Cotton Blankets Research Articles

Extending Cucumber Shelf Life: A Comparative Study of Low-Cost Drip Cooling Systems Using Different Fabric Coverings

Aims: Postharvest losses of cucumbers pose significant challenges for small-scale farmers in developing regions due to limited access to modern cold storage. This study investigated the effectiveness of low-cost indigenous drip coolers with different fabric coverings as an alternative preservation method. Study Design: Completely Randomized Design (CRD) with five treatments and three replications. Place and Duration of Study: Department of Crop Science, Surigao del Norte State University – Mainit Campus, Mainit, Surigao del Norte, Philippines on March 1-20, 2024. Methodology: Cucumber fruits were stored in indigenous drip coolers constructed with various recycled fabric coverings. Treatment combinations were: T1 - Control ambient temperature, T2 - Alpha Gina fabric, T3 - Silk satin bedsheets, T4 – Cotton comforter, and T5 - Cotton Blanket. The study evaluated color change, firmness, shriveling index, visual quality rating, weight loss, and damage rate over 20 days storage period. Results: Significant differences in cucumber fruit quality emerged at different time points across various parameters. Differences in color change and firmness were observed on day 15 (p = 0.023), while shriveling and visual quality showed differences by day 20 of storage (p = 0.042 and p = 0.042, respectively). However, in terms of weight loss, the Alpha gina fabric significantly had the highest loss among fabric covers used (p = 0.038). Consistently, the control ambient group exhibited the poorest quality, while treatments like the cotton comforter and silk satin bedsheet were most effective in preserving cucumber quality. Conclusion: This study demonstrates the effectiveness of indigenous drip coolers in preserving cucumber quality, with silk satin bedsheets and cotton comforter coverings consistently outperforming other materials and ambient conditions. These coolers were effective in slowing color change, maintaining firmness, reducing shriveling, and preserving overall visual quality. The study highlights the importance of fabric selection in drip cooler design, with cotton comforter and silk satin bedsheet coverings likely offering better air circulation, moisture retention, and insulation.

The Effect of Brief Warming during Induction of General Anesthesia and Warmed Intravenous Fluid on Intraoperative Hypothermia in Patients Undergoing Urologic Surgery.

Background and Objectives: Transurethral urologic surgeries frequently lead to hypothermia due to bladder irrigation. Prewarming in the preoperative holding area can reduce the risk of hypothermia but disrupts surgical workflow, preventing it from being of practical use. This study explored whether early intraoperative warming during induction of anesthesia, known as peri-induction warming, using a forced-air warming device combined with warmed intravenous fluid could prevent intraoperative hypothermia. Materials and Methods: Fifty patients scheduled for transurethral resection of the bladder (TURB) or prostate (TURP) were enrolled and were randomly allocated to either the peri-induction warming or control group. The peri-induction warming group underwent whole-body warming during anesthesia induction using a forced-air warming device and was administered warmed intravenous fluid during surgery. In contrast, the control group was covered with a cotton blanket during anesthesia induction and received room-temperature intravenous fluid during surgery. Core temperature was measured upon entrance to the operating room (T0), immediately after induction of anesthesia (T1), and in 10 min intervals until the end of the operation (Tend). The incidence of intraoperative hypothermia, change in core temperature (T0-Tend), core temperature drop rate (T0-Tend/[duration of anesthesia]), postoperative shivering, and postoperative thermal comfort were assessed. Results: The incidence of intraoperative hypothermia did not differ significantly between the two groups. However, the peri-induction warming group exhibited significantly less change in core temperature (0.61 ± 0.3 °C vs. 0.93 ± 0.4 °C, p = 0.002) and a slower core temperature drop rate (0.009 ± 0.005 °C/min vs. 0.013 ± 0.004 °C/min, p = 0.013) than the control group. The peri-induction warming group also reported higher thermal comfort scores (p = 0.041) and less need for postoperative warming (p = 0.034) compared to the control group. Conclusions: Brief peri-induction warming combined with warmed intravenous fluid was insufficient to prevent intraoperative hypothermia in patients undergoing urologic surgery. However, it improved patient thermal comfort and mitigated the absolute amount and rate of temperature drop.

