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Efficacy of intraoperative cooling methods
O Plattner1, A Kurz, D I Sessler
1Department of Anesthesia and Perioperative Care, University of California, San Francisco 94143-0648, USA.
Anesthesiology
|November 20, 1997
Summary
Comparing five perioperative cooling methods, ice-water immersion provided the fastest core cooling rates. Noninvasive methods like forced air or circulating water are less effective but easier to implement for patients requiring therapeutic hypothermia.
Area of Science:
- Medical research
- Physiology
- Therapeutic hypothermia
Background:
- Perioperative cooling is crucial for conditions like malignant hyperthermia crises and neurosurgical therapeutic hypothermia.
- Evaluating heat transfer and core cooling rates across different methods is essential for clinical application.
Purpose of the Study:
- To compare the efficacy of five distinct cooling methods in achieving rapid core body temperature reduction.
- To assess heat transfer and core cooling rates for each method in healthy volunteers.
Main Methods:
- Six healthy volunteers underwent anesthetization.
- Five cooling methods were tested: circulating water, forced air, gastric lavage, bladder lavage, and ice-water immersion.
- Each method was applied for 40 minutes or until core temperature reached 34°C, with rewarming between trials.
Main Results:
- Gastric lavage was discontinued due to adverse effects (cramping, diarrhea).
- Bladder lavage yielded minimal cooling (0.8°C/h).
- Forced air and circulating water showed comparable, moderate cooling (approx. 1.6-1.7°C/h).
- Ice-water immersion demonstrated significantly higher cooling rates (9.7°C/h) with a notable afterdrop.
Conclusions:
- Ice-water immersion is the most effective method for rapid core cooling.
- Forced-air and circulating-water cooling are less effective but noninvasive and practical for some patients.
- When noninvasive methods are insufficient, ice-water immersion or peritoneal lavage are recommended for rapid cooling.