1 , respectively ; median difference , −0.01 ° C·hr−1 ; 95 % confidence interval , −0.04 to 0.00 ° C·hr−1 ; P = 0.005 ) . There were no between-group differences in the secondary outcomes . Conclusion A minimum of 30 min of preoperative forced-air convective warming decreased the overall intraoperative hypothermic exposure . While redistribution hypothermia still occurs despite pre- and intraoperative forced-air warming , their combined application results in greater preservation of intraoperative normothermia compared with intraoperative forced-air warming alone . Trial registration www . clinical trials.gov ( NCT02177903 ) . Registered 25 June 2014.RésuméObjectifL’objectif de cette étude était d’évaluer les conséquences du réchauffement préopératoire par air forcé sur l’hypothermie peropératoire . MéthodesDans cette étude r and omisée contrôlée , des patients adultes devant subir une chirurgie élective non cardiaque sous anesthésie générale ont été stratifiés en fonction de la durée prévue de l’intervention ( < 2,5 h ou ≥ 2,5 h ) puis r and omisés dans un groupe de réchauffement préalable utilisant un système à air forcé BairPaws ™ pendant au moins 30 min en préopératoire ou dans un groupe témoin avec couvertures chauffantes sur dem and e. Tous les patients ont été réchauffés pendant l’intervention au moyen de couvertures chauffantes à air forcé par convection . La température périopératoire a été mesurée au moyen du système de surveillance de la température SpotOnMD consistant en un capteur jetable à usage unique placé sur le front des patients . Le critère principal d’évaluation était l’ampleur de l’hypothermie peropératoire calculée comme l’aire sous la courbe température-temps pour des températures central es < 36 ° C entre l’induction de l’anesthésie générale et la sortie de la salle d’opération . Les critères d’évaluation secondaires ont inclus les infections du site chirurgical , le nombre de culots de globules rouges nécessaires et la consommation d’opioïdes au cours des 24 heures postopératoires . RésultatsLes résultats de 200 participants ont été analysés ( 101 contrôles ; 99 patients préréchauffés ) . L’amplitude médiane de l’hypothermie [ écart interquartile ] des participants préréchauffés a été plus faible que celle des contrôles ( respectivement , 0,00 [ 0,00 - 0,12 ] ° C·hr−1 contre 0,05 [ 0,00 - 0,36 ] ° C·hr−1 ; différence entre médianes , −0,01 ° C·hr−1 ; intervalle de confiance à 95 % , −0,04 à 0,00 ° C·hr−1 ; P < 0,005 ) . Il n’y a pas eu de différence entre les groupes sur les critères d’évaluation secondaires . Conclusion Un minimum de 30 min de réchauffement préopératoire au moyen d’un système à air forcé à convection a diminué l’exposition globale à l’hypothermie peropératoire . Bien qu’une hypothermie de redistribution survienne toujours en dépit du réchauffement peropératoire à l’air forcé , leur application combinée entraîne une meilleure conservation de la normothermie peropératoire , comparativement au réchauffement peropératoire à l’air forcé seul . Enregistrement de l’essai cliniquewww.essaiscliniques.gov ( NCT02177903 ) . Enregistré le 25 juin 2014 BACKGROUND Intraoperative hypothermia is a common event during laparoscopic abdominal surgery . On one h and , intraoperative hypothermia can delay the metabolism and prevent tissue damage . One the other h and , long-term and severe intraoperative hypothermia may also lead to perioperative complications , such as increasing of peripheral resistance , coagulation dysfunction , intraoperative hemorrhage and postoperative shivering . Maintenance of normothermia during surgical procedures may improve the quality of patient care . OBJECTIVES This study investigated the feasibility and efficacy of intraoperative cutaneous warming with an underbody warming system during laparoscopic gastrointestinal surgery . METHODS 110 patients undergoing laparoscopic surgery for gastrointestinal cancer between January and December 2011 were r and omized into the laparoscopic control ( Control ) group and laparoscopic intervention ( Intervention ) group . Nasopharyngeal temperature , prothrombin time , activated partial thromboplastin time , and thrombin time were measured before and during surgery , intraoperative and postoperative complications , as well as shivering after anesthesia and visual analog scale score for pain evaluation after surgery were also recorded . Clinical risk factors that may cause intraoperative hypothermia during laparoscopic surgery were also analyzed by correlation analysis . RESULTS The two groups were comparable at the baseline . Intraoperative hypothermia was observed in 29 patients ( 52.7 % ) in Control group and 3 ( 5.5 % ) in Intervention group . Nasopharyngeal temperature in Control group was significantly decreased since 30min after the start of operation until the end of surgery comparing to that at the start of anesthesia , but there was no difference in the Intervention group . In Intervention group , the nasopharyngeal temperature was remaining at ∼36.5 ° C , indicating the feasibility