The initiation: a patient’s story

I stare at my feet poking out of the thin cotton blankets. My right leg is wrapped to the knee in a blue cast and propped up on pillows, my left leg lies to the side, numb and tingling. I channel Uma Thurman in Kill Bill — “Just wiggle your big toe.” I concentrate, sending all of my will and

Directional fiber framework wrapped by graphene flakes for supporting phase change material with fast thermal energy storage properties

Organic phase change materials (PCMs) have low thermal conductivity and poor form stability, which prohibit their usage in high-efficient heat storage and thermal management. This study demonstrated how to efficiently fabricate phase change composites (PCCs) with directional thermal conductivity and good form stability using vertically aligned carbon fibers as supporting scaffolds. Cotton blankets with aligned fibers were firstly impregnated with graphene flake solutions, which were then rolled to columns along the fiber direction and subsequently carbonized to obtain the porous carbon fiber scaffolds. PCCs were prepared by vacuum impregnation of paraffin into the scaffolds. The porous scaffolds supported PCCs showed good shape stability and greatly improved thermal transfer properties, which were especially endowed with a directional heat conductivity as a result of the vertically arranged hollow carbon fiber structure. The thermal conductivity of PCCs along the axial direction of the fibers was greater than along the lateral direction, because the arranged fibers provided the majority of the thermal transfer path in PCCs. With a carbon content of 19.46 wt%, the axial thermal conductivity was 2.13 W K−1 m−1, which was twice of the lateral one and 8.5 times of the PW. Last but not least, the PCCs also possessed high latent heat capacity, high thermal cycling and chemical stability. These results suggest that the novel carbon scaffolds may enable PCCs with directionally improved thermal transfer properties.

Determining the Effectiveness of Forced-Air Warming Blankets in Maintaining Postoperative Body Temperature: A Randomized Controlled Trial

PurposeThe aim of this study is to determine the effectiveness of forced-air warming blankets in normalizing body temperature in the postoperative period. DesignRandomized controlled trial MethodsThe study sample consisted of patients (N = 67) who underwent lung lobectomy in the Thoracic Surgery Service of a university hospital. Forced-air warming blankets were used in the treatment group and 100% cotton blankets were used in the control group. Patients’ body temperatures were monitored using a tympanic thermometer until it reached 37°C. FindingsThe body temperature of the patients in the treatment group reached 37°C in a shorter time than that of the patients in the control group (52.27 ± 29.79 min and 139.0 ± 81.93 min, respectively; P < .001), and that the perception of comfort of the patients in the treatment and control groups increased (P < .001) after warming. ConclusionsWe recommend that forced-air warming blankets are used for patients undergoing lung lobectomy in order to reach normal body temperature in a shorter time.

Efficacy of active forced air warming during induction of anesthesia to prevent inadvertent perioperative hypothermia in intraoperative warming patients: Comparison with passive warming, a randomized controlled trial.

Background:This study aimed to evaluate the efficacy of peri-induction forced air warming to prevent inadvertent perioperative hypothermia, defined as a reduction in body temperature to <36.0°C during the perioperative period, in intraoperatively warmed patients receiving major surgery lasting >120 minutes.Methods:In total, 130 patients scheduled for elective surgery under general anesthesia lasting >120 minutes were divided into 2 groups: peri-induction warming (n = 65) and control (n = 65). Patients in the peri-induction warming group were warmed during the anesthetic induction period using a forced-air warmer set at 47°C, whereas patients in the control group were covered passively with a cotton blanket. All patients were warmed with a forced-air warmer during surgery. Body temperature was measured using a tympanic membrane thermometer in the pre- and postoperative periods and using a nasopharyngeal temperature probe during surgery. Patients were evaluated for shivering scale score, thermal comfort scale score, and satisfaction score in the post-anesthesia care unit.Results:The incidence rates of intraoperative and postoperative hypothermia were lower in the peri-induction warming group than in the control group (19.0% vs 57.1%, P < .001; 3.3% vs 16.9%, P = .013, respectively). Body temperature was higher in the peri-induction warming group (P < .001). However, intraoperative blood loss, as well as postoperative thermal comfort scale score, shivering scale score, and patient satisfaction score, were similar between groups. Post-anesthesia care unit duration was also similar between groups.Conclusions:Peri-induction active forced air warming is an effective, simple, and convenient method to prevent inadvertent perioperative hypothermia in intraoperatively warmed patients undergoing major surgery lasting >120 minutes.

