Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation

Abstract

Study Objective: To compare the ability of forced-air warming and reflective insulation to maintain intraoperative normothermia. Design: Prospective, randomized clinical trial. Setting: Operating rooms of a general hospital. Patients: 20 ASA physical status I and II patients undergoing elective total hip arthroplasty. Interventions: Patients were randomly assigned to be warmed intraoperatively using forced-air or reflective insulation. Inspired gases were conditioned using a heat-and-moisture exchanger in both groups, and infused intravenous fluids were warmed to 37°C. Measurements and Main Results: Distal esophageal (core) temperatures decreased approximately 0.5°C in both groups during the first 45 minutes of anesthesia. Subsequently, core temperatures increased slightly in the patients given forced-air warming. In contrast, core temperatures continued to decrease in patients covered with reflective insulation. After 135 minutes of anesthesia, core temperatures were 36.4 ± 0.6°C (mean ± SD) in the forced-air group but only 35.4 ± 0.6°C in the insulated group ( p < 0.01, unpaired t-test). These data indicate that forced-air warming is superior to reflective insulation. Conclusion: Reflective insulation was unable to maintain intraoperative normothermia during total hip arthroplasty. Active warming, such as that provided by forced air, was required to prevent hypothermia.