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TECHNOLOGY, COMPUTING, AND SIMULATION

Resistive-Heating and Forced-Air Warming Are Comparably Effective

Chiharu Negishi, MD^*, Kenji Hasegawa, MD^*, Shihoko Mukai, MD^*, Fumitoshi Nakagawa, BS^*, Makoto Ozaki, MD^*, and Daniel I. Sessler, MD

Department of *Anesthesia, Tokyo Women’s Medical University, Tokyo, Japan; OUTCOMES RESEARCH^TM Institute, Department of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky; and Ludwig Boltzmann Institute, University of Vienna, Vienna, Austria

Address correspondence and reprint requests to Daniel I. Sessler, MD, OUTCOMES RESEARCH^TM Institute, 501 E. Broadway, Ste. 210, Louisville, KY 40202. Address e-mail to sesslerdan{at}aol.com

Serious adverse outcomes from perioperative hypothermia are well documented. Consequently, intraoperative warming has become routine. We thus evaluated the efficacy of a novel, nondisposable carbon-fiber resistive-heating system. Twenty-four patients undergoing open abdominal surgery lasting approximately 4 h were randomly assigned to warming with 1) a full-length circulating water mattress set at 42°C, 2) a lower-body forced-air cover with the blower set on high, or 3) a three-extremity carbon-fiber resistive-heating blanket set to 42°C. Patients were anesthetized with a combination of continuous epidural and general anesthesia. All fluids were warmed to 37°C, and ambient temperature was kept near 22°C. Core (tympanic membrane) temperature changes among the groups were compared by using factorial analysis of variance and Scheffé F tests; results are presented as means ± SD. Potential confounding factors did not differ significantly among the groups. In the first 2 h of surgery, core temperature decreased by 1.9°C ± 0.5°C in the circulating-water group, 1.0°C ± 0.6°C in the forced-air group, and 0.8°C ± 0.2°C in the resistive-heating group. At the end of surgery, the decreases were 2.0°C ± 0.8°C in the circulating-water group, 0.6°C ± 1.0°C in the forced-air group, and 0.5°C ± 0.4°C in the resistive-heating group. Core temperature decreases were significantly greater in the circulating-water group at all times after 150 elapsed minutes; however, temperature changes in the forced-air and resistive-heating groups never differed significantly. Even during major abdominal surgery, resistive heating maintains core temperature as effectively as forced air.

IMPLICATIONS: Efficacy was similar for forced-air and resistive heating, and both maintained intraoperative core temperature far better than circulating-water mattresses. We thus conclude that even during major abdominal surgery, resistive heating maintains core temperature as effectively as forced air.

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