title: Intensified thermal management for patients undergoing transcatheter aortic valve implantation (TAVI).
abstract: BACKGROUND
  Transcatheter aortic valve implantation via the transapical approach (TAVI-TA) without cardiopulmonary bypass (CPB) is a minimally invasive alternative to open-heart valve replacement. Despite minimal exposure and extensive draping perioperative hypothermia still remains a problem.
  
  
  METHODS
  In this observational study, we compared the effects of two methods of thermal management on the perioperative course of core temperature. The methods were standard thermal management (STM) with a circulating hot water blanket under the patient, forced-air warming with a lower body blanket and warmed infused fluids, and an intensified thermal management (ITM) with additional prewarming using forced-air in the pre-operative holding area on the awake patient.
  
  
  RESULTS
  Nineteen patients received STM and 20 were treated with ITM. On ICU admission, ITM-patients had a higher core temperature (36.4±0.7°C vs. 35.5±0.9°C, p=0.001), required less time to achieve normothermia (median (IQR) in min: 0 (0-15) vs. 150 (0-300), p=0.003) and a shorter period of ventilatory support (median (IQR) in min: 0 (0-0) vs. 246 (0-451), p=0.001).
  
  
  CONCLUSIONS
  ITM during TAVI-TA reduces the incidence of hypothermia and allows for faster recovery with less need of ventilatory support.
authors.affiliation: Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Robert-Koch-Str, 40, 37075 Göttingen, Germany. ibrande@gwdg.de
authors.forename: Ivo F
authors.initials: IF
authors.lastname: Brandes
authors.forename: Marc
authors.initials: M
authors.lastname: Jipp
authors.forename: Aron F
authors.initials: AF
authors.lastname: Popov
authors.forename: Ralf
authors.initials: R
authors.lastname: Seipelt
authors.forename: Michael
authors.initials: M
authors.lastname: Quintel
authors.forename: Anselm
authors.initials: A
authors.lastname: Bräuer
mesh_terms: D000369:Aged, 80 and over; D000704:Analysis of Variance; D001021:Aortic Valve / Q000601:surgery*; D001833:Body Temperature Regulation; D006328:Cardiac Catheterization; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D008297:Male; D019370:Observation; D018709:Statistics, Nonparametric; D016896:Treatment Outcome