Prevention of perioperative hypothermia with forced-air warming systems and upper-body blankets

Forced-air warming is known as an effective procedure in prevention and treatment of perioperative hypothermia. Hypothermia is associated with disturbances of coagulation, raises postoperative oxygen consumption by shivering, increases cardiac morbidity, leads to a higher incidence of wound infection, and prolongs hospital stay. Additionally, preoperative local warming reduces the incidence of wound infection after clean surgery. In an animal experiment it has been demonstrated that even during large abdominal operations the major source of heat loss was the skin. Although evaporation accounted for the largest heat loss from the abdominal cavity, it was a minor source due to the smaller heat losing area. As a consequence, reduction of heat loss from the skin is the most promising approach to avoid hypothermia. During abdominal surgery and lower-limb surgery, the use of upper blankets is favourable. The use of upper-body blankets implies a reduction of heat loss in a relevant area and, furthermore, a heat gain. The covered area is approximately 0.35 m2, or approximately 15%-20% of body surface. The heat balance in this area can be changed by 46.1W to 55.0W by forced-air warming systems with upper body blankets. Depending on the surgical procedure and resulting fluid demand, forced-air warming with upper-body blankets-in combination with insulation and fluid warming-is an effective method to prevent perioperative hypothermia.