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Efficacy of Forced-Air Warming to Prevent Perioperative Hypothermia in Morbidly-Obese Versus Non-obese Patients

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Abstract

Background

Hypothermia is associated with an increased postoperative morbidity and mortality. Forced-air warming systems are the most effective methods for its prevention. When using a mattress, a reduction in the area of diffusion of warm air by crushing due to excess weight cannot be ruled out.

Methods

We designed a prospective study to compare the efficacy of a forced-air warming mattress (Bair Hugger® 585) to prevent hypothermia (core temperature (CT°) < 36 °C) in morbidly obese (group MO, body mass index (BMI) ≥ 40 kg/m2) and non-obese patients (group NO, BMI < 30 kg/m2).

Results

Twenty-six patients were included in group MO (84% bariatric surgery, 96% laparoscopic procedures) and 32 in group NO (37.5% cholecystectomy, 62.5% laparoscopic procedures). The incidence of hypothermia was not different between the two groups 1 h after induction (H1) and at extubation: 22 vs 19% (not significant (NS)) and 23 vs 19% (NS) for the group MO versus group NO. At H1, the mean CT° was not different: 36.3 ± 0.4 °C vs 36.4 ± 0.5 °C (NS), group MO versus group NO. No patient presented severe hypothermia (CT° < 34.9 °C). Dysfunction of the forced-air warming mattress was observed for eight patients (31%) in group MO but for none in group NO.

Conclusion

The forced-air warming mattress is effective in preventing hypothermia in MO patients. However, excess weight is associated with frequent dysfunction of the system, which does not make it a practical system in a context of MO.

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References

  1. Vaughan MS, Vaughan RW, Cork RC. Postoperative hypothermia in adults: relationship of age, anesthesia, and shivering to rewarming. Anesth Analg. 1981;60(10):746–51.

    Article  CAS  Google Scholar 

  2. Reynolds L, Beckmann J, Kurz A. Perioperative complications of hypothermia. Best Pract Res Clin Anaesthesiol. 2008;22(4):645–57. https://doi.org/10.1016/j.bpa.2008.07.005.

    Article  PubMed  Google Scholar 

  3. Mason DS, Sapala JA, Wood MH, et al. Influence of a forced air warming system on morbidly obese patients undergoing Roux-en-Y gastric bypass. Obes Surg. 1998;8(4):453–60. https://doi.org/10.1381/096089298765554359.

    Article  CAS  PubMed  Google Scholar 

  4. Sessler DI. Perioperative heat balance. Anesthesiology. 2000;92(2):578–96. https://doi.org/10.1097/00000542-200002000-00042.

    Article  CAS  PubMed  Google Scholar 

  5. Hart SR, Bordes B, Hart J, et al. Unintended perioperative hypothermia. Ochsner J. 2011;11(3):259–70.

    PubMed  PubMed Central  Google Scholar 

  6. Sun Z, Honar H, Sessler DI, et al. Intraoperative core temperature patterns, transfusion requirement, and hospital duration in patients warmed with forced air. Anesthesiology. 2015;122(2):276–85. https://doi.org/10.1097/ALN.0000000000000551.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Welch TC. AANA journal course. Update for nurse anesthetists. A common sense approach to hypothermia. AANA Journal. 2002;70(3):227–31.

    PubMed  Google Scholar 

  8. Karayan J, Thomas D, Lacoste L, et al. Delayed forced air warming prevents hypothermia during abdominal aortic surgery. Br J Anaesth. 1996;76(3):459–60. https://doi.org/10.1093/bja/76.3.459.

    Article  CAS  PubMed  Google Scholar 

  9. Savastano DM, Gorbach AM, Eden HS, et al. Adiposity and human regional body temperature. Am J Clin Nutr. 2009;90(5):1124–31. https://doi.org/10.3945/ajcn.2009.27567.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Nguyen NT, Fleming NW, Singh A, et al. Evaluation of core temperature during laparoscopic and open gastric bypass. Obes Surg. 2001;11(5):570–5. https://doi.org/10.1381/09608920160557039.

    Article  CAS  PubMed  Google Scholar 

  11. Bamgbade OA. Perioperative temperature management in day-case surgical patients. Eur J Anaesthesiol. 2012;29(7):354–5. https://doi.org/10.1097/EJA.0b013e32835132df.

    Article  PubMed  Google Scholar 

  12. Smith CE, Desai R, Glorioso V, et al. Preventing hypothermia: convective and intravenous fluid warming versus convective warming alone. J Clin Anesth. 1998;10(5):380–5. https://doi.org/10.1016/S0952-8180(98)00049-X.

    Article  CAS  PubMed  Google Scholar 

  13. Kurz A. Thermal care in the perioperative period. Best Pract Res Clin Anaesthesiol. 2008;22(1):39–62. https://doi.org/10.1016/j.bpa.2007.10.004.

    Article  PubMed  Google Scholar 

  14. Ohtsuka N, Yamakage M, Chen X, et al. Evaluation of four techniques of warming intravenous fluids. J Anesth. 2002;16(2):145–9. https://doi.org/10.1007/s005400200010.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service d’Anesthésie, CHU Louis Mourier, AP-HP, Université Paris 7, Denis Diderot PRES Sorbonne Paris Cité, 178 rue des Renouillers, 92700, Colombes, France

    Raphael Okoué, Pascal Nzé & Hawa Keita

  2. Service de Chirurgie Digestive et Générale, CHU Louis Mourier, AP-HP, Université Paris 7, Denis Diderot PRES Sorbonne Paris Cité, 178 rue des Renouillers, 92700, Colombes, France

    Daniela Calabrese & Simon Msika

  3. EA Recherche Clinique coordonnée ville-hôpital, Méthodologies et Société (REMES), Université Paris Diderot, Sorbonne Paris Cité, 75010, Paris, France

    Hawa Keita

Authors
  1. Raphael Okoué
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  2. Daniela Calabrese
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  3. Pascal Nzé
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  4. Simon Msika
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  5. Hawa Keita
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Corresponding author

Correspondence to Hawa Keita.

Ethics declarations

The study was approved by the ethics committee of the Hôpitaux Universitaires Paris Nord Val de Seine (HUPNVS), Paris 7 University (Institutional Review Board reference 13-001). Informed consent was obtained for all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Okoué, R., Calabrese, D., Nzé, P. et al. Efficacy of Forced-Air Warming to Prevent Perioperative Hypothermia in Morbidly-Obese Versus Non-obese Patients. OBES SURG 28, 1955–1959 (2018). https://doi.org/10.1007/s11695-017-3108-5

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  • DOI: https://doi.org/10.1007/s11695-017-3108-5

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