Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 6)
Efficacy of external warming in attenuation of hypothermia in surgical patients
Authors:
Snježana Zeba*, Maja Šurbatović*, Milan Marjanović†, Jasna Jevdjić‡, Zoran Hajduković*, Radovan Karkalić§, Dalibor Jovanović||, Sonja Radaković*
Background/Aim. Hypothermia in surgical patients can be theconsequence of long duration of surgical intervention, general
anaesthesia and low temperature in operating room. Postoperative
hypothermia contributes to a number of postoperative complications
such as arrhythmia, myocardial ischemia, hypertension,
bleeding, wound infection, coagulopathy, and prolonged effect
of muscle relaxants. External heating procedures are used to prevent
this condition. The aim of this study was to evaluate the efficiency
of external warming system in alleviation of cold stress
and hypothermia in patients who underwent major surgical procedures.
Methods. The study was conducted in the Military
Medical Academy in Belgrade. A total of 30 patients of both
genders underwent abdominal surgical procedures, randomly divided
into two equal groups: the one was externally warmed using
warm air mattress (W), while in the control group (C) surgical
procedure was performed in regular conditions, without additional
warming. Oesophageal temperature (Te) was used as indicator
of changes in core temperature, during surgery and awakening
postoperative period, and temperature of control sites on
the right hand (Th) and the right foot (Tf) reflected the changes
in skin temperatures during surgery. Te and skin temperatures
were monitored during the intraoperative period, with continuous
measurement of Te during the following 90 minutes of the
postoperative period. Heart rates and blood pressures were monitored
continuously during the intraoperative and awakening period.
Results. In the W group, the average Te, Tf and Th did not
change significantly during the intraoperative as well as the postoperative
period. In the controls, the average Te significantly decreased
during the intraoperative period (from 35.61 ± 0.35ºC at
0 minute to 33.86 ± 0.51ºC at 120th minute). Compared to the
W group, Te in the C group was significantly lower in all the observed
periods. Average values of Tf and Th significantly decreased
in the C group (from 30.83 ± 1.85 at 20th minute to 29.0
± 1.39ºC at 120th minute, and from 32.75 ± 0.96 to 31.05 ±
1.09ºC, respectively). Conclusion. The obtained results confirm
that the external warming using warm air mattress was able to attenuate
hypothermia, i.e. substantial decrease in core temperature,
compared with the similar exposure to cold stress in the
control group.
