The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off-pump coronary artery bypass surgery

Ji Young Kim, Helen Shinn, Young Jun Oh, Yong Woo Hong, Hyun Jeong Kwak, Young Lan Kwak

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Objective: Redistribution hypothermia adversely affects hemodynamics and postoperative recovery in patients undergoing cardiac surgery. In off-pump coronary bypass surgery (OPCAB), maintaining the temperature is important because warming by cardiopulmonary bypass is omitted. Prewarming studies reported earlier showing prewarming as an effective means of preventing redistribution hypothermia was time consuming since it required at least 1-2 h to prewarm the patients before the surgery. Because prewarming for such a long time is impractical in clinical practice, this study evaluated the efficacy of active warming during the preanesthetic period for the prevention of redistribution hypothermia in the early operative period of OPCAB. Methods: After gaining the approval of Institutional Review Board and informed consent from the patients, 40 patients undergoing OPCAB were divided into control and prewarming groups. The patients in control group (n = 20) were managed with warm mattresses and cotton blankets, whereas patients in prewarming group (n = 20) were actively warmed with a forced-air warming device before the induction of anesthesia. Hemodynamic variables and temperature were recorded before anesthesia (Tpre) and at 30 min intervals after anesthesia for 90 min (T30, T60, and T90). Results: Active warming duration was 49.7 ± 9.9 min. There were no statistically significant differences in skin temperature, core temperature and hemodynamic variables between the two groups at preinduction period except for mean arterial pressure and central venous pressure. The core temperature at T30, T60, and T90 was statistically higher in prewarming group than that in control group. Core temperature of six (30%) and seven patients (35%) in control group was reduced below 35°C at T60 and T90, respectively, whereas core temperature of only one patient (5%) in prewarming group was reduced below 35°C at T90 (P = 0.02). Conclusions: Active warming using forced air blanket before the induction of anesthesia reduced the incidence and degree of redistribution hypothermia in patients undergoing OPCAB. It is a simple method with reasonable cost, which does not delay the induction of anesthesia nor the surgery.

Original languageEnglish
Pages (from-to)343-347
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Volume29
Issue number3
DOIs
Publication statusPublished - 2006 Mar 1

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Off-Pump Coronary Artery Bypass
Hypothermia
Coronary Artery Bypass
Anesthesia
Skin
Temperature
Control Groups
Hemodynamics
Air
Central Venous Pressure
Skin Temperature
Research Ethics Committees
Informed Consent
Cardiopulmonary Bypass
Thoracic Surgery
Arterial Pressure
Costs and Cost Analysis
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

@article{b18b05dcf0464a33a9c3008ac8a0df71,
title = "The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off-pump coronary artery bypass surgery",
abstract = "Objective: Redistribution hypothermia adversely affects hemodynamics and postoperative recovery in patients undergoing cardiac surgery. In off-pump coronary bypass surgery (OPCAB), maintaining the temperature is important because warming by cardiopulmonary bypass is omitted. Prewarming studies reported earlier showing prewarming as an effective means of preventing redistribution hypothermia was time consuming since it required at least 1-2 h to prewarm the patients before the surgery. Because prewarming for such a long time is impractical in clinical practice, this study evaluated the efficacy of active warming during the preanesthetic period for the prevention of redistribution hypothermia in the early operative period of OPCAB. Methods: After gaining the approval of Institutional Review Board and informed consent from the patients, 40 patients undergoing OPCAB were divided into control and prewarming groups. The patients in control group (n = 20) were managed with warm mattresses and cotton blankets, whereas patients in prewarming group (n = 20) were actively warmed with a forced-air warming device before the induction of anesthesia. Hemodynamic variables and temperature were recorded before anesthesia (Tpre) and at 30 min intervals after anesthesia for 90 min (T30, T60, and T90). Results: Active warming duration was 49.7 ± 9.9 min. There were no statistically significant differences in skin temperature, core temperature and hemodynamic variables between the two groups at preinduction period except for mean arterial pressure and central venous pressure. The core temperature at T30, T60, and T90 was statistically higher in prewarming group than that in control group. Core temperature of six (30{\%}) and seven patients (35{\%}) in control group was reduced below 35°C at T60 and T90, respectively, whereas core temperature of only one patient (5{\%}) in prewarming group was reduced below 35°C at T90 (P = 0.02). Conclusions: Active warming using forced air blanket before the induction of anesthesia reduced the incidence and degree of redistribution hypothermia in patients undergoing OPCAB. It is a simple method with reasonable cost, which does not delay the induction of anesthesia nor the surgery.",
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The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off-pump coronary artery bypass surgery. / Kim, Ji Young; Shinn, Helen; Oh, Young Jun; Hong, Yong Woo; Kwak, Hyun Jeong; Kwak, Young Lan.

