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The efficacy of pre-warming on reducing intraprocedural hypothermia in endovascular coiling of cerebral aneurysms
- 作者:Keun Man Shin (6)
Jung Hwan Ahn (7) Il Seok Kim (6) Jong Young Lee (8) Sang Soo Kang (6) Sung Jun Hong (6) Hyun Mo Chung (6) Hee Jae Lee (9)
6. Department of Anesthesiology and Pain Medicine ; Kangdong Sacred Heart Hospital ; Hallym University Medical Center ; 150 ; Sungan-ro ; Gangdong-gu ; Seoul ; 134-701 ; South Korea 7. Department of Emergency Medicine ; Bundang Jesaeng General Hospital ; Seongnam ; South Korea 8. Department of Neurosurgery ; Kangdong Sacred Heart Hospital ; Hallym University Medical Center ; Seoul ; South Korea 9. Department of Pharmacology ; School of Medicine ; Kangwon National University ; Chuncheon ; South Korea
- 关键词:Cerebral aneurysm ; Hypothermia ; Interventional neuroradiology ; Pre ; warming
- 刊名:BMC Anesthesiology
- 出版年:2015
- 出版时间:December 2015
- 年:2015
- 卷:15
- 期:1
- 参考文献:1. Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R, International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group: International subarachnoid aneurysm trial of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized trial. / Lancet 2002,360(9324):1267-4. CrossRef
2. Webb ST, Farling PA: Survey of arrangements for anaesthesia for interventional neuroradiology for aneurysmal subarachnoid haemorrhage. / Anaesthesia 2005,60(6):560-. 10.1111/j.1365-2044.2005.04191.x CrossRef 3. Todd MM, Hindman BJ, Clarke WR, Torner JC, Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) Investigators: Mild intraoperative hypothermia during surgery for intracranial aneurysm. / N Engl J Med 2005,352(2):135-5. 10.1056/NEJMoa040975 CrossRef 4. Hindman BJ, Bayman EO, Pfisterer WK, Torner JC, Todd MM, IHAST investigators: No association between intraoperative hypothermia or supplemental protective drug and neurologic outcomes in patients undergoing temporary clipping during cerebral aneurysm surgery: findings from the Intraoperative Hypothermia for Aneurysm Surgery Trial. / Anesthesiology 2010,112(1):86-01. 10.1097/ALN.0b013e3181c5e28f CrossRef 5. Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, Beattie C: Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. / J Am Med Assoc 1997,277(14):1127-4. 10.1001/jama.1997.03540380041029 CrossRef 6. Lenhardt R, Marker E, Goll V, Tschernich H, Kurz A, Sessler DI, Narzt E, Lackner F: Mild intraoperative hypothermia prolongs postoperative recovery. / Anesthesiology 1997,87(6):1318-3. 10.1097/00000542-199712000-00009 CrossRef 7. Horn EP, Sessler DI, Standl T, Schroeder F, Bartz HJ, Beyer JC, Schulte am Esch J: Non-thermoregulatory shivering in patients recovering from isoflurane or desflurane anesthesia. / Anesthesiology 1998,89(4):878-6. 10.1097/00000542-199810000-00012 CrossRef 8. Kurz A, Sessler DI, Lenhardt R: Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalization. Study of wound infection and temperature group. / N Engl J Med 1996,334(19):1209-5. 10.1056/NEJM199605093341901 CrossRef 9. Rajagopalan S, Mascha E, Na J, Sessler DI: The effects of mild perioperative hypothermia on blood loss and transfusion requirement. / Anesthesiology 2008,108(1):71-. 10.1097/01.anes.0000296719.73450.52 CrossRef 10. Forbes SS, Eskicioglu C, Nathens AB, Fenech DS, Laflamme C, McLean RF, McLeod RS, Best Practice in General Surgery Committee, University of Toronto: Evidence-based guidelines for prevention of perioperative hypothermia. / J Am Coll Surg 2009,209< - 刊物主题:Anesthesiology; Internal Medicine; Emergency Medicine; Intensive / Critical Care Medicine;
- 出版者:BioMed Central
- ISSN:1471-2253
文摘
Background The anesthetic management of patients undergoing endovascular treatment of cerebral aneurysms in the interventional neuroradiology suite can be challenged by hypothermia because of low ambient temperature for operating and maintaining its equipments. We evaluated the efficacy of skin surface warming prior to induction of anesthesia to prevent the decrease in core temperature and reduce the incidence of hypothermia. Methods Seventy-two patients were randomized to pre-warmed and control group. The patients in pre-warmed group were warmed 30?minutes before induction with a forced-air warming blanket set at 38°C. Pre-induction tympanic temperature (Tpre) was measured using an infrared tympanic thermometer and core temperature was measured at the esophagus immediately after intubation (T0) and recorded at 20?minutes intervals (T20, T40, T60, T80, T100, and T120). The number of patients who became hypothermic at each time was recorded. Results Tpre in the control and pre-warmed group were 36.4?±-.4°C and 36.6?±-.3°C, whereas T0 were 36.5?±-.4°C and 36.6?±-.2°C. Core temperatures in the pre-warmed group were significantly higher than the control group at T20, T40, T60, T80, T100, and T120 (P--.001). Compared to T0, core temperatures at each time were significantly lower in both two groups (P--.007 at T20 in pre-warmed group, P--.001 at the other times in both groups). The incidence of hypothermia was significantly lower in the pre-warmed group than the control group from T20 to T120 (P--.002 at T20, P--.001 at the other times). Conclusion Pre-warming for 30?minutes at 38°C did not modify the trends of the temperature decrease seen in the INR suite. It just slightly elevated the beginning post intubation base temperature. The rate of decrease was similar from T20 to T120. However, pre-warming considerably reduced the risk of intraprocedural hypothermia. Trial registration Clinical Research Information Service (CRiS) Identifier: KCT0001320. Registered December 19th, 2014.
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