The Effect of Active Warming on Postoperative Hypothermia on Body Temperature and Thermal Comfort: A Randomized Controlled Trial

PurposeThe purpose of this study was to determine the effect of active warming method in temperature control and thermal comfort in hypothermia after surgery. DesignA randomized controlled trial. MethodsThe study sample consisted of 64 male and female postanesthesia care unit and intensive care unit neurosurgery postoperative inpatients. The experimental group was warmed using the active warming method, and the control group's routine care was continued via a cotton blanket. Patients were warmed until their tympanic body temperature reached 37°C. FindingsThe time needed to adequately warm patients was approximately twice as short in those who received active warming as compared with the control group. The perception of thermal comfort was significantly higher in the first hour in patients who received the active warming method (P < .05). ConclusionsThe active warming method resulted in a shorter time to warming in hypothermia after surgery and an increase in the perception of thermal comfort and body temperature.

Improving intraoperative temperature management in elective repeat cesarean deliveries: a retrospective observational cohort study

BackgroundInadvertent perioperative hypothermia (< 36 °C) occurs frequently during elective cesarean delivery and most institutions do employ perioperative active warming. The purpose of this retrospective observational cohort study was to determine if the addition of preoperative forced air warming in conjunction with intraoperative underbody forced air warming improved core temperature and reducing inadvertent perioperative hypothermia during elective repeat elective cesarean delivery with neuraxial anesthesia.MethodsWe evaluated the addition of perioperative active warming to standard passive warming methods (preheated intravenous/irrigation fluids and cotton blankets) in 120 parturients scheduled for repeat elective cesarean delivery (passive warming, n = 60 vs. active + passive warming, n = 60) in a retrospective observational cohort study. The primary outcomes of interest were core temperature at the end of the procedure and a decrease in inadvertent perioperative hypothermia (< 36 °C). Secondary outcomes were surgical site infections and adverse markers of neonatal outcome.ResultsThe mean temperature at the end of surgery after instituting the active warming protocol was 36.0 ± 0.5 °C (mean ± SD, 95% CI 35.9–36.1) vs. 35.4 ± 0.5 °C (mean ± SD, 95% CI 35.3–35.5) compared to passive warming techniques (p < 0.001) and the incidence of inadvertent perioperative hypothermia at the end of the procedure was less in the active warming group - 68% versus 92% in the control group (p < 0.001). There was no difference in surgical site infections or neonatal outcomes.ConclusionsPerioperative active warming in combination with passive warming techniques was associated with a higher maternal temperature and lower incidence of inadvertent perioperative hypothermia with no detectable differences in surgical site infections or indicators of adverse neonatal outcomes.

Electrostatic Charging of a Human Body Caused by Activities and Material Combinations in Hospitals

Electrostatic charging of hospital personnel and patients during various activities increases the risk of electrostatic discharge (ESD) malfunctions of medical devices and the likelihood of patients’ adverse events. Therefore, the test level for ESD immunity of medical devices, specified in the IEC 60601-1-2 standard needs to reflect the reasonably maximum electrostatic voltages during usage. This study investigated the effects of material combinations and relative humidity on the body voltage while performing two routine clinical activities of lying down on a hospital bed and transferring to a bed using a sliding board. The peak body voltages in nearly 50% of the lying down experiments and 40% of sliding tests exceeded the test voltage level in the IEC 60601-1-2 standard (i.e., 15 kV). Using cotton blankets in lying down experiments and nylon sheets during sliding experiments resulted in 50% and 40% larger median than the median including all combinations, respectively. Sliding boards with antistatic coating reduced the peak body voltage by 24% on average, however, 33% of the tests still exceeded 15 kV. Based on the findings, recommendations are provided for healthcare facilities and medical device manufacturers to mitigate the risks of ESD malfunctions.

