title: Use of a warming catheter to achieve normothermia in large burns.
abstract: Maintaining burn patients' body temperature during surgery is a significant challenge. Although increasing the ambient operating room (OR) temperature and other passive rewarming methods help, such measures have limited effectiveness and prove taxing on OR personnel. Initial studies indicate that an intravascular warming catheter may improve and sustain burn patient body temperatures. The authors hypothesize that the warming catheter is similarly effective at maintaining normothermia despite a lower OR temperature than in a cohort of matched control burn patients. This is a retrospective case-control study involving patients with major burns treated between January 2006 and June 2011. Cases received an intravascular warming catheter, whereas controls receive traditional temperature conserving interventions. As the catheters maintained body temperature, the room temperature was gradually lowered to normal. Twenty-three patients were involved in 31 cases using the catheter, compared with 39 controls in 62 surgeries. The mean temperature deviation for each catheter group was -0.76 ± 1°C and -0.80 ± 0.9°C for the control group. Given 20-minute intervals throughout the operations, the mean patient temperature for cases and controls never deviated by more than 1°C. OR staff satisfaction has improved with decreased room temperatures. An intravenous warming catheter reliably maintained patient core body temperature during surgery. To date, this is the largest cohort study of such a catheter among burn patients. This system may be more effective than current warming techniques, with the potential to decrease the total number of procedures and the time to complete wound closure.
authors.affiliation: Division of Burn Care, Jackson Memorial Hospital/University of Miami Burn Center, Florida, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Davis
authors.forename: Luis I
authors.initials: LI
authors.lastname: Rodriguez
authors.forename: Olga D
authors.initials: OD
authors.lastname: Quintana
authors.forename: Robin
authors.initials: R
authors.lastname: Varas
authors.forename: Louis R
authors.initials: LR
authors.lastname: Pizano
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Varon
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001831:Body Temperature; D002056:Burns / Q000503:physiopathology*; D016022:Case-Control Studies; D002404:Catheterization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017694:Rewarming / Q000295:instrumentation*; D016896:Treatment Outcome