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GENERAL ARTICLES

Negative Pressure Rewarming vs. Forced Air Warming in Hypothermic Postanesthetic Volunteers

Akiko Taguchi, MD^*, Cem F. Arkilic, MD^*, Arundhathi Ahluwalia, MD^*, Daniel I. Sessler, MD, and Andrea Kurz, MD

*Department of Anesthesiology, Washington University, St. Louis, St. Louis, Missouri, OUTCOMES RESEARCH^TM Institute, Department of Anesthesiology, University of Louisville, Louisville, Kentucky, and Ludwig Boltzmann Institute for Clinical Anesthesia and Intensive Care, University of Vienna, Vienna, Austria; and Department of Anesthesiology, Washington University, St. Louis, and the Department of Anesthesiology and Intensive Care Medicine, University of Vienna, Vienna, Austria

Address correspondence to Andrea Kurz, MD, Department of Anesthesiology, Washington University, 660 S. Euclid Avenue, St. Louis, MO, 63110. Address e-mail to kurza{at}msnotes.wustl.edu

We compared changes in core temperature and systemic heat balance with a new negative pressure/warming device (Vital Heat® ) that uses negative pressure combined with heat to facilitate warming in vasoconstricted postoperative patients to those resulting from passive insulation or forced air. Seven healthy volunteers were anesthetized and cooled to a tympanic membrane temperature near 34°C. Anesthesia was discontinued and shivering was prevented by using meperidine. The vasoconstricted volunteers were rewarmed for 2 h using three randomly assigned methods: 1) Vital Heat® plus cotton blanket; 2) one layer of cotton blanket; 3) forced-air warming. Thermal flux was recorded from 15 skin-surface sites; metabolic heat production was estimated from total body oxygen consumption. Metabolic heat production remained constant throughout the study. Systemic heat loss remained constant during warming with cotton blankets but decreased significantly during the other treatments. Systemic heat balance increased significantly more with forced air (140 ± 21 kcal) than with Vital Heat® (66 ± 19 kcal) or cotton blankets (47 ± 18 kcal). Core temperature increased no faster with Vital Heat® warming (1.3 ± 0.4°C) than with a cotton blanket (1.2 ± 0.4°C). In contrast, core temperature increased more rapidly with forced air warming (2.6 ± 0.6°C). In this study we show that calories from a negative pressure rewarming device are largely constrained to the forearm and that heat does not flow to the core thermal compartment.

Implications: In this study we show that calories from a negative pressure rewarming device are largely constrained to the forearm, and that heat does not flow to the core thermal compartment. Consequently, this warming concept is not more effective than passive insulation in hypothermic postanesthetic subjects. In contrast, rewarming is very effective with convective warming.

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				A B Williams, A Salmon, P Graham, D Galler, M J Payton, and M Bradley Rewarming of healthy volunteers after induced mild hypothermia: a healthy volunteer study Emerg. Med. J., March 1, 2005; 22(3): 182 - 184. [Abstract] [Full Text] [PDF]

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999