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CARDIOVASCULAR ANESTHESIA

A Randomized Controlled Trial of the Arctic Sun® Temperature Management System Versus Conventional Methods for Preventing Hypothermia During Off-Pump Cardiac Surgery

From the Department of Anesthesiology and Surgery, Duke University Medical Center, Durham, North Carolina

Address correspondence and reprint requests to Hilary P. Grocott, MD, Associate Professor of Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710. Address email to h.grocott{at}duke.edu

In this trial we compared the hypothermia avoidance abilities of the Arctic Sun® Temperature Management System (a servo-regulated system that circulates temperature-controlled water through unique energy transfer pads adherent to the patient’s body) with conventional temperature control methods. Patients undergoing off-pump coronary artery bypass (OPCAB) surgery were randomized to either the Arctic Sun System alone (AS group) or conventional methods (control group; increased room temperature, heated IV fluids, convective forced air warming system) for the prevention of hypothermia (defined by a temperature <36°C). The AS group had nasopharyngeal temperature servo-regulated to a target of 36.8°C. Temperature was recorded throughout the operative period and comparisons were made between groups for both the time and area under the curve (AUC) for a temperature <36°C (AUC<36°C). Twenty-nine patients (AS group = 14, control group = 15) were studied. The AS group had significantly less hypothermia than the control group, both for duration of time <36°C (2.5 [0–22] min, median [interquartile range] AS group versus 118 [49–192] min, control group; P = 0.0008) as well as for AUC<36°C (0.3 [0–2.2] °C x min, AS group versus 17.1 [3.6–173.4] °C x min, control group; P = 0.002). The Arctic Sun Temperature Management System significantly reduced intraoperative hypothermia during OPCAB surgery. Importantly, this was achieved in the absence of any other temperature modulating techniques, including the use of IV fluid warming or increases in the ambient operating room temperature.

IMPLICATIONS: The Arctic Sun® Temperature Management System was more effective than conventional methods in preventing hypothermia during off-pump coronary artery bypass graft surgery.

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