This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kurz, A. Articles by Hackl, W. Search for Related Content PubMed PubMed Citation Articles by Kurz, A. Articles by Hackl, W.

Forced-Air Warming Maintains Intraoperative Normotherrnia Better Than Circulating-Water Mattresses

Department of Anesthesia and Intensive Care, University of Vienna, Vienna, and Department of Internal Medicine, Krankenhaus Floridsdorf, Austria

The hypothesis that forced-air warming preserves core temperature better than circulating-water mattresses was tested in: (a) 16 adults undergoing major maxillofacial surgery, including radical node resection and flap reconstruction; (b) 53 adults undergoing hip arthroplasty, having 25% of their body surface area available for warming; (c) 20 infants undergoing minor maxillofacial surgery; and (d) 10 young children undergoing pelvic or femoral osteotomies. Patients having each type of surgery were randomly assigned to forced-air warming (40°C) or conductive warming using a full-length circulating-water mattress at 40°C. Forced-air warming was applied to the legs of the adults undergoing maxillofacial surgery and to one arm, the shoulders, and the neck in the adults undergoing hip arthroplasty; a U-shaped, tubular forced-air cover was positioned around the pediatric patients. Core temperatures increased in all patients given forced-air warming and decreased or remained constant in those without active warming. Furthermore, we needed to decrease the temperature of the warmer from high to medium (37°C) in most patients assigned to forced-air warming to prevent hyperthermia. After 15 h of anesthesia, rectal temperatures in the adults undergoing maxillofacial surgery were 3.4"C higher in the forced-air group (P < 0.01). After 4 h of anesthesia, esophageal temperatures had increased 0.8 ± 0.5"C in the patients warmed with forced-air and decreased 0.8 2 0.3"C in those warmed by circulating-water mattresses (P < 0.01). Rectal temperatures in the infants undergoing maxillofacial surgery decreased 0.3 ± 0.1 "C in both the forced-air and circulating-water groups after premedication with midazolam. Core temperatures then decreased an additional 0.4"C in each group during the first 45 min of anesthesia, but after 165 min of anesthesia, were 1.3"C higher in the patients warmed with forced-air (P < 0.01). Esophageal temperatures in the children undergoing orthopaedic surgery decreased 0.5"C in each group during the first 60 min of anesthesia. Temperatures subsequently increased in the forced-air group and decreased in those given circulating water. After 150 min of anesthesia, core temperatures were 1.6"C higher in the patients warmed with forced air (P < 0.01). These data indicate that forced-air warming is more effective than circulating water in preventing intraoperative hypothermia in infants, children, and adults.

This article has been cited by other articles:

				A. Brauer, H. Bovenschulte, T. Perl, W. Zink, M. J. M. English, and M. Quintel What Determines the Efficacy of Forced-Air Warming Systems? A Manikin Evaluation with Upper Body Blankets Anesth. Analg., January 1, 2009; 108(1): 192 - 198. [Abstract] [Full Text] [PDF]

				J. Andrzejowski, J. Hoyle, G. Eapen, and D. Turnbull Effect of prewarming on post-induction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general anaesthesia Br. J. Anaesth., November 1, 2008; 101(5): 627 - 631. [Abstract] [Full Text] [PDF]

				O. Kimberger, C. Held, K. Stadelmann, N. Mayer, C. Hunkeler, D. I. Sessler, and A. Kurz Resistive Polymer Versus Forced-Air Warming: Comparable Heat Transfer and Core Rewarming Rates in Volunteers Anesth. Analg., November 1, 2008; 107(5): 1621 - 1626. [Abstract] [Full Text] [PDF]

				S. R. Insler, M. H. Bakri, F. Nageeb, E. Mascha, T. Mihaljevic, and D. I. Sessler An Evaluation of a Full-Access Underbody Forced-Air Warming System During Near-Normothermic, On-pump Cardiac Surgery Anesth. Analg., March 1, 2008; 106(3): 746 - 750. [Abstract] [Full Text] [PDF]

