Prevention of perioperative hypothermia during off-pump coronary artery bypass surgery

In Germany more than 5,000 off-pump coronary artery bypass operations are performed every year. However, peri-operative hypothermia is a common problem during such surgery, and is associated with an adverse patient outcome. A number of measures aimed at preventing pert-operative hypothermia are available. The use of warm-water garments or adhesive hydrogel pads is highly successful and cost effective, although such systems are quite expensive. If this technology is not available a combination of methods should be employed to reduce pen-operative hypothermia. Although of limited efficacy, resistive heating mattresses placed on the body or forced-air warming systems are the best alternative. Adjunctive measures include increasing OR temperature to a level still tolerable for the surgeon, infusion warming with a circulation of at least 2,000 ml, and a heated mattress placed under the back. If a patient has become hypothermic during surgery, active re-warming should be initiated.