The Experts below are selected from a list of 210 Experts worldwide ranked by ideXlab platform

Anselm Bräuer - One of the best experts on this subject based on the ideXlab platform.

  • Prevention of intraoperative hypothermia in neonates and infants: results of a prospective multicenter observational study with a new Forced-Air Warming System with increased warm air flow.
    Paediatric anaesthesia, 2013
    Co-Authors: Lars Witt, Nils Dennhardt, C. Eich, Thomas Mader, Thomas Fischer, Anselm Bräuer, Robert Sümpelmann
    Abstract:

    Summary Objectives Neonates and infants are at the highest risk of developing perioperative hypothermia. A number of methods to prevent hypothermia during pediatric anesthesia are in use, and despite the fact that conventional Forced-Air warmers are the most effective devices, they are not always sufficient enough to maintain body temperature. Therefore, recently a new Forced-Air Warming System with an increased warm air flow was introduced to the market. Aim The aim of this study was to evaluate this new Forced-Air Warming System in neonates and infants during pediatric anesthesia. We hypothesized that the new blanket alone is sufficient enough to prevent neonates and infants from intraoperative hypothermia. Methods Neonates and infants (body weight

  • Comparison of Forced-Air Warming and resistive heating.
    Minerva anestesiologica, 2008
    Co-Authors: Thorsten Perl, L Flöther, W Weyland, Michael Quintel, Anselm Bräuer
    Abstract:

    Background Perioperative hypothermia is common during anesthesia and surgery and is accompanied by several complications. Forced-Air Warming is recognized as an effective procedure to prevent hypothermia. The aim of this study was to compare a resistive heating device with a Forced-Air Warming device. Methods Prospective randomized trial. Setting heat transfer laboratory of a University hospital. Participants six healthy volunteers. Interventions Warming with a Forced-Air Warming device (BairHugger 505 and Upper Body Blanket 522; Arizant Healthcare Inc., Eden Prairie, MN, USA) or a resistive heating device (Geratherm Adult System; Geratherm Medical AG, Geschwenda, Germany). Measures heat transfer was measured with 11 calibrated heat flux transducers on the upper body. Additionally, blanket and skin temperatures were measured. The t-test for matched pairs was used for statistical evaluation. Results Skin temperature under the covered surface was not statistically different between the two groups (37.3+/-0.2 degrees C in the Forced-Air Warming group and 37.8+/-0.2 degrees C in the resistive heating group). In contrast, blanket temperature (40.3+/-0.6 degrees C vs 38.1+/-0.4 degrees C, P=0.002) and heat transfer (13.2+/-3.6 W vs 7.8+/-1.9 W, P=0.048) were significantly higher in the resistive heating group. Conclusion Heat transfer in the resistive heating System was significantly greater than that of the Forced-Air Warming System.

  • Conductive heat exchange with a gel-coated circulating water mattress.
    Anesthesia and analgesia, 2004
    Co-Authors: Anselm Bräuer, Larissa Pacholik, Thorsten Perl, Michael J. English, Wolfgang Weyland, Ulrich Braun
    Abstract:

    The use of Forced-Air Warming is associated with costs for the disposable blankets. As an alternative method, we studied heat transfer with a reusable gel-coated circulating water mattress placed under the back in eight healthy volunteers. Heat flux was measured with six calibrated heat flux transducers. Additionally, mattress temperature, skin temperature, and core temperature were measured. Water temperature was set to 25 degrees C, 30 degrees C, 35 degrees C, and 41 degrees C. Heat transfer was calculated by multiplying heat flux by contact area. Mattress temperature, skin temperature, and heat flux were used to determine the heat exchange coefficient for conduction. Heat flux and water temperature were related by the following equation: heat flux = 10.3 x water temperature - 374 (r(2) = 0.98). The heat exchange coefficient for conduction was 121 W . m(-2) . degrees C(-1). The maximal heat transfer with the gel-coated circulating water mattress was 18.4 +/- 3.3 W. Because of the small effect on the heat balance of the body, a gel-coated circulating water mattress placed only on the back cannot replace a Forced-Air Warming System.

