title: The efficacy of pre-warming on reducing intraprocedural hypothermia in endovascular coiling of cerebral aneurysms.
abstract: BACKGROUND
  The anesthetic management of patients undergoing endovascular treatment of cerebral aneurysms in the interventional neuroradiology suite can be challenged by hypothermia because of low ambient temperature for operating and maintaining its equipments. We evaluated the efficacy of skin surface warming prior to induction of anesthesia to prevent the decrease in core temperature and reduce the incidence of hypothermia.
  
  
  METHODS
  Seventy-two patients were randomized to pre-warmed and control group. The patients in pre-warmed group were warmed 30 minutes before induction with a forced-air warming blanket set at 38°C. Pre-induction tympanic temperature (Tpre) was measured using an infrared tympanic thermometer and core temperature was measured at the esophagus immediately after intubation (T0) and recorded at 20 minutes intervals (T20, T40, T60, T80, T100, and T120). The number of patients who became hypothermic at each time was recorded.
  
  
  RESULTS
  Tpre in the control and pre-warmed group were 36.4 ± 0.4°C and 36.6 ± 0.3°C, whereas T0 were 36.5 ± 0.4°C and 36.6 ± 0.2°C. Core temperatures in the pre-warmed group were significantly higher than the control group at T20, T40, T60, T80, T100, and T120 (P < 0.001). Compared to T0, core temperatures at each time were significantly lower in both two groups (P = 0.007 at T20 in pre-warmed group, P < 0.001 at the other times in both groups). The incidence of hypothermia was significantly lower in the pre-warmed group than the control group from T20 to T120 (P = 0.002 at T20, P < 0.001 at the other times).
  
  
  CONCLUSIONS
  Pre-warming for 30 minutes at 38°C did not modify the trends of the temperature decrease seen in the INR suite. It just slightly elevated the beginning post intubation base temperature. The rate of decrease was similar from T20 to T120. However, pre-warming considerably reduced the risk of intraprocedural hypothermia.
  
  
  BACKGROUND
  Clinical Research Information Service (CRiS) Identifier: KCT0001320. Registered December 19th, 2014.
authors: Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150, Sungan-ro, Gangdong-gu, Seoul, 134-701 South Korea.
authors: Keun Man
authors: KM
authors: Shin
authors: Department of Emergency Medicine, Bundang Jesaeng General Hospital, Seongnam, South Korea.
authors: Jung Hwan
authors: JH
authors: Ahn
authors: Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150, Sungan-ro, Gangdong-gu, Seoul, 134-701 South Korea.
authors: Il Seok
authors: IS
authors: Kim
authors: Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea.
authors: Jong Young
authors: JY
authors: Lee
authors: Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150, Sungan-ro, Gangdong-gu, Seoul, 134-701 South Korea.
authors: Sang Soo
authors: SS
authors: Kang
authors: Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150, Sungan-ro, Gangdong-gu, Seoul, 134-701 South Korea.
authors: Sung Jun
authors: SJ
authors: Hong
authors: Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150, Sungan-ro, Gangdong-gu, Seoul, 134-701 South Korea.
authors: Hyun Mo
authors: HM
authors: Chung
authors: Department of Pharmacology, School of Medicine, Kangwon National University, Chuncheon, South Korea.
authors: Hee Jae
authors: HJ
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D001831:Body Temperature; D003080:Cold Temperature / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D002532:Intracranial Aneurysm / Q000601:surgery*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D065286:Prophylactic Surgical Procedures / Q000379:methods*; D017694:Rewarming / Q000379:methods*; D055815:Young Adult
keywords: Cerebral aneurysm; Hypothermia; Interventional neuroradiology; Pre-warming