S003: INTRAOPERATIVE ABDOMINAL SURGERY WARMING BY A CLOSE-CIRCUIT WATER SLEEVE
Allison McIntosh1; Stephanie Lewis, MD2,3; Giorgio Melloni, PhD4; Peter Wu, MD2,3; Jeffery Weiss, DO2,3; Enrico Camporesi, MD2,3
1University of South Florida Morsani College of Medicine; 2Department of Anesthesiology and Perioperative Medicine, Morsani College of Medicine; 3TEAMHealth, Anesthesia, Tampa General Hospital; 4TIMI Study Group at Brigham and Women's Hospital, Department of Cardiovascular Medicine, Harvard Medical School, Boston, MA
Introduction: Post-operative hypothermia is an adverse effect of anesthesia due to widespread inhibition of thermoregulatory processes, which can be mitigated through intraoperative warming. While forced warm-air systems are commonly used, they can disperse airborne particles into open cavities and pose challenges during procedures. Our study compared a water-sleeve warming system with a standard forced-air warming system to evaluate its efficacy in maintaining normothermia during intrabdominal surgery.
Methods: In this controlled trial, 67 patients who underwent elective intrabdominal surgery were assigned to either the water-sleeve warming system (N=30) or the forced-air warming system (N=37). Patients gave written consent to the assignment of the warming method (IRB#1814, USF). The water-sleeve system utilized a plastic sleeve circulating warm sterile water at 40°C on the patient's upper arm, with mild suction (-7 cm H2O) applied to promote venous dilation. The forced-air system used a disposable perforated blanket over the patient's upper body. Operating room temperatures were maintained at 20°C. Temperatures were recorded preoperatively, t = 0 (sublingual), intraoperatively every 15 minutes (esophageal), and postoperatively upon arrival in PACU (sublingual), final.
Results: The water-sleeve group maintained a slightly higher median temperature intraoperatively compared to the control group (see figure), although these differences were not statistically significant. A Fisher test (see table) revealed that the water-sleeve group had fewer patients experiencing at least one interval below 36°C. Both warming methods successfully maintained normothermia upon arrival at the post-anesthesia care unit (PACU).
Conclusions: This study demonstrated that the water-sleeve and forced-air warming systems were comparably effective in maintaining normothermia during intrabdominal surgery. No significant differences were observed in intraoperative or postoperative temperatures between the two groups. Given the similar efficacy and utility, further research is needed to evaluate whether the water-sleeve warming system may offer additional benefits, such as potentially reducing the risk of postoperative infections.