Piotr K. Janicki - One of the best experts on this subject based on the ideXlab platform.

  • Water Warming garment versus forced air Warming System in prevention of intraoperative hypothermia during liver transplantation: a randomized controlled trial [ISRCTN32154832].
    BMC anesthesiology, 2002
    Co-Authors: Piotr K. Janicki, Cristina Stoica, William C. Chapman, J. Kelly Wright, Garry Walker, Ram Pai, Ann Walia, Mias Pretorius, C. Wright Pinson
    Abstract:

    Background 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.

  • Water Warming garment versus forced air Warming System in prevention of intraoperative hypothermia during liver transplantation: a randomized controlled trial [ISRCTN32154832]
    BMC Anesthesiology, 2002
    Co-Authors: Piotr K. Janicki, Cristina Stoica, William C. Chapman, J. Kelly Wright, Garry Walker, Ann Walia, Mias Pretorius, C. Wright Pinson
    Abstract:

    Background 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. Methods In 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. Results The 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. Conclusions The investigated water Warming System results in better maintenance of intraoperative normothermia than routine air forced Warming applied to upper- and lower body.

  • Comparison of Two Different Temperature Maintenance Strategies during Open Abdominal Surgery: Upper Body Forced-Air Warming versus Whole Body Water Garment
    Anesthesiology, 2001
    Co-Authors: Piotr K. Janicki, Michael S. Higgins, Jill Janssen, Raymond F. Johnson, Charles Beattie
    Abstract:

    BACKGROUND A new System has been developed that circulates warm water through a whole body garment worn by the patient during surgery. In this study the authors compared two different strategies for the maintenance of intraoperative normothermia. One strategy used a new water garment Warming System that permitted active Warming of both the upper and lower extremities and the back. The other strategy used a single (upper body) Forced-Air Warming System. METHODS In this prospective, randomized study, 53 adult patients were enrolled in one of two intraoperative temperature management groups during open abdominal surgery with general anesthesia. The water-garment group (n = 25) received Warming with a body temperature (rectal) set point of 36.8 degrees C. The Forced-Air-warmer group (n = 28) received routine Warming therapy using upper body Forced-Air Warming System (set on high). The ambient temperature in the operating room was maintained constant at approximately 20 degrees C. Rectal, distal esophageal, tympanic, forearm, and fingertip temperatures were recorded perioperatively and during 2 h after surgery. Extubated patients in both groups were assessed postoperatively for shivering, use of additional Warming devices, and subjective thermal comfort. RESULTS The mean rectal and esophageal temperatures at incision, 1 h after incision, at skin closure, and immediately postoperatively were significantly higher (0.4-0.6 degrees C) in the group that received water-garment Warming when compared with the group that received upper body Forced-Air Warming. The calculated 95% confidence intervals for the above differences in core temperatures were 0.7-0.1, 0.8-0.2, 0.8-0.2, and 0.9-0.1, retrospectively. In addition, 14 and 7% of patients in the control upper body Forced-Air group remained hypothermic (< 35.5 degrees C) 1 and 2 h after surgery, respectively. No core temperature less than 35.5 degrees C was observed perioperatively in any of the patients from the water-garment group. A similar frequency of the thermal stress events (shivering, use of additional Warming devices, subjective thermal discomfort) was observed after extubation in both groups during the 2 h after surgery. CONCLUSIONS The investigated water Warming System, by virtue of its ability to deliver heat to a greater percentage of the body, results in better maintenance of intraoperative normothermia that does Forced-Air Warming applied only to the upper extremities, as is common practice.

Daniel I. Sessler - One of the best experts on this subject based on the ideXlab platform.

  • An evaluation of a full-access underbody Forced-Air Warming System during near-normothermic, on-pump cardiac surgery.
    Anesthesia and analgesia, 2008
    Co-Authors: Steven R. Insler, Mohamed H. Bakri, Fady Nageeb, Edward J. Mascha, Tomislav Mihaljevic, Daniel I. Sessler
    Abstract:

    BACKGROUND A new underbody Forced-Air Warming System is available for use during cardiac surgery. We tested the hypothesis combining underbody Forced-Air Warming with standard thermal management would maintain intraoperative core temperature and reduce core temperature after-drop (largest decrease in core temperature in the 60 min after bypass) in patients undergoing near-normothermic cardiopulmonary bypass (CPB). METHODS Patients undergoing routine, nonemergent cardiac surgery were randomly assigned to routine thermal management (fluid Warming and passive insulation, n = 30) or routine management supplemented by an active underbody Forced-Air System (n = 30; Arizant Healthcare Model 635, Eden Prairie, MN). Core body temperature was measured by bladder catheter at 15-min intervals during the perioperative period. Comparisons were made between groups for temperature before, during, and after CPB. RESULTS Data from four patients were excluded for cause, leaving 29 patients in the routine management group and 27 patients in the Forced-Air group. Initial temperatures were similar, but temperatures in the Forced-Air group were higher than in the routine group at the start of CPB (36.3 degrees C +/- 0.6 degrees C vs 35.7 degrees C +/- 0.7 degrees C, P = 0.002). There were no differences between groups in the lowest temperatures during CPB (forced air, 35.5 degrees C +/- 1.5 degrees C vs routine, 35.3 degrees C +/- 1.3 degrees C, P = 0.67); the end of CPB (36.7 degrees C +/- 0.4 degrees C vs 36.6 degrees C +/- 0.4 degrees C, P > 0.99); or the temperature at departure from the operating room (36.5 degrees C +/- 0.4 degrees C vs 36.2 degrees C +/- 0.5 degrees C, P = 0.36). After-drop was 0.03 degrees C +/- 0.54 degrees C in patients randomized to underbody Forced-Air Warming and 0.21 degrees C +/- 0.51 degrees C in those assigned to routine management (P = 0.20). CONCLUSIONS Adding an underbody Forced-Air Warming System to the near-normothermic thermal management protocol significantly increased pre-bypass temperature; however, it had no further clinically important effect on core temperature.

  • Resistive Polymer Versus Forced-Air Warming : Comparable Heat Transfer and Core ReWarming Rates in Volunteers
    Anesthesia and analgesia, 2008
    Co-Authors: Oliver Kimberger, Daniel I. Sessler, Christine Held, Karin Stadelmann, Nikolaus Mayer, Corinne Hunkeler, Andrea Kurz
    Abstract:

    BACKGROUND: Mild perioperative hypothermia increases the risk of several severe complications. Perioperative patient Warming to preserve normothermia has thus become routine, with Forced-Air Warming being used most often. In previous studies, various resistive Warming Systems have shown mixed results in comparison with Forced-Air. Recently, a polymer-based resistive patient Warming System has been developed. We compared the efficacy of a standard Forced-Air Warming System with the resistive polymer System in volunteers. METHODS: Eight healthy volunteers participated, each on two separate study days. Unanesthetized volunteers were cooled to a core temperature (tympanic membrane) of 34 degrees C by application of Forced-Air at 10 degrees C and a circulating-water mattress at 4 degrees C. Meperidine and buspirone were administered to prevent shivering. In a randomly designated order, volunteers were then rewarmed (until their core temperatures reached 36 degrees C) with one of the following active Warming Systems: (1) Forced-Air Warming (Bair Hugger Warming cover #300, blower #750, Arizant, Eden Prairie, MN); or (2) polymer fiber resistive Warming (HotDog whole body blanket, HotDog standard controller, Augustine Biomedical, Eden Prairie, MN). The alternate System was used on the second study day. Metabolic heat production, cutaneous heat loss, and core temperature were measured. RESULTS: Metabolic heat production and cutaneous heat loss were similar with each System. After a 30-min delay, core temperature increased nearly linearly by 0.98 (95% confidence interval 0.91-1.04) degrees C/h with Forced-Air and by 0.92 (0.85-1.00) degrees C/h with resistive heating (P = 0.4). CONCLUSIONS: Heating efficacy and core reWarming rates were similar with full-body Forced-Air and full-body resistive polymer heating in healthy volunteers.