Effect of the ASPAN Guideline on Perioperative Hypothermia Among Patients With Upper Extremity Surgery Under General Anesthesia: A Randomized Controlled Trial

PurposeTo evaluate the effect of using the evidence-based hypothermia guideline developed by the American Society of PeriAnesthesia Nurses on body temperature, shivering, thermal discomfort and comfort, and incidence of hypothermia. DesignRandomized controlled trial with 54 patients undergoing upper arm surgery with general anesthesia in the Republic of Korea. MethodsParticipants in the experimental group received a head turban, sleeping socks, a heated blanket, a Bair Hugger for forced-air warming, and a Mega Acer kit (ACE Medical Co, Seoul, Korea) for warming intravenous fluid. Participants in the control group received a typical hospital cotton blanket. FindingsBody temperature, shivering, thermal discomfort, and thermal comfort showed significant improvements in the experimental group compared with the control group. ConclusionsThe American Society of PeriAnesthesia Nurses guideline is applicable for preventing hypothermia under general anesthesia, which, in turn, aids in patient recovery through the suppression of various hypothermia-related complications.

Prevalence and multivariable factors associated with inadvertent intraoperative hypothermia in video-assisted thoracoscopic surgery: a single-center retrospective study

BackgroundInadvertent intraoperative hypothermia increases the risk of adverse events, but its related risk factors have not been defined in video-assisted thoracoscopic surgery (VATS). This study aimed at analyzing the prevalence and factors related to inadvertent intraoperative hypothermia in adults undergoing elective VATS under general anesthesia.MethodsThis was a retrospective study using data from the Peking University People’s Hospital from January through December, 2018. Data were collected on age, sex, height, weight, American Society of Anesthesiologists physical status, the duration of preparation and surgery, timing of surgery, surgery types, anesthesia types, intraoperative core temperature and the length of stay (LOS) in the hospital from the electronic database in our center. Patients were covered with a cotton blanket preoperatively and the surgical draping during the operation. A circulation-water warming mattress set to 38 °C were placed under the body of the patients. Inadvertent intraoperative hypothermia was identified as a core temperature monitored in nasopharynx < 36 °C. Multivariate logistic regression analysis was used to identify independent risk factors of hypothermia.ResultsWe found that 72.7% (95% CI 70.5 to 75.0%) of 1467 adult patients who underwent VATS suffered hypothermia during surgery. The factors associated with inadvertent intraoperative hypothermia included age (OR = 1.23, 95% CI 1.11 to 1.36, p < 0.001), BMI (OR = 1.83, 95% CI 1.43 to 2.35, p < 0.001), the duration of preparation (OR = 1.01, 95% CI 1.00 to 1.02, p = 0.014), the duration of surgery (OR = 2.10, 95% CI 1.63 to 2.70, p < 0.001), timing of surgery (OR = 1.64, 95% CI 1.28 to 2.12, p < 0.001), ambient temperature in the operating room (OR = 0.67, 95% CI 0.53 to 0.85, p = 0.001) and general anesthesia combined with paravertebral block after induction of anesthesia (OR = 2.30, 95% CI 1.31 to 4.03, p = 0.004). The average LOS in the hospital in the hypothermia group and the normothemic group was 9 days and 8 days, respectively (p < 0.001).ConclusionsWe highlight the high prevalence of inadvertent intraoperative hypothermia during elective VATS and identify key risk factors including age, duration of surgery more than 2 h, surgery in the morning and general anesthesia combined with paravertebral block (PVB) after intubation. We also find that hypothermia did prolong the LOS in the hospital.

Too Cool? Hip Fracture Care and Maintaining Body Temperature

Introduction:Patients with hip fractures can become cold during the perioperative period despite measures applied to maintain warmth. Poor temperature control is linked with increasing complications and poorer functional outcomes. There is generic evidence for the benefits of maintaining normothermia, however this is sparse where specifically concerning hip fracture. We provide the first comprehensive review in this population.Significance:Large studies have revealed dramatic impact on wound infection, transfusion rates, increased morbidity and mortality. With very few studies relating to hip fracture patients, this review aimed to capture an overview of available literature regarding hypothermia and its impact on outcomes.Results:Increased mortality, readmission rates and surgical site infections are all associated with poor temperature control. This is more profound, and more common, in older frail patients. Increasing age and lower BMI were recognized as demographic factors that increase risk of hypothermia, which was routinely identified within modern day practice despite the use of active warming.Conclusion:There is a gap in research related to fragility fractures and how hypothermia impacts outcomes. Inadvertent intraoperative hypothermia still occurs routinely, even when active warming and cotton blankets are applied. No studies documented temperature readings postoperatively once patients had been returned to the ward. This is a point in the timeline where patients could be hypothermic. More studies need to be performed relating to this area of surgery.

