Forced air warming during sedation in the cardiac catheterisation laboratory: a randomised controlled trial

被引:12
作者
Conway, Aaron [1 ,2 ,7 ]
Ersotelos, Suzanna [3 ]
Sutherland, Joanna [4 ,5 ]
Duff, Jed [6 ]
机构
[1] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld, Australia
[2] Wesley Hosp, Cardiac Catheter Theatres, Brisbane, Qld, Australia
[3] St Vincents Private Hosp, Cardiac Catheter Lab, Sydney, NSW, Australia
[4] Coffs Harbour Hlth Campus, Dept Anesthesia, Coffs Harbour, Australia
[5] Univ New South Wales, Rural Clin Sch, Coffs Harbour, NSW, Australia
[6] Univ Newcastle, Sch Nursing & Midwifery, Callaghan, NSW, Australia
[7] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Kelvin Grove, Qld 4059, Australia
基金
澳大利亚国家健康与医学研究理事会;
关键词
cardiac procedures and therapy; health care economics; health services; PERIOPERATIVE HYPOTHERMIA; INADVERTENT HYPOTHERMIA; SHIVERING THRESHOLDS; PROCEDURAL SEDATION; DEPENDENT DECREASE; CORE TEMPERATURE; THERMAL COMFORT; VASOCONSTRICTION; NORMOTHERMIA; ANESTHESIA;
D O I
10.1136/heartjnl-2017-312191
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Forced air warming (FAW) during general anaesthesia is a safe and effective intervention used to reduce hypothermia. The objective of this study was to determine if FAW reduces hypothermia when used for procedures performed with sedation in the cardiac catheterisation laboratory. Methods A parallel-group randomised controlled trial was conducted. Adults receiving sedation in a cardiac catheterisation laboratory at two sites were randomised to receive FAW or usual care, which involved passive warming with heated cotton blankets. Hypothermia, defined as a temperature less than 36 degrees C measured with a sublingual digital thermometer after procedures, was the primary outcome. Other outcomes were postprocedure temperature, shivering, thermal comfort and major complications. Results A total of 140 participants were randomised. Fewer participants who received FAW were hypothermic (39/70, 56% vs 48/69, 70%, difference 14%; adjusted RR 0.75, 95% CI=0.60 to 0.94), and body temperature was 0.3 degrees C higher (95% CI=0.1 to 0.5, p=0.004). FAW increased thermal comfort (63/70, 90% vs51/69, 74% difference 16%, RR 1.21, 95% CI=1.04 to 1.42). The incidence of shivering was similar (3/69, 4% vs 0/71 0%, difference 4%, 95% CI=-1.1 to 9.8). One patient in the control group required reintervention for bleeding. No other major complications occurred. Conclusion FAW reduced hypothermia and improved thermal comfort. The difference in temperature between groups was modest and less than that observed in previous studies where use of FAW decreased risk of surgical complications. Therefore, it should not be considered clinically significant. Trial registration number ACTRN12616000013460.
引用
收藏
页码:685 / 690
页数:6
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