Maintenance of normothermia during burn surgery with an intravascular temperature control system: a non-randomised controlled trial.
BACKGROUND
Hypothermia remains one of the major factors limiting surgery in extensively burned patients. We evaluated the effectiveness of an intravascular rewarming technique using CoolGard 3000™ system and Icy™ catheter to maintain normothermia during surgeries of severe burned patients and compared these findings to a historical control group.


METHODS
This was a controlled non-randomised trial conducted between March 2008 and August 2009. Patients with burns greater than or equal to 40% of the total body surface area were included. Before the first burn excision, the Icy™ catheter was placed in the inferior vena cava via the femoral vein. Warming was then initiated and maintained until the bladder temperature reached over 37.5°C. The bladder temperature was recorded every 30min during surgery and for the first hour post-operatively and compared to a historical control group.


RESULTS
We enrolled 4 patients and 11 surgeries in the CoolGard™ group and compared them to 3 patients and 10 surgeries in the historical cohort. All intraoperative bladder temperatures from T=30 were statistically different in the two groups. In the CoolGard™ group, no patient became hypothermic and no surgery was aborted because the patient's temperature had rapidly fallen below the threshold temperature (35.5°C). No device-related complication was reported.


CONCLUSIONS
The use of an intravenous warming catheter is a novel approach to maintain normothermia during surgery in burn victims and may be more effective than traditional methods.
Prunet
Bertrand
B
Burn Center and Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France. bertrand.prunet@orange.fr
Asencio
Yves
Y
Lacroix
Guillaume
G
Bordes
Julien
J
Montcriol
Ambroise
A
D'Aranda
Erwan
E
Pradier
Jean-Philippe
JP
Dantzer
Eric
E
Meaudre
Eric
E
Goutorbe
Philippe
P
Kaiser
Eric
E
D000328:Adult; D001831:Body Temperature / Q000502:physiology; D002056:Burns / Q000150:complications* / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011184:Postoperative Period; D011446:Prospective Studies; D017694:Rewarming / Q000379:methods*; D001743:Urinary Bladder