Management of Shivering in Post-Spinal Anesthesia Using Warming Blankets and Warm Fluid Therapy

Hypothermia is a common and serious complication of spinal surgery and it is associated with many harmful perioperative outcomes. The aim of this study was to compare the effectiveness of warming blankets and warm fluid therapy to manage shivering. A quasi-experiment with a non-equivalent control group was applied as the research design. There were 60 patients involved in the study. The instrument of this study was a warmer fluid modification, a warming blanket and a cotton blanket. The data was analyzed using an applied paired t-test and independent t-test. After 60 minutes of the intervention, the mean and SD of body temperature of the patients receiving warm fluids was 36.71 ± 0.18, a warming blanket was 36.12 ± 0.35, and the control group was 35.76 ± 0.22. The p values were 0,000. Warm fluid therapy and warming blankets are significant in terms of increasing the body temperature of post-spinal anesthesia patients. Warm fluids are more effective than warming blanket. Warming blankets and warm fluid therapy can be used as a way to increase the body temperature of patients with hypothermia.

Essential oils as tick repellents on clothing

Essential oils show promise as natural alternatives to synthetic tick repellents, but few studies have investigated their repellent efficacy in vivo or under field conditions. Here, blanket-drags and standardised walks were employed to evaluate tick acquisition by 1 m2 cotton blankets or cotton trousers, respectively, in woodland edge habitats of known high tick abundance. Blankets and trousers had been treated with one of 5% oregano, rosemary, spearmint or thyme oils, 20% DEET (N,N-diethyl-3-methylbenzamide) (positive control) or ethanol excipient-only (negative control). The number of ticks present on the blankets or trousers differed significantly between treatments: spearmint oil treatments resulted in significantly fewer ticks than the negative controls for both blankets and trousers and significantly fewer ticks were present on the oregano oil treated blankets. For ticks that did attach to the trousers, the rate of drop off within 3 min was significantly higher for trousers treated with spearmint oil or thyme oil than ethanol, oregano oil and rosemary oil. No reduction in repellence was detected over a 24 h period between treatment and testing. The results suggest that 5% oregano and spearmint oils exhibit potential as natural clothing repellents, with an effective equivalence to 20% DEET.

Comparison of Electric Resistive Heating Pads and Forced-Air Warming for Pre-hospital Warming of Non-shivering Hypothermic Subjects.

Victims of severe hypothermia require external rewarming, as self-rewarming through shivering heat production is either minimal or absent. The US Military commonly uses forced-air warming in field hospitals, but these systems require significant power (600-800 W) and are not portable. This study compared the rewarming effectiveness of an electric resistive heating pad system (requiring 80 W) to forced-air rewarming on cold subjects in whom shivering was pharmacologically inhibited. Shivering was inhibited by intravenous meperidine (1.5 mg/kg), administered during the last 10 min of cold-water immersion. Subjects then exited from the cold water, were dried and lay on a rescue bag for 120 min in one of the following conditions: spontaneous rewarming only (rescue bag closed); electric resistive heating pads (EHP) wrapped from the anterior to posterior torso (rescue bag closed); or, forced-air warming (FAW) over the anterior surface of the body (rescue bag left open and cotton blanket draped over warming blanket). Supplemental meperidine (to a maximum cumulative dose of 3.3 mg/kg) was administered as required during rewarming to suppress shivering. Six healthy subjects (3 m, 3 f) were cooled on three different occasions, each in 8°C water to an average nadir core temperature of 34.4 ± 0.6°C (including afterdrop). There were no significant differences between core rewarming rates (spontaneous; 0.6 ± 0.3, FAW; 0.7 ± 0.2, RHP; 0.6 ± 0.2°C/h) or post-cooling afterdrop (spontaneous; 1.9 ± 0.4, FAW; 1.9 ± 0.3, RHP; 1.6 ± 0.2°C) in any of the 3 conditions. There were also no significant differences between metabolic heat production (S; 74 ± 20, FAW; 66 ± 12, RHP; 63 ± 9 W). Total heat gain was greater with FAW (36 W gain) than EHP (13 W gain) and spontaneous (13 W loss) warming (p < 0.005). Total heat gain was greater in FAW than both EHP, and spontaneous rewarming conditions, however, there were no observed differences found in rewarming rates, post-cooling afterdrop or metabolic heat production. The electric heat pad system provided similar rewarming performance to a forced-air warming system commonly used in US military field hospitals for hypothermic patients. A battery-powered version of this system would not only relieve pressure on the field hospital power supply but could also potentially allow extending use to locations closer to the field of operations and during transport. Such a system could be studied in larger groups in prospective trials on colder patients.

