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Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation
S F Borms1, S L Engelen, D G Himpe
1Department of Anesthesiology, Middelheim General Hospital, Antwerp, Belgium.
Study Objective:
To compare the ability of forced-air warming and reflective insulation to maintain intraoperative normothermia.
Design:
Prospective, randomized clinical trial.
Setting:
Operating rooms of a general hospital.
Patients:
20 ASA physical status I and II patients undergoing elective total hip arthroplasty.
Interventions:
Patients were randomly assigned to be warmed intraoperatively using forced-air or reflective insulation. Inspired gases were conditioned using a heat-and-moisture exchanger in both groups, and infused intravenous fluids were warmed to 37 degrees C.
Measurements And Main Results:
Distal esophageal (core) temperatures decreased approximately 0.5 degrees C in both groups during the first 45 minutes of anesthesia. Subsequently, core temperatures increased slightly in the patients given forced-air warming. In contrast, core temperatures continued to decrease in patients covered with reflective insulation. After 135 minutes of anesthesia, core temperatures were 36.4 +/- 0.6 degrees C (mean +/- SD) in the forced-air group but only 35.4 +/- 0.6 degrees C in the insulated group (p < 0.01, unpaired t-test). These data indicate that forced-air warming is superior to reflective insulation.
Conclusion:
Reflective insulation was unable to maintain intraoperative normothermia during total hip arthroplasty. Active warming, such as that provided by forced air, was required to prevent hypothermia.