title: Efficacy of a novel prewarming system in the prevention of perioperative hypothermia. A prospective, randomized, multicenter study.
abstract: BACKGROUND
  Perioperative hypothermia is a common complication during general anesthesia. Although rewarming of patients before surgery has been used as a preventive measure and some guidelines recommend it, the implementation of prewarming for every surgical patient is cumbersome. Therefore, we sought to determine the efficacy of two novel prewarming methods that could facilitate prewarming in daily practice.
  
  
  METHODS
  This was a prospective, randomized, multi-center, controlled study. After IRB approval and informed consent, 90 patients undergoing surgery of 30-120 min duration with general anesthesia were randomly assigned to three groups: 1) standard preoperative insulation (Group A); 2) passive preoperative insulation with a commercial prewarming suit (Group B); 3) active preoperative prewarming with a forced-air warmer connected to a prewarming suit (Group C). All patients received warmed IV fluids and intraoperative forced air warming after induction of anesthesia. Oral temperatures were recorded in the preoperative and postoperative periods. Intraoperative core temperatures were measured with an esophageal probe.
  
  
  RESULTS
  Repeated-measures analysis of variance (ANOVA) and post hoc Scheffé's test identified a significantly higher core temperature in the actively prewarmed group (Group C) compared to both passive groups (A, B) at 15, 30, 45, 60, and 75 min (P<0.05) after induction of anesthesia and at the end of surgery. During the first 30 min after admission at PACU, also higher oral temperatures were measured in Group C, compared with both passive insulation groups.
  
  
  CONCLUSIONS
  In our study active prewarming with a forced-air warmer and an insulating prewarming suit achieves significantly higher core temperatures during anesthesia and at the end of surgery and avoids hypothermia at the end of surgery compared to commercial or conventional insulation techniques.
authors.affiliation: Department of Anesthesiology, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany - tperl@gwdg.de.
authors.forename: T
authors.initials: T
authors.lastname: Perl
authors.forename: L H
authors.initials: LH
authors.lastname: Peichl
authors.forename: K
authors.initials: K
authors.lastname: Reyntjens
authors.forename: I
authors.initials: I
authors.lastname: Deblaere
authors.forename: J M
authors.initials: JM
authors.lastname: Zaballos
authors.forename: A
authors.initials: A
authors.lastname: Bräuer
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D005260:Female; D006361:Heating; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D011446:Prospective Studies