Resistive Warming Mattress, Forced-Air Warming System, or a Combination of the Two in the Prevention of Intraoperative Inadvertent Hypothermia: A Randomized Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(2):5 J Perianesth Nurs. 2023 Aug;38(4):611-615.What this means for my practice?
In patients between the age of 18-64yrs undergoing scheduled orthopedic surgeries while the combination of the two RWM+FAW showed a slightly lower incidence of IIH the results were not significant thus showing no added benefit of using both methods together. Greater satisfaction but a higher incidence of shivering and feeling cold was recorded with the combined methods. The study was limited by inclusion of a younger patient pool preventing generalization of results, only inclusion of scheduled orthopedic surgeries and no data regarding the cost or quantity of IV fluids was recorded.
Study Summary
123 patients between the age of 18-64 years who were scheduled for orthopedic surgery lasting more than 30 minutes under spinal anesthesia were included in this prospective, parallel study in which patients were randomly allotted to be warmed intraoperatively using either Resistive Warming Mattress (RWM; n=41), Forced-Air Warming System (FAW; n=41) or a combination of the two (RWM+FAW; n=41). The primary outcome of interest was the incidence of intraoperative inadvertent hypothermia (IIH). The additional outcomes observed were the feeling of cold, incidence of cyanosis, incidence of shivering and patient satisfaction which was measured using a visual analog scale (VAS). The combination group showed a lower incidence of IIH, however, this was not statistically significant. While satisfaction was significantly higher in the combination group, a higher incidence of patients feeling cold and shivering was observed in the combination group.
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