Self-Fashioning for Survivance: Akimel O'odham Story and History in the Hispanic and Early American Periods

Self-Fashioning for Survivance:Akimel O'odham Story and History in the Hispanic and Early American Periods* Jennifer Bess (bio) The earth is spinning aroundThe earth is spinning aroundAnd my people are spinning around with the earth.The earth is spinning fasterThe earth is spinning fasterAnd my people are spinning faster with the earth.At that time when Siuuhu was singing these songs, that is a sign that some day we'll find out that the earth is turning around all the time. —Julian Hayden, Juan Smith, and William Allison Smith, "Pima Creation Myth"1 The legends I have told were told by the old Pimas many, many years ago to entertain and instruct their children. Today, these old stories are almost forgotten by the younger Pimas. I don't think they should be forgotten. They are a part of Pima tradition. They show what life was like in those old days and what bothered the people such as floods and drought and old Ho'ok's bad manners. They show what our ancestors thought was important. They help us to understand what is important today. —George Webb, A Pima Remembers 2 [End Page 725] At the height of deliberations dividing Akimel O'odham (River People, also called Pima) and Anglo-American farmers over the life-sustaining waters of the Gila River in south-central Arizona in the early twentieth century, 444 "Indians of the Pima Tribe" repeated in their testimony before the U.S. Senate a refrain dating back at least two generations: "We Pimas…have always been the white man's friend."3 Between 1848 and 1854, they had proven their friendship through the respite their grandfathers offered to 60,000 migrants crossing Arizona on their way to California.4 Providing safety from Apache assaults, forage for animals, and food and water for travelers, the eight Akimel O'odham villages stretching along 12 to 15 miles of the middle Gila River marked the junction at which four southern trails to California converged.5 As fortyniner Benjamin Butler Harris remarked in regards to this hub of activity, "So many 'Pilgrims' of different companies accumulating here at one time caused disintegration and new combinations of companies."6 They came to this oasis in the Sonoran Desert trading clothing, whiskey, and weapons for cotton blankets, corn, wheat, tobacco, pumpkins, melons, and other foodstuffs. As Cave Johnson Couts limned, due to the fact that the "Gila bottom…surpasses anything we have ever witnessed for fertility," the Akimel O'odham were able to be generous.7 "The Pima," wrote George Webb a century later in A Pima Remembers, "have always been known for their hospitality. If you came to the home of another Pima, no matter what time of day, the first thing placed before you would be some kind of food…. In those days the Pimas always had plenty."8 This era of prosperity and generosity, witnessed by Anglo-Americans and eulogized by Webb, illustrates one of many chapters in a local history characterized by adaptation, innovation, and co-creation. And as demonstrated below, the "spinning" world of the Akimel O'odham sacred stories provided them with a lens through which to interpret the past, see opportunities in the present, and build the future. The following study draws from the fields of oral narrative theory, archaeology, history, religion, and anthropology to provide necessary foundations in order to explore the importance of adaptation, innovation, and "world-building" in Akimel O'odham sacred story and history.9 Inspired by the studies of anthropologist William Roseberry and historian Colleen O'Neill, both of whom illustrate the reciprocal nature of culture and history, this essay reveals the mutually reinforcing and dynamic relationship between the philosophies articulated in the sacred stories and the lived history of their guiding messages.10 Along the two axes of [End Page 726] storytelling and history, this study seeks to bring into relief three interrelated points: the importance of sacred story and oral history as complements to written history and archaeology in understanding the past; the value of storytelling as an interpretive lens to that history; and the example that the Akimel O'odham provide of Native adaptability...

