In the fixed effect model , the warming group had significantly less pain and lower incidence of wound infection , compared with the no-warming group .
In the r and om effect model , the warming group was also associated with lower risk of post-anesthetic shivering .
Both in the r and om and the fixed effect models , the warming group was associated with significantly less blood loss .
Perioperative warming of surgical patients is effective in reducing postoperative wound pain , wound infection and shivering .
Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy .
OBJECTIVE The objective of this review was to systematic ally analyze the trials on the effectiveness of perioperative warming in surgical patients .
Forced-Air Warming Decreases Vasodilator Requirement After Coronary Artery Bypass Surgery
Postoperative hypothermia is common and associated with adverse hemodynamic consequences , including adrenergically mediated systemic vasoconstriction and hypertension . Hypothermia is also a known predictor of dysrhythmias and myocardial ischemia in high-risk patients . We describe a prospect i ve , r and omized trial design ed to test the hypothesis that forced-air warming ( FAW ) provides improved hemodynamic variables after coronary artery bypass graft . After institutional review board approval and written informed consent , 149 patients undergoing coronary artery bypass graft were r and omized to receive postoperative warming with either FAW ( n = 81 ) or a circulating water mattress ( n = 68 ) . Core temperature was measured at the tympanic membrane . A weighted mean skin temperature was calculated . Heart rate , mean arterial blood pressure , central venous pressure , cardiac output , and systemic vascular resistance were monitored for 22 h postoperatively . Mean arterial blood pressure was maintained by protocol between 70 and 80 mm Hg by titration of nitroglycerin and sodium nitroprusside . The two groups had similar demographic characteristics . Tympanic and mean skin temperatures were similar between groups on intensive care unit admission . During postoperative rewarming , tympanic temperature was similar between groups , but mean skin temperature was significantly greater in the FAW group ( P < 0.05 ) . Heart rate , mean arterial pressure , central venous pressure , cardiac output , and systemic vascular resistance were similar for the two groups . The percent of patients requiring nitroprusside to achieve the hemodynamic goals was less ( P < 0.05 ) in the FAW group . In conclusion , aggressive cutaneous warming with FAW results in a higher mean skin temperature and a decreased requirement for vasodilator therapy in hypothermic patients after cardiac surgery . This most likely reflects attenuation of the adrenergic response or opening of cutaneous vascular beds as a result of surface warming . Implication s Forced-air warming after cardiac surgery decreases the requirement for vasodilator drugs and may be beneficial in maintaining hemodynamic variables within predefined limits
In the fixed effect model , the warming group had significantly less pain and lower incidence of wound infection , compared with the no-warming group .
In the r and om effect model , the warming group was also associated with lower risk of post-anesthetic shivering .
Both in the r and om and the fixed effect models , the warming group was associated with significantly less blood loss .
Perioperative warming of surgical patients is effective in reducing postoperative wound pain , wound infection and shivering .
Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy .
OBJECTIVE The objective of this review was to systematic ally analyze the trials on the effectiveness of perioperative warming in surgical patients .