Abstract
BackgroundThe authors compared two strategies for the maintenance of intraoperative normothermia during orthotopic liver transplantation (OLT): the routine forced-air warming system and the newly developed, whole body water garment.MethodsIn this prospective, randomized and open-labelled study, 24 adult patients were enrolled in one of two intraoperative temperature management groups during OLT. The water-garment group (N = 12) received warming with a body temperature (esophageal) set point of 36.8°C. The forced air-warmer group (N = 12) received routine warming therapy using upper- and lower-body forced-air warming system. Body core temperature (primary outcome) was recorded intraoperatively and during the two hours after surgery in both groups.ResultsThe mean core temperatures during incision, one hour after incision and during the skin closing were significantly higher (p < 0.05, t test with Bonferroni corrections for the individual tests) in the water warmer group compared to the control group (36.7 ± 0.1, 36.7 ± 0.2, 36.8 ± 0.1 vs 36.1 ± 0.4, 36.1 ± 0.4, 36.07 ± 0.4°C, respectively). Moreover, significantly higher core temperatures were observed in the water warmer group than in the control group during the placement of cold liver allograft (36.75 ± 0.17 vs 36.09 ± 0.38°C, respectively) and during the allograft reperfusion period (36.3 ± 0.26 vs 35.52 ± 0.42°C, respectively). In addition, the core temperatures immediately after admission to the SICU (36.75 ± 0.13 vs 36.22 ± 0.3°C, respectively) and at one hr (36.95 ± 0.13 vs 36.46 ± 0.2°C, respectively) were significantly higher in the water warmer group, compared to the control group, whereas the core temperature did not differ significantly afte two hours in ICU in both groups.ConclusionsThe investigated water warming system results in better maintenance of intraoperative normothermia than routine air forced warming applied to upper- and lower body.
Highlights
The authors compared two strategies for the maintenance of intraoperative normothermia during orthotopic liver transplantation (OLT): the routine forced-air warming system and the newly developed, whole body water garment
The published clinical reports about effectiveness of the water garment device in the open abdominal and cardiac surgery provided initial evidences that the intraoperative use of this system results in better maintenance of intraoperative normothermia when compared with forced air warming system
As this garment is able to cover more of the patient, and deliver heat to greater percentage of the body than forced air warming, it was hypothesized that the warming water system might potentially prevent hypothermia during OLT more efficiently than forced air warmer
Summary
The authors compared two strategies for the maintenance of intraoperative normothermia during orthotopic liver transplantation (OLT): the routine forced-air warming system and the newly developed, whole body water garment. The published clinical reports about effectiveness of the water garment device in the open abdominal and cardiac surgery provided initial evidences that the intraoperative use of this system results in better maintenance of intraoperative normothermia when compared with forced air warming system. As this garment is able to cover more of the patient, and deliver heat to greater percentage of the body than forced air warming, it was hypothesized that the warming water system might potentially prevent hypothermia during OLT more efficiently than forced air warmer
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