				A. J. Butwick, S. S. Lipman, and B. Carvalho Intraoperative Forced Air-Warming During Cesarean Delivery Under Spinal Anesthesia Does Not Prevent Maternal Hypothermia Anesth. Analg., November 1, 2007; 105(5): 1413 - 1419. [Abstract] [Full Text] [PDF]

				A. Brauer, L. Pacholik, T. Perl, M. J. M. English, W. Weyland, and U. Braun Conductive Heat Exchange with a Gel-Coated Circulating Water Mattress Anesth. Analg., December 1, 2004; 99(6): 1742 - 1746. [Abstract] [Full Text] [PDF]

				C. Negishi, K. Hasegawa, S. Mukai, F. Nakagawa, M. Ozaki, and D. I. Sessler Resistive-Heating and Forced-Air Warming Are Comparably Effective Anesth. Analg., June 1, 2003; 96(6): 1683 - 1687. [Abstract] [Full Text] [PDF]

				E.-P. Horn, F. Schroeder, A. Gottschalk, D. I. Sessler, N. Hiltmeyer, T. Standl, and J. Schulte am Esch Active Warming During Cesarean Delivery Anesth. Analg., February 1, 2002; 94(2): 409 - 414. [Abstract] [Full Text] [PDF]

				F. Jin and F. Chung Minimizing perioperative adverse events in the elderly{dagger} Br. J. Anaesth., October 1, 2001; 87(4): 608 - 624. [Abstract] [Full Text] [PDF]

				O. Plattner, O. Akca, F. Herbst, C. F. Arkilic, R. Fugger, M. Barlan, A. Kurz, H. Hopf, A. Werba, and D. I. Sessler The Influence of 2 Surgical Bandage Systems on Wound Tissue Oxygen Tension Arch Surg, July 1, 2000; 135(7): 818 - 822. [Abstract] [Full Text] [PDF]

				H. K. El-Rahmany, S. M. Frank, G. M. Schneider, N. A. El-Gamal, C. A. Vannier, R. Ammar, and A. S. Okasha Forced-Air Warming Decreases Vasodilator Requirement After Coronary Artery Bypass Surgery Anesth. Analg., February 1, 2000; 90(2): 286 - 286. [Abstract] [Full Text] [PDF]

				M. Yamakage, Y. Kamada, Y. Honma, N. Tsujiguchi, and A. Namiki Predictive Variables of Hypothermia in the Early Phase of General Anesthesia Anesth. Analg., February 1, 2000; 90(2): 456 - 456. [Abstract] [Full Text] [PDF]

				R. Greif, O. Akca, E.-P. Horn, A. Kurz, D. I. Sessler, and The Outcomes Research Group Supplemental Perioperative Oxygen to Reduce the Incidence of Surgical-Wound Infection N. Engl. J. Med., January 20, 2000; 342(3): 161 - 167. [Abstract] [Full Text] [PDF]

				D. I. Sessler Temperature Monitoring and Management During Neuraxial Anesthesia Anesth. Analg., February 1, 1999; 88(2): 243 - 243. [Full Text] [PDF]

				P. S. Myles Aspects of Anesthesia for Lung Transplantation Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1998; 2(2): 140 - 154. [Abstract] [PDF]

				M. S. L. Goheen, M. B. Ducharme, G. P. Kenny, C. E. Johnston, J. Frim, G. K. Bristow, and G. G. Giesbrecht Efficacy of forced-air and inhalation rewarming by using a human model for severe hypothermia J Appl Physiol, November 1, 1997; 83(5): 1635 - 1640. [Abstract] [Full Text] [PDF]

				D. I. Sessler Mild Perioperative Hypothermia N. Engl. J. Med., June 12, 1997; 336(24): 1730 - 1737. [Full Text] [PDF]

				A. Kurz, D. I. Sessler, R. Lenhardt, The Study of Wound Infection and, and Temperature Group Perioperative Normothermia to Reduce the Incidence of Surgical-Wound Infection and Shorten Hospitalization N. Engl. J. Med., May 9, 1996; 334(19): 1209 - 1216. [Abstract] [Full Text] [PDF]

				N. Mortensen and C. S. Garrard Colorectal Surgery Comes in from the Cold N. Engl. J. Med., May 9, 1996; 334(19): 1263 - 1264. [Full Text]