and efficiency of the underbody warming system in preventing intraoperative hypothermia during laparoscopic gastrointestinal surgery . Moreover , with anesthesia and operation time increased , there was no significant change of coagulation function , hemoglobin level as well as less intraoperative hemorrhage , less postoperative shivering and lower visual analog scale score in Intervention group comparing to Control group . Multivariate logistic regression analysis revealed that anesthesia time and volume of CO2 were independent risk factors for perioperative hypothermia . CONCLUSIONS Cutaneous warming with an underbody warming system is a feasible and effective method to prevent intraoperative hypothermia during laparoscopic gastrointestinal surgery STUDY OBJECTIVES To evaluate the effects of intraoperative skin-surface warming with and without 1 hour of preoperative warming , in preventing intraoperative hypothermia , and postoperative hypothermia , and shivering , and in offering good conditions to early tracheal extubation . DESIGN Prospect i ve , r and omized , blind study . SETTING Teaching hospital . PATIENTS 30 ASA physical status I and II female patients scheduled for elective abdominal surgery . INTERVENTIONS Patients received st and ard general anesthesia . In 10 patients , no special pre caution s were taken to avoid hypothermia . Ten patients were su bmi tted to preoperative and intraoperative active warming . Ten patients were only warmed intraoperatively . MEASUREMENTS AND MAIN RESULTS Temperatures were recorded at 15-minute intervals . The patients who were warmed preoperatively and intraoperatively had core temperatures significantly more elevated than the other patients during the first two hours of anesthesia . All patients warmed intraoperatively were normothermic only at the end of the surgery . The majority of the patients warmed preoperatively and intraoperatively or intraoperatively only were extubated early , and none had shivering . In contrast , five unwarmed patients shivered . CONCLUSIONS One hour of preoperative warning combined with intraoperative skin-surface warming , not simply intraoperative warming alone , avoided hypothermia caused by general anesthesia during the first two hours of surgery . Both methods prevented postoperative hypothermia and shivering and offered good conditions for early tracheal extubation CONTEXT AND OBJECTIVE Inadvertent perioperative hypothermia is common during spinal anesthesia and after midazolam administration . The aim of this study was to evaluate the effects of intraoperative skin-surface warming with and without 45 minutes of preoperative warming in preventing intraoperative and postoperative hypothermia caused by spinal anesthesia in patients with midazolam premedication . DESIGN AND SETTING Prospect i ve and r and omized study at Hospital das Clínicas , Universidade Estadual Paulista , Botucatu . METHODS Thirty patients presenting American Society of Anesthesiologists ( ASA ) physical status I and II who were scheduled for elective lower abdominal surgery were utilized . The patients received midazolam premedication ( 7.5 mg by intramuscular injection ) and st and ard spinal anesthesia . Ten patients ( Gcontrol ) received preoperative and intraoperative passive thermal insulation . Ten patients ( Gpre+intra ) underwent preoperative and intraoperative active warming . Ten patients ( Gintra ) were only warmed intraoperatively . RESULTS After 45 min of preoperative warming , the patients in Gpre+intra had significantly higher core temperatures than did the patients in the unwarmed groups ( Gcontrol and Gintra ) before the anesthesia ( p < 0.05 ) but not at the beginning of surgery ( p > 0.05 ) . The patients who were warmed intraoperatively had significantly higher core temperatures than did the patients in Gcontrol at the end of surgery ( p < 0.05 ) . All the patients were hypothermic at admission to the recovery room ( T CORE < 36 degrees C ) . CONCLUSIONS Forty-five minutes of preoperative warming combined with intraoperative skin-surface warming does not avoid but minimizes hypothermia caused by spinal anesthesia in patients with midazolam premedication OBJECTIVE To evaluate the effect of intraoperative combined forced-air warming and fluid warming system on  patient 's core temperature , blood loss , transfusion dem and , extubation time , and incidence of postoperative shivering . METHODS Forty patients with American Society of Anesthesiologists physical status I and II , aged 18 - 70 years , scheduled for elective abdominal surgery were r and omly assigned to receive intraoperative warming from a forced-air blanket and fluid warming system or conventional cotton blanket , 20 in each group . The core temperature was recorded every 20 minutes during the operation , as well as the blood loss , blood transfusion , extubation time , and incidence of postoperative shivering . RESULTS The core temperature at the end of the surgery in the warming group was significantly different from that in the control group ( 36.4 + /- 0.4 degrees C vs. 35.3 + /- 0.5 degrees C , P < 0.001 ) . Application of intraoperative warming significantly shortened the time between the end of the surgery and extubation ( P < 0.01 ) . Postoperative shivering occurred in 30 % of the patients in the control group compared to no patient in the warming group ( P < 0.01 ) . CONCLUSION Active warming with air-forced blanket and fluid warming system provides sufficient heat to prevent hypothermia during abdominal surgery Objective : To analyze the association between perioperative normothermia ( temperature ≥36 ° C ) and  surgical site infections ( SSIs ) after gastrointestinal ( GI ) surgery . Summary of Background Data : Although active warming during colorectal surgery reduces SSIs , there is limited evidence that perioperative normothermia is associated with lower rates of SSI . Nonetheless , hospitals participating in the Surgical Care Improvement Project must report normothermia rates during major surgery . Methods : We conducted a nested , matched , case-control study ; cases consisted of GI surgery patients enrolled in our National Surgical Quality Improvement Program data base between March 2006 and March 2009 who developed SSIs . Patient/surgery risk factors for SSI were obtained from the National Surgical Quality Improvement Program data base . Perioperative temperature/antibiotic/glucose data were obtained from medical records . Cases/controls were compared using univariate/r and om effects/logistic regression models . Independent risk factors for SSIs were identified using multivariate/r and om effects/logistic regression models . Results : A total of 146 cases and 323 matched controls were identified ; 82 % of patients underwent noncolorectal surgery . Cases were more likely to have final intraoperative normothermia compared with controls ( 87.6 % vs. 77.8 % , P = 0.015 ) ; rates of immediate postoperative normothermia were similar ( 70.6 % vs. 65.3 % , respectively , P = 0.19 ) . Emergent surgery/higher wound class were associated with higher rates of intraoperative normothermia . Independent risk factors for SSI were diabetes , surgical complexity , small bowel surgery , and nonlaparoscopic surgery . There was no independent association between perioperative normothermia and SSI ( adjusted odds ratio , 1.05 ; 95 % confidence interval , 0.48–2.33 ; P = 0.90 ) . Conclusions : Pay-for-reporting measures focusing on perioperative normothermia may be of limited value in preventing SSI after GI surgery . Studies to define the benefit of active warming after noncolorectal GI surgery are warranted According to a two-phase protocol , 127 patients undergoing arthroscopic knee surgery were r and omly assigned to receive intraoperative warming from a forced-air blanket ( n = 69 ) or conventional warmed cotton blankets ( n = 58 ) . During the initial phase ( Phase I ) , active warming was applied during the intraoperative period only , permitting double-blind assessment of postoperative events . In Phase II , warming was continued into the recovery area , which unblinded the assessment . Active warming raised skin temperature perioperatively , and reduced the decline in core temperature compared to the control group . Postoperatively , core temperature increased toward preoperative values at similar rates in both treatment groups , but was still lower in control patients after an hour in the postanesthesia care unit ( PACU ) . Postoperative shivering occurred in 35 % of all patients and was not prevented by either intraoperative or combined intraoperative and postoperative warming . However , significantly fewer actively warmed patients experienced prolonged postoperative shivering . The addition of postoperative warming appeared to provide little , if any , additional benefit . Despite the decreased duration of postoperative shivering in the actively warmed group , we were unable to demonstrate any reduction in the PACU stay Background : Intraoperative hypothermia initially results from internal redistribution of heat facilitated by anesthesia-induced vasodilatlon . Preinductlon skin-surface warming minimizes postinduction hypothermia in anesthetized volunteers . However , its efficacy might be reduced in surgical situations , because of multiple sources of heat loss . Methods : Intraoperative core and mean skin temperatures were measured during total hip arthroplasty in 16 patients , r and omly assigned to be covered preoperatlvely with a warming blanket for ≥90 min ( prewarmed group ) or not covered ( unwarmed group ) . Results : During the first hour of anesthesia , core temperature decreased more than twice as much in the unwarmed group ( −0.7 ± 0.1 ° C ; mean ± SE ) than in the prewarmed patients ( −0.3 ± 0.1 ° C ) . At the end of surgery , core temperature was 36.3 ± 0.1 ° C in the prewarmed group and 35.2 ± 0.2 ° C in the unwarmed group . During recovery , seven patients obviously shivered in the unwarmed group and none in the prewarmed group . Conclusions : Preanesthetic skin-surface warming reduces the initial