Core temperatures during major abdominal surgery in patients warmed with new circulating-water garment, forced-air warming, or carbon-fiber resistive-heating system

It has been reported that recently developed circulating-water garments transfer more heat than a forced-air warming system. The authors evaluated the hypothesis that circulating-water leg wraps combined with a water mattress better maintain intraoperative core temperature a parts per thousand yen36A degrees C than either forced-air warming or carbon-fiber resistive heating during major abdominal surgery. Thirty-six patients undergoing open abdominal surgery were randomly assigned to warming with: (1) circulating-water leg wraps combined with a full-length circulating-water mattress set at 42A degrees C, (2) a lower-body forced-air cover set on high (a parts per thousand 43A degrees C), and (3) a carbon-fiber resistive-heating cover set at 42A degrees C. Patients were anesthetized with general anesthesia combined with continuous epidural analgesia. The primary outcome was intraoperative tympanic-membrane temperature a parts per thousand yen36A degrees C. In the 2 h after anesthesia induction, core temperature decreased 1.0 +/- A 0.5A degrees C in the forced-air group, 0.9 +/- A 0.2A degrees C in the carbon-fiber group, and 0.4 +/- A 0.4A degrees C in the circulating-water leg wraps and mattress group (P < 0.05 vs. forced-air and carbon-fiber heating). At the end of surgery, core temperature was 0.2 +/- A 0.7A degrees C above preoperative values in the circulating-water group but remained 0.6 +/- A 0.9A degrees C less in the forced-air and 0.6 +/- A 0.4A degrees C less in the carbon-fiber groups (P < 0.05 vs. carbon fiber). The combination of circulating-water leg wraps and a mattress better maintain intraoperative core temperature than did forced-air and carbon-fiber warming systems.