In: European Journal of Cardio-thoracic Surgery, Vol. 29, No. 3, 01.03.2006, p. 343-347.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off-pump coronary artery bypass surgery

AU - Kim, Ji Young

AU - Shinn, Helen

AU - Oh, Young Jun

AU - Hong, Yong Woo

AU - Kwak, Hyun Jeong

AU - Kwak, Young Lan

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N2 - Objective: Redistribution hypothermia adversely affects hemodynamics and postoperative recovery in patients undergoing cardiac surgery. In off-pump coronary bypass surgery (OPCAB), maintaining the temperature is important because warming by cardiopulmonary bypass is omitted. Prewarming studies reported earlier showing prewarming as an effective means of preventing redistribution hypothermia was time consuming since it required at least 1-2 h to prewarm the patients before the surgery. Because prewarming for such a long time is impractical in clinical practice, this study evaluated the efficacy of active warming during the preanesthetic period for the prevention of redistribution hypothermia in the early operative period of OPCAB. Methods: After gaining the approval of Institutional Review Board and informed consent from the patients, 40 patients undergoing OPCAB were divided into control and prewarming groups. The patients in control group (n = 20) were managed with warm mattresses and cotton blankets, whereas patients in prewarming group (n = 20) were actively warmed with a forced-air warming device before the induction of anesthesia. Hemodynamic variables and temperature were recorded before anesthesia (Tpre) and at 30 min intervals after anesthesia for 90 min (T30, T60, and T90). Results: Active warming duration was 49.7 ± 9.9 min. There were no statistically significant differences in skin temperature, core temperature and hemodynamic variables between the two groups at preinduction period except for mean arterial pressure and central venous pressure. The core temperature at T30, T60, and T90 was statistically higher in prewarming group than that in control group. Core temperature of six (30%) and seven patients (35%) in control group was reduced below 35°C at T60 and T90, respectively, whereas core temperature of only one patient (5%) in prewarming group was reduced below 35°C at T90 (P = 0.02). Conclusions: Active warming using forced air blanket before the induction of anesthesia reduced the incidence and degree of redistribution hypothermia in patients undergoing OPCAB. It is a simple method with reasonable cost, which does not delay the induction of anesthesia nor the surgery.

AB - Objective: Redistribution hypothermia adversely affects hemodynamics and postoperative recovery in patients undergoing cardiac surgery. In off-pump coronary bypass surgery (OPCAB), maintaining the temperature is important because warming by cardiopulmonary bypass is omitted. Prewarming studies reported earlier showing prewarming as an effective means of preventing redistribution hypothermia was time consuming since it required at least 1-2 h to prewarm the patients before the surgery. Because prewarming for such a long time is impractical in clinical practice, this study evaluated the efficacy of active warming during the preanesthetic period for the prevention of redistribution hypothermia in the early operative period of OPCAB. Methods: After gaining the approval of Institutional Review Board and informed consent from the patients, 40 patients undergoing OPCAB were divided into control and prewarming groups. The patients in control group (n = 20) were managed with warm mattresses and cotton blankets, whereas patients in prewarming group (n = 20) were actively warmed with a forced-air warming device before the induction of anesthesia. Hemodynamic variables and temperature were recorded before anesthesia (Tpre) and at 30 min intervals after anesthesia for 90 min (T30, T60, and T90). Results: Active warming duration was 49.7 ± 9.9 min. There were no statistically significant differences in skin temperature, core temperature and hemodynamic variables between the two groups at preinduction period except for mean arterial pressure and central venous pressure. The core temperature at T30, T60, and T90 was statistically higher in prewarming group than that in control group. Core temperature of six (30%) and seven patients (35%) in control group was reduced below 35°C at T60 and T90, respectively, whereas core temperature of only one patient (5%) in prewarming group was reduced below 35°C at T90 (P = 0.02). Conclusions: Active warming using forced air blanket before the induction of anesthesia reduced the incidence and degree of redistribution hypothermia in patients undergoing OPCAB. It is a simple method with reasonable cost, which does not delay the induction of anesthesia nor the surgery.

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