postinductlon hypothermia in surgical patients , preventing intraoperative hypothermia and postoperative shivering even for procedures lasting 3 h or longer Actively warming  patients during surgery is considered the best method of preventing inadvertent hypothermia . In order to investigate the effect of forced air warming on postoperative oxygen consumption , we studied 26 patients undergoing orthopaedic surgery  using a prospect i ve , r and omized trial design . We measured oxygen consumption , carbon dioxide production , temperature , thermal comfort and pain scores . Apart from intraoperative temperature , there were no significant differences in these measurements between the two groups . This study demonstrated the gradual heat gain and also the potential for hyperthermia from pre- and intraoperative forced air warming . We conclude that forced air warming is not necessary for moderate duration non-body-cavity surgery if effective preinduction covering of patients and minimal surgical exposure is achieved We have investigated patients undergoing cardiac surgery with hypothermic bypass to see if the addition of skin surface warming during systemic rewarming on bypass ( heated group , n = 43 ) would improve perioperative thermal balance compared with conventional management without skin warming  ( control group , n = 43 ) in an open , r and omized , controlled study . Intraoperative skin warming with a water mattress and forced warm air over the face , neck and shoulders attenuated the afterdrop in nasopharyngeal temperature after weaning from bypass ( 2.3 ( 1.2 ) degrees C and 1.3 ( 0.5 ) degrees C in the control and heated groups , respectively ) ( P < 0.05 ) and result ed in higher rectal temperature 4 h after surgery . Despite similar st and ard coagulation tests , heated patients had lower blood loss via the chest tubes ( 600 ( 264 ) ml vs 956 ( 448 ) ml in control patients ) ( P < 0.05 ) and less requirements for i.v . colloid infusion ( 1662 ( 404 ) ml vs 1994 ( 389 ) ml ) ( P < 0.05 ) . There was a significant inverse correlation between rectal temperature on arrival in the ICU and postoperative blood loss ( r = 0.57 , P < 0.001 ) . These data suggest that additional skin surface warming with a water mattress and forced warm air helped to preserve perioperative thermal balance and may contribute to reduced bleeding after cardiac surgery STUDY OBJECTIVE To test the hypothesis that only one hour of preinduction skin-surface warming decreases the rate at which core hypothermia develops during the first hour of anesthesia . DESIGN R and omized , prospect i ve study . SETTING Operating theater of a university hospital . PATIENTS 16 ASA status I and II adult patients scheduled for laparoscopic cholecystectomy under general anesthesia . INTERVENTIONS Eight patients were assigned to receive forced-air warming for one hour before induction of anesthesia ( prewarmed group ) ; the other eight patients were covered only with a wool blanket during a similar preinduction period ( control group ) . MEASUREMENTS AND MAIN RESULTS Tympanic membrane ( core ) and mean skin-surface temperatures were measured at 15-minutes intervals , starting one hour before induction of anesthesia . Mean skin temperature increased from 34.0 + /- 0.1 C to 37.0 + /- 0.2 degrees C in the pre-warmed group ( p < 0.05 ) , but remained unchanged at 34.7 + /- 0.3 degrees C in the control group . Core temperature during the preinduction period did not change significantly in either group . Following induction of anesthesia , core temperature decreased at a rate of 1.1 + /- 0.1 degrees C/hr in the control group , but only 0.6 + /- 0.1 degrees C/hr in the pre-warmed group ( p < 0.05 ) . After one hour of anesthesia , six of eight pre-warmed patients had core temperatures of at least 36.5 degrees C , whereas only one of the eight control patients did ( p < 0.05 ) . CONCLUSIONS A single hour of preoperative skin-surface warming reduced the rate at which core hypothermia developed during the first hour of anesthesia . Preoperative skin surface warming is particularly helpful during short procedures because redistribution hypothermia is otherwise difficult to treat Postoperative hypothermia is common and associated with adverse hemodynamic consequences , including adrenergically mediated systemic vasoconstriction and hypertension . Hypothermia is also a known predictor of dysrhythmias and myocardial ischemia in high-risk patients . We describe a prospect i ve , r and omized trial design ed to test the hypothesis that forced-air warming ( FAW ) provides improved hemodynamic variables after coronary artery bypass graft . After institutional review board approval and written informed consent , 149 patients undergoing coronary artery bypass graft were r and omized to receive postoperative warming with either FAW ( n = 81 ) or a circulating water mattress ( n = 68 ) . Core temperature was measured at the tympanic membrane . A weighted mean skin temperature was calculated . Heart rate , mean arterial blood pressure , central