title: What influence does intermittent pneumatic compression of the lower limbs intraoperatively have on core hypothermia?
abstract: BACKGROUND
  Intermittent pneumatic compression (IPC) devices have been widely used for thrombosis prophylaxis in laparoscopic colorectal surgery. However, periodic compression using an IPC device may inject augmented boluses of cool blood from the lower limbs into the central circulation repetitively, thereby causing a reduction in core temperature. The authors therefore conducted a prospective, randomized, double-blind, controlled study to compare the effects of intraoperative IPC on core temperature in patients undergoing laparoscopic colorectal surgery.
  
  
  METHODS
  For this study, 56 patients ages 18-60 years and scheduled to undergo laparoscopic resection for colorectal cancer under general anesthesia were randomly assigned to receive either no IPC (control group) or calf-thigh-length IPC in both legs using the SCD Express (IPC group). Anesthetic, thermal, and pneumoperitoneum management were standardized. Esophageal temperature, as an indicator of core temperature, was measured at 15-min intervals for 2 h after induction of anesthesia.
  
  
  RESULTS
  A total of 47 subjects (23 control and 24 IPC subjects) were included in the analysis. The core temperature drop in the IPC group was significantly greater than in the control group, starting from 45 min after induction of anesthesia (P < 0.05). As a result, the total temperature drop during the 2-h study period was significantly greater in the IPC group (1.2 ± 0.3 °C) than in the control group (0.9 ± 0.3 °C) (P = 0.004).
  
  
  CONCLUSIONS
  Because intraoperative application of IPC carries an increased risk of a core temperature drop, appropriate temperature monitoring and active thermal management are required for surgical patients receiving IPC.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University-Seoul Metropolitan Boramae Hospital, Seoul, Republic of Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Huh
authors.forename: Yong-Beom
authors.initials: YB
authors.lastname: Cho
authors.forename: Mi-Kyung
authors.initials: MK
authors.lastname: Yang
authors.forename: Yeon-Kyeong
authors.initials: YK
authors.lastname: Yoo
authors.forename: Duk-Kyung
authors.initials: DK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D001831:Body Temperature / Q000502:physiology; D015179:Colorectal Neoplasms / Q000601:surgery*; D004311:Double-Blind Method; D004947:Esophagus / Q000502:physiology; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000209:etiology* / Q000503:physiopathology; D048228:Intermittent Pneumatic Compression Devices / Q000009:adverse effects*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult