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Heated humidified high-flow nasal oxygen prevents intraoperative body temperature decrease in non-intubated thoracoscopy

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Abstract

Purpose

In patients receiving non-intubated video-assisted thoracic surgery (NIVATS), transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has been applied instead of oxygen mask for better oxygenation. However, the THRIVE effects on intraoperative temperature decrease have not been investigated.

Methods

Pre- and postoperative temperatures, measured by an infrared tympanic ear thermometer, taken before sending patients to the operation room and immediately upon their arrival in the postoperative anesthesia unit, were collected from medical records of patients who received NIVATS either with oxygen mask or THRIVE. Intraoperative temperature decrease, calculated by preoperative temperature minus postoperative temperature, was compared between different groups. Multiple linear regression analysis was performed to determine factors associated with intraoperative temperature decrease.

Results

Records of 256 adult patients with forced-air warming were retrospectively analyzed. 172 patients of them received THRIVE and 84 patients received oxygen mask. Preoperative temperatures were comparable between groups (THRIVE: 36.25 ± 0.46 °C; mask: 36.30 ± 0.39 °C, p = 0.43). Postoperative temperatures were significantly higher in patients using THRIVE than those using oxygen masks (36.05 ± 0.59 vs 35.87 ± 0.62 °C, p = 0.025). Significantly less intraoperative temperature decrease was shown in THRIVE group (THRIVE: 0.20 ± 0.69 °C; mask: 0.43 ± 0.69 °C, p = 0.04). According to the multiple linear regression analysis, significant temperature decrease was associated with the advanced age (βage = 0.01) but not the anesthetic duration. Using THRIVE was correlated with significantly less body temperature decrease (βTRIVE = − 0.24).

Conclusions

THRIVE effectively prevents intraoperative temperature decrease during NIVATS, especially in old patients.

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Funding

This work was supported without funding sources.

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Author notes

  1. C. J. Lai and K. C. Yeh have equal contribution to the first author.

Authors and Affiliations

  1. Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Jen-Ai Road, Section 1, Taipei, 10051, Taiwan, Republic of China

    C. J. Lai, K. C. Yeh, M. L. Wang, W. H. Tai & Ya-Jung Cheng

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  1. C. J. Lai
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  2. K. C. Yeh
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  3. M. L. Wang
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  4. W. H. Tai
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  5. Ya-Jung Cheng
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Corresponding author

Correspondence to Ya-Jung Cheng.

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Ethical approval

The Institutional/Independent Review Board (IRB) of National Taiwan University Hospital waived the need for informed consent. IRB number: 201801005RINB.

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The authors declare that they have no competing interests.

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Lai, C.J., Yeh, K.C., Wang, M.L. et al. Heated humidified high-flow nasal oxygen prevents intraoperative body temperature decrease in non-intubated thoracoscopy. J Anesth 32, 872–879 (2018). https://doi.org/10.1007/s00540-018-2567-8

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  • DOI: https://doi.org/10.1007/s00540-018-2567-8

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