venous pressure , cardiac output , and systemic vascular resistance were monitored for 22 h postoperatively . Mean arterial blood pressure was maintained by protocol between 70 and 80 mm Hg by titration of nitroglycerin and sodium nitroprusside . The two groups had similar demographic characteristics . Tympanic and mean skin temperatures were similar between groups on intensive care unit admission . During postoperative rewarming , tympanic temperature was similar between groups , but mean skin temperature was significantly greater in the FAW group ( P < 0.05 ) . Heart rate , mean arterial pressure , central venous pressure , cardiac output , and systemic vascular resistance were similar for the two groups . The percent of patients requiring nitroprusside to achieve the hemodynamic goals was less ( P < 0.05 ) in the FAW group . In conclusion , aggressive cutaneous warming with FAW results in a higher mean skin temperature and a decreased requirement for vasodilator therapy in hypothermic patients after cardiac surgery . This most likely reflects attenuation of the adrenergic response or opening of cutaneous vascular beds as a result of surface warming . Implication s Forced-air warming after cardiac surgery decreases the requirement for vasodilator drugs and may be beneficial in maintaining hemodynamic variables within predefined limits BACKGROUND / AIM Hypothermia in surgical patients can be the consequence of long duration of surgical intervention , general anaesthesia and low temperature in operating room . Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia , myocardial ischemia , hypertension , bleeding , wound infection , coagulopathy , and prolonged effect of muscle relaxants . External heating procedures are used to prevent this condition . The aim of this study was to evaluate the efficiency of external warming system in alleviation of cold stress and hypothermia in patients who underwent major surgical procedures . METHODS The study was conducted in the Military Medical Academy in Bel grade . A total of 30 patients of both genders underwent abdominal surgical procedures , r and omly divided into two equal groups : the one was externally warmed using warm air mattress ( W ) , while in the control group ( C ) surgical procedure was performed in regular conditions , without additional warming . Oesophageal temperature ( Te ) was used as indicator of changes in core temperature , during surgery and awakening postoperative period , and temperature of control sites on the right h and ( Th ) and the right foot ( Tf ) reflected the changes in skin temperatures during surgery . Te and skin temperatures were monitored during the intraoperative period , with continuous measurement of Te during the following 90 minutes of the postoperative period . Heart rates and blood pressures were monitored continuously during the intraoperative and awakening period . RESULTS In the W group , the average Te , Tf and Th did not change significantly during the intraoperative as well as the postoperative period . In the controls , the average Te significantly decreased during the intraoperative period ( from 35.61 ± 0.35 ° C at 0 minute to 33.86 ± 0.51 ° C at 120th minute ) . Compared to the W group , Te in the C group was significantly lower in all the observed periods . Average values of Tf and Th significantly decreased in the C group ( from 30.83 ± 1.85 at 20th minute to 29.0 ± 1.39 ° C at 120th minute , and from 32.75 ± 0.96 to 31.05 ± 1.09 ° C , respectively ) . CONCLUSION The obtained results confirm that the external warming using warm air mattress was able to attenuate hypothermia , i.e. substantial decrease in core temperature , compared with the similar exposure to cold stress in the control group OBJECTIVE Even mild perioperative hypothermia ( 34 degrees -36 degrees C ) can cause numerous adverse outcomes , including morbid cardiac events , coagulopathy with increased blood loss , and a decreased resistance to surgical wound infection . The purpose of this study was to evaluate the effect of fluid warming on preventing hypothermia during off-pump coronary artery bypass ( OPCAB ) surgery . DESIGN A prospect i ve r and omized clinical study . SETTING A tertiary care university hospital . PARTICIPANTS Forty patients undergoing OPCAB procedures . INTERVENTIONS Patients were r and omized into control ( n = 20 ) and Hotline ( n = 20 ) groups . In the Hotline group , all intravenous fluids were warmed to 41 degrees C by using 2 Hotline ( SIMS Inc , Rockl and , MD ) systems . All patients ( control and Hotline groups ) were managed with st and ardized institutional practice by using a combination of increased ambient operating room temperature ( to 25 degrees C ) and the use of a warmed water mattress ( 38 degrees C ) . MEASUREMENTS AND MAIN RESULTS Temperatures were recorded every hour after the induction of anesthesia at the pulmonary artery , nasopharynx , rectum , and bladder . In the Hotline group , temperatures were maintained or increased . In the control group , temperatures gradually