Maintaining intraoperative normothermia reduces blood loss in patients undergoing major operations: a pilot randomized controlled clinical trial

BackgroundInadvertent intraoperative hypothermia (core temperature < 36 °C) is a common but preventable adverse event. This study aimed to determine whether active intraoperative warming reduced bleeding in patients undergoing major operations: open thoracic surgery and hip replacement surgery.Methods/DesignThe study was a pilot, prospective, parallel two-arm randomized controlled trial. Eligible patients were randomly allocated to two groups: passive warming (PW), with application of a cotton blanket (thermal insulation), or active warming (AW), with a forced-air warming system. The primary endpoint was intraoperative blood loss, and secondary endpoints were surgical-site infection, cardiovascular events, and length of stay in the post-anesthesia care unit, intensive care unit, and hospital.ResultsSixty-two patients were enrolled. Forced-air active warming maintained intraoperative normothermia in all AW subjects, whereas intraoperative hypothermia occurred in 21/32 (71.8%) of PW patients (p = 0.000). The volume of blood loss was more in the PW group (682 ± 426 ml) than in the AW group (464 ± 324 ml) (p < 0.021), and the perioperative hemoglobin value declined more in the PW group (28.6 ± 17.5 g/L) than in the AW group (21.0 ± 9.9 g/L) (p = 0.045). However, there were no difference in other clinical outcomes between two groups.ConclusionIntraoperative active warming is associated with less blood loss than passive warming in open thoracic and hip replacement operations in this pilot study.Trial registrationThis trial was registered with Clinicaltrials.gov (Identifier: NCT02214524) on 27 August 2014.

Pre-Operative Warming: Are Warm Cotton Blankets Enough?

Hypothermia is a serious, yet preventable post-operative challenge. Post-operative hypothermia can lead to multiple complications including infection, poor wound healing, cardiac events, and death.

Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China.

Background/ObjectiveInadvertent intraoperative hypothermia (core temperature <36°C) is a frequently preventable complication with several adverse consequences. Our study aimed to determine the overall incidence of inadvertent intraoperative hypothermia and its risk factors associated with clinical outcomes in this national survey in China.MethodsWe conducted a national cross-sectional study with 30 days postoperative follow-up from November 2014 through August 2015. A total of 3132 eligible patients underwent general anesthesia were randomly selected from 28 hospitals in the nationwide of China.ResultsThe overall incidence of intraoperative hypothermia was as high as 44.3%, in which cumulative incidence rates of hypothermia being 17.8%, 36.2%, 42.5% and 44.1% within 1 h, 2 h, 3 h and 4 h respectively following induction of anesthesia. All patients were warmed passively by covering of surgical draping, sheets or cotton blankets, whereas only 14.2% of patients received active warming with space heaters or electric heater or electronic blankets. Compared to normothermic patients, patients with hypothermia is associated with more postoperative ICU admit, longer PACU and more postoperative hospital days, but no difference in surgical site infection (SSI) rates or 30-day mortality. Several factors were shown to be associated with decreased risk of hypothermia. They are active warming (OR = 0.46, 95% CI 0.26–0.81), BMI ≥ 25 (OR = 0.54, 95% CI 0.45–0.65), higher baseline core temperature (OR = 0.04, 95% CI 0.03–0.06), and higher ambient temperature (OR = 0.83, 95% CI 0.78–0.88). Risk factors associated with an increased risk of hypothermia included major-plus surgery (OR = 1.49, 95% CI 1.23–1.79), and long anesthesia (>2 h) (OR = 2.60, 95% CI 2.09–3.24).ConclusionsThe incidence of intraoperative hypothermia in China is high, and the rate of active warming of patients during operation is low. Hypothermia is associated with more postoperative shivering, increased ICU admissions, and longer postoperative hospital days.

Safety of Rolled and Folded Cotton Blankets Warmed in 130°F and 200°F Cabinets

In 2014, ECRI recommended that blanket warming cabinets be set at a maximum temperature of 130°F because of safety concerns with warmed rolled and folded blankets. We could find no research to support this recommendation. The purpose of this study was to measure skin temperatures and thermal comfort in healthy volunteers before and after application of folded and rolled dry cotton blankets warmed in 130°F or 200°F cabinets. Randomized, descriptive, and comparative study. Participants (n = 20) received two blankets (one rolled and one folded) from warming cabinets set at 130°F or 200°F. Folded blankets were applied to the back and rolled to the neck. Skin temperatures and thermal comfort were obtained at fixed time intervals. Skin temperatures from blankets in the 200°F cabinet were greater than those in the 130°F cabinet. No skin temperatures reached temperature and/or duration thresholds for dermal injury. This study provides supportive evidence that warming cabinets may be set at a maximum of 200°F without compromising patient safety.