Warming Update: Next steps in patient warming
It is widely known that hypothermia can result from temperature drops that occur during surgical procedures, which can lead to potentially severe health consequences. Highlighting how important patient warming is, how perioperative hypothermia happens, its potential consequences and preventive measures, with an emphasis on prewarming, Mölnlycke Health Care hosted a Warming Update webinar on November 8, 2012, to illustrate how adopting a critical but simple activity (patient warming) can result in cost savings and reduced risk of complications.
Featuring Dr Dan Sessler from the Cleveland Clinic and Dr Johan Raeder from Oslo University Hospital, renowned experts in this field, the webinar aimed to instruct participants on how and why they need to improve patient warming. In addition, Dr Karin Ganlöv presented Mölnlycke Health Care's BARRIER® EasyWarm® solution as one way to combat perioperative hypothermia.
“Importance of patient warming”
Dr Dan Sessler, Cleveland Clinic, Cleveland, Ohio, USA
Dr Sessler started by describing normal thermoregulation and how this is affected by anaesthesia. He described how hypothermia develops during surgery and how quickly it happens. He moved on to discuss the many well-documented complications of inadvertent intraoperative hypothermia; complications increase significantly already at temperatures below 36°C. Inadvertent hypothermia increases the risk of myocardial events, especially myocardial infarctions, increases bleeding and the need for transfusions, triples the risk of surgical wound infections, prolongs the effects action of anaesthetic (and other) drugs, doubles the time in postoperative recovery, prolongs hospitalization and in addition, decreases the patient’s well-being, as it reduces thermal comfort. Dr Sessler’s advice was to monitor core body temperature in all patients undergoing surgery planned to last more than 30 minutes and to maintain normothermia (prewarming helps).
“Prewarming, why and how?”
Dr Johan Raeder, Oslo University Hospital, Ullevål, Oslo, Norway
Dr Raeder described in detail the different phases of inadvertent intraoperative hypothermia, and the conventional approaches in counteracting this development. He also showed that current clinical practice fails to prevent the initial drop in temperature occurring immediately after induction of anaesthesia. Regardless of which warming technique is applied, after induction of anaesthesia, the initial post-induction temperature drop occurs anyway. Dr Raeder continued by describing how we can prevent the rapid initial drop in core body temperature by prewarming the periphery of the patient. He showed evidence from both patients and healthy volunteers. He went on to emphasize the risks of hypothermia. Dr Raeder concluded by emphasizing the risks of hypothermia and by advising the introduction of prewarming as a clinical practice to prevent inadvertent intraoperative hypothermia along with regular patient warming practices.
“BARRIER EasyWarm - a new, innovative patient-warming solution”
Dr Karin Ganlöv, Medical Director, Mölnlycke Health Care
The BARRIER EasyWarm solution is a self-activating warming blanket that generates heat by an exothermic reaction and starts to warm up as soon as it is removed from its outer packaging and comes in contact with air. Since the warming blanket has no additional equipment it can be put on the patient before surgery, i.e. be used for prewarming, and can then stay with the patient both during and after surgery. It is regarded as very easy and quick to set up and use.
Below is a brief video from the event.