Robert Sümpelmann - One of the best experts on this subject based on the ideXlab platform.

Guido Fanelli - One of the best experts on this subject based on the ideXlab platform.

  • The efficacy of a resistive heating under-patient blanket versus a Forced-Air Warming System: a randomized controlled trial.
    Anesthesia and analgesia, 2009
    Co-Authors: Andrea Fanelli, G. Danelli, Daniela Ghisi, Andrea Ortu, Elisa Moschini, Guido Fanelli
    Abstract:

    BACKGROUND:We compared temperature changes in patients undergoing hip replacement during Warming with a resistive heating blanket or air-forced System.METHODS:Fifty-six patients were enrolled. Patients were randomly allocated to the “Forced-Air group” (Forced-Air System) or to the “heating-blanket g

  • Effects of sympathetic blockade on the efficiency of Forced-Air Warming during combined spinal-epidural anesthesia for total hip arthroplasty.
    Journal of clinical anesthesia, 1999
    Co-Authors: Andrea Casati, Guido Fanelli, Simonetta Baroncini, Roberto Pattono, Stefano Bonarelli, Paolo Musto, Marco Berti, Giorgio Torri
    Abstract:

    Abstract Study Objective: To evaluate if active cutaneous Warming of the two upper limbs with reflex vasoconstriction is less effective in maintaining intraoperative normothermia than Warming the vasodilated unoperated lower limb during combined spinal-epidural anesthesia (CSE). Design: Prospective, randomized study. Setting: Inpatient anesthesia at university departments of orthopedic surgery. Patients: 48 ASA physical status I, II, and III patients, who were scheduled for elective total hip arthroplasty. Interventions: Patients received CSE with intrathecal injection of 15 mg of 0.5% hyperbaric bupivacaine. All procedures started 8 to 10 am, and operating room temperature was maintained between 21° and 23°C, with relative humidity ranging between 40% and 45%. For Warming therapy, patients received active Forced-Air Warming of either the two upper limbs (Group Upper body, n=24), or the unoperated lower limb (Group Lower extremity, n=24). Core temperature was measured before CSE placement (baseline), and then every 30 minutes until completion of surgery. Time for fulfillment of clinical discharging criteria from the recovery area was evaluated by a blinded observer. Measurements and Main Results: Demographic data, duration of surgery, intraoperative blood losses, crystalloid infusion, and hemodynamic variables were similar in the two groups. Core temperature slightly decreased in both groups, but at the end of surgery the mean core temperature was 36.2° ± 0.5°C in Group Upper body and 36.3 ± 0.5 in Group Lower extremity (NS). At recovery room arrival, seven patients in Group Upper body (29%) and three patients in Group Lower extremity (12.5%) had a core temperature less than 36°C (NS). Shivering was observed in one patient in Group Upper body and in two patients in Group Lower extremity (NS). Clinical discharging criteria were fulfilled after 37 ± 16 minutes in Group Upper body and 30 ± 32 minutes in Group Lower extremity (NS). Conclusions: Forced-Air cutaneous Warming allows the anesthesiologist to maintain normothermia during CSE for total hip replacement even if the convective blanket is placed on a relatively small skin surface with reflex vasoconstriction. Placing the Forced-Air Warming System on the vasodilated unoperated lower limb may be troublesome to the surgeons and does not offer clinically relevant advantages in Warming efficiency.