Evaluation of two warming systems after cardiopulmonary bypass |
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Authors: | Janke E L; Pilkington S N; Smith D C |
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Institution: | Shackleton Department of Anaesthetics, Southampton General Hospital, Tremona Road, Southampton SO16 6YD |
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Abstract: | We have compared the Thermomat electric undermattress (JMW Systems,
Edinburgh, UK) and the Bair Hugger (Augustine Medical, Courtelary,
Switzerland) forced-air warming blanket in 30 adult patients after cardiac
surgery. All patients were warmed to an oesophageal temperature of 38
degrees C before termination of cardiopulmonary bypass (CPB); those with
oesophageal temperatures < 35.5 degrees C at skin closure were allocated
randomly to be rewarmed in the intensive care unit either on the Thermomat
(n = 15) or under the Bair Hugger blanket (n = 15), at their highest
settings. Oesophageal and lateral thigh skin temperatures were recorded
every 15 min for 4 h. There was a significantly faster increase in core
temperature (0.5 vs 0.75 degrees C h-1; P < 0.0002) and skin temperature
(0.86 vs 1.3 degrees C h-1; P < 0.001) in the Bair Hugger group.
However, there was no difference in the number of patients who reached a
core temperature of 36 degrees C (15 Bair Hugger, 14 Thermomat) or 37
degrees C (11 Bair Hugger, seven Thermomat), or in the number of patients
who reached a skin temperature of 37 degrees C in 4 h (four Bair Hugger,
one Thermomat). Twelve patients in the Bair Hugger group reached a skin
temperature of 36 degrees C compared with two in the Thermomat group (P
< 0.001). The Bair Hugger warmed faster than the Thermomat both
centrally and peripherally, and warmed more patients to a core temperature
of 37 degrees C in 4 h, but did not reduce the time to tracheal extubation
or alter important clinical aspects of postoperative course.
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