Untersuchung der Effektivität konduktiver versus konvektiver Wärmung von Patienten zur Vermeidung intraoperativer Hypothermie während radikaler Prostatektomie

Intraoperative hypothermia during radical prostatectomy - the efficacy of conductive versus convective patient warming

by Anke Timphus
Doctoral thesis
Date of Examination:2014-11-24
Date of issue:2014-11-10
Advisor:Prof. Dr. Andreas Weyland
Referee:Prof. Dr. Andreas Weyland
Referee:PD Dr. Elmar Heinrich
Referee:Prof. Dr. Torsten Liersch
Persistent Address: http://dx.doi.org/10.53846/goediss-4769

 

 

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Abstract

English

Intraoperative hypothermia during radical prostatectomy – the efficacy of conductive versus convective patient warming Design: Prospective randomized effectiveness trial Background: In the prevention of perioperative hypothermia conductive warming is an alternative to the conventional clinical standard of convective air warming. This prospective randomized study was undertaken to compare efficacy of conductive warming with electrically heated silicone pads with convective air warming of the upper body. Methods: After approval from the Ethics Committee of the University of Göttingen, 24 male patients scheduled for radical prostatectomy were included. They were randomly assigned to one of two groups. In group 1 (n=12), convective air warming was performed with an upper body blanket (Zebamed®) attached to a heating device (Warm-Touch® 5800). Patients of group 2 (n=12) were subjected to a conductive warming device (Barkey paddytherm®) consisting of four silicone warming pads which were placed onto upper body and legs covering a total of 1728 cm² body area. Members of both groups were additionally covered with blankets (Barkey thermcare 1®) and an infusion warmer (Barkey autotherm®/autoline®) was applied. The body temperatures were measured with nasopharyngeal and esophageal thermometers. For statistical analysis a 2-way ANOVA repeated measures design was employed. Results: In both groups body temperature decreased after induction of anaesthesia. However, convective air warming significantly reduced perioperative heat loss in comparison with conductive warming. In the group 1 (convective warming) the body temperature increased after the initial decline, whereas body temperature in group 2 (conductive warming) decreased continuously until the end of surgery. At conclusion of surgery the average body temperature showed a significant difference between convective air warming (group 1: Tnas 36,8 ± 0,43°C; Teso 36,7 ± 0,37°C) and conductive warming (group 2: Tnas 35,7 ± 0,38°C; Teso 35,7 ± 0,42°C). Further, 0% of patients in the convective air warming group compared to 75% in the conductive warming group were hypotherm at the end of surgery. Conclusions: Convective air warming with upper body blankets during lower abdominal surgery is superior over conductive warming through 4 electrically heated silicone pads. In combination with additional warming devices such as fluid warmers it can reliably prevent perioperative hypothermia.
Keywords: intraoperative hypothermia; convective warming; conductive warming; air warming; perioperative hypothermia
Schlagwörter: konvektive Wärmung; konduktive Wärmung; intraoperative Hypothermie; perioperative Hypothermie
 
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