The role of systemic warming of surgical patients at admission and during their initial hospital phase

• Main Author: Satheesan, Kanagasingham Stephen
• Published: University of Newcastle Upon Tyne 2013
• Subjects: 617.059
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.627635

The deleterious consequences of hypothermia are well documented. Most surgical patients suffer from at least mild hypothermia as a result of their pathophysiological and environmental factors. Over the past few decades research in to perioperative temperature homeostasis has unravelled a wide range of physiological adverse effects that hypothermia could have on surgical patients. Active warming has been shown to be effective in maintaining normothermi a and improving clinical outcomes such a mortality and morbidity, particularly infectious outcomes. In addition, studies have shown that warming patients during emergency transport is effective in reducing their pain and anxiety and improving their comfort. Surgical patients presenting to the A&E department are at risk of developing hypothermia. This clinical trial has investigated the role of systemic warming of surgical patient at admission and during their initial hospital phase. This was a prospective randomised clinical trial comparing a standard group (control) with a treatment (warming) group. Adult, mentally competent patients presenting to A&E with abdominal pain or a suspected fractured hip were invited to take part in this trial. The treatment group received active systemic warming using an Inditherm ™ carbon polymer, resistive warming mattress, set at 40 °C at admission for up to 4 hour . The control group received standard A&E care without active warming. Their demographics and physiological variables were recorded. Their core temperature (CT) was measured using an infrared temporal artery thermometer, with mean skin temperature, at admission and every hour up to 4 hours. Mean skin temperature (MST) was measured using an infrared skin thermometer at admission, mid phase (2 hours) and at the end of the admission period (4 hours). In addition pain, anxiety and comfort scores were measured using standard 100mm visual analogue scales (VAS).