decreased . There were no significant differences between the 2 groups in hemodynamic parameters , serum catecholamine concentrations , duration of intensive care unit stay , or duration of ward stay . CONCLUSIONS The results show that the warming of intravenous fluids by using the Hotline system prevents decreases in systemic temperatures during OPCAB surgery Forced-air warming is the most commonly used and effective method of active warming . A new radiant warming device ( Suntouch ™ , Fisher and Paykel ) may provide an alternative when the skin surface available for warming is limited . We conducted a r and omized controlled trial to compare the efficacy of the Suntouch ™ radiant warmer and forced-air warming . With ethics committee approval , 60 surgical patients having procedures anticipated to be more than two hours in duration were recruited . Patients were r and omized to either radiant warming or forced-air warming . All intravenous fluids were warmed but prewarming was not used . The final intraoperative core temperatures ( ° C ) for the radiant warming and forced-air warming groups were 36.0±0.5 and 36.4±0.6 ( P=0.002 ) respectively . No other patient variables were significantly different . The Suntouch ™ is not as effective as the forced air warming for intraoperative warming during long surgical procedures . The device may be useful when forced-air warming is not possible BACKGROUND Mild perioperative hypothermia , which is common during major surgery , may promote surgical-wound infection by triggering thermoregulatory vasoconstriction , which decreases subcutaneous oxygen tension . Reduced levels of oxygen in tissue impair oxidative killing by neutrophils and decrease the strength of the healing wound by reducing the deposition of collagen . Hypothermia also directly impairs immune function . We tested the hypothesis that hypothermia both increases susceptibility to surgical-wound infection and lengthens hospitalization . METHODS Two hundred patients undergoing colorectal surgery were r and omly assigned to routine intraoperative thermal care ( the hypothermia group ) or additional warming ( the normothermia group ) . The patient 's anesthetic care was st and ardized , and they were all given cefam and ole and metronidazole . In a double-blind protocol , their wounds were evaluated daily until discharge from the hospital and in the clinic after two weeks ; wounds containing culture-positive pus were considered infected . The patients ' surgeons remained unaware of the patients ' group assignments . RESULTS The mean ( + /- SD ) final intraoperative core temperature was 34.7 + /- 0.6 degrees C in the hypothermia group and 36.6 + /- 0.5 degrees C in the normothermia group ( P < 0.001 ) Surgical-wound infections were found in 18 of 96 patients assigned to hypothermia ( 19 percent ) but in only 6 of 104 patients assigned to normothermia ( 6 percent , P = 0.009 ) . The sutures were removed one day later in the patients assigned to hypothermia than in those assigned to normothermia ( P = 0.002 ) , and the duration of hospitalization was prolonged by 2.6 days ( approximately 20 percent ) in hypothermia group ( P = 0.01 ) . CONCLUSIONS Hypothermia itself may delay healing and predispose patients to wound infections . Maintaining normothermia intraoperatively is likely to decrease the incidence of infectious complications in patients undergoing colorectal resection and to shorten their hospitalizations OBJECTIVES To evaluate the efficacy of two different nursing interventions regarding control of body heat loss , using blankets during the intraoperative period of elderly patients . METHODS This was an experimental , comparative , applied , longitudinal prospect i ve study with a quantitative approach . Eighty-one elderly patients undergoing elective surgery with a surgical time frame of at least one hour were selected by systematic probability sampling into two Experimental and one Control Group . Informed consent was obtained from participants . Data was collected by biophysiological measurement , using a tympanic thermometer . RESULTS After the homogeneity of variables - gender , surgical duration , age , BMR , anesthesia , room humidity and temperature , drugs and liquid infusion- had been demonstrated , the interventions were confronted . Incidence of hypothermia ( 59.3 % ) and body heat loss ( E1=-0.6 degrees C , E2=-0.6 degrees C and C=-0.7 degrees C ) were not significantly different between the groups ( p=0.85 and p=0.7 respectively ) . CONCLUSIONS Results show the need for associated extra body warming methods to maintain normothermia
The results of this study suggest that preoperative warming can reduce rates of SSI after surgery .
OBJECTIVE To determine whether preoperative warming can reduce the risk of surgical site infection ( SSI ) after surgery .
BACKGROUND Intraoperative hypothermia is a risk factor for the occurrence of  SSI in patients after surgery .
However , the effectiveness of preoperative warming in reducing the incidence of the condition remains unclear .