Reduction of postoperative hypothermia with a new warming device: a prospective randomized study in off-pump coronary artery surgery.
Hypothermia has been used for decades in cardiac surgery to limit the ischemic insult to the heart. With the diffusion of off-pump coronary artery surgery, the practice of arresting and cooling the heart has been abandoned. At University of Miami Miller School of Medicine, we tested a new warming device by performing a prospective study in which 50 patients were randomized to either the use of the Kimberly-Clark warming system or to standard methods of control of body temperature. The two groups were compared in terms of core body temperature (CBT), intra- and postoperative blood loss, blood products transfusions, extubation time, intensive care unit (ICU) and hospital length of stay and incidence of infections. Five patients in the control group and 0 patients in the study group dropped their CBT below 35 degrees C during the operation (P<0.01). Total blood loss, measured in terms of cell-saver and chest tube drainage, was 27 % and 14 % less for the study group (P<0.01). Hospital length of stay was 1.2 day less in the study group (P<0.01). The Kimberly-Clark Patient Warming System allowed for better control of core body temperature during off pump coronary artery bypass surgery compared to traditional techniques. This translated in less intra and postoperative blood loss and shorter hospital length of stay. Other advantages, such as decreased blood-products transfusions, decreased incidence of infections, decreased ICU length of stay and overall reduction of costs might be evident on larger study groups.
Calcaterra
D
D
Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine, Iowa City, IA 52242-1062, USA. domenico-calcaterra@uiowa.edu
Ricci
M
M
Lombardi
P
P
Katariya
K
K
Panos
A
A
Salerno
T A
TA
D001831:Body Temperature / Q000502:physiology*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D007035:Hypothermia / Q000517:prevention & control*; D007432:Intraoperative Period; D007902:Length of Stay; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome