Water warming garment versus forced air warming system in prevention of intraoperative hypothermia during liver transplantation: a randomized controlled trial [ISRCTN32154832]

Piotr K Janicki¹ , Cristina Stoica¹ , William C Chapman² , J Kelly Wright² , Garry Walker¹ , Ram Pai¹ , Ann Walia¹ , Mias Pretorius¹ and C Wright Pinson²

¹Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, 37232-4125, USA

²Division of Hepatobiliary Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, 37232-4125, USA

author email corresponding author email

BMC Anesthesiology 2002, 2:7doi:10.1186/1471-2253-2-7


Published:	19 November 2002

Abstract

Background

The authors compared two strategies for the maintenance of intraoperative normothermia during orthotopic liver transplantation (OLT): the routine forced-air warming system and the newly developed, whole body water garment.

Methods

In this prospective, randomized and open-labelled study, 24 adult patients were enrolled in one of two intraoperative temperature management groups during OLT. The water-garment group (N = 12) received warming with a body temperature (esophageal) set point of 36.8°C. The forced air-warmer group (N = 12) received routine warming therapy using upper- and lower-body forced-air warming system. Body core temperature (primary outcome) was recorded intraoperatively and during the two hours after surgery in both groups.

Results

The mean core temperatures during incision, one hour after incision and during the skin closing were significantly higher (p < 0.05, t test with Bonferroni corrections for the individual tests) in the water warmer group compared to the control group (36.7 ± 0.1, 36.7 ± 0.2, 36.8 ± 0.1 vs 36.1 ± 0.4, 36.1 ± 0.4, 36.07 ± 0.4°C, respectively). Moreover, significantly higher core temperatures were observed in the water warmer group than in the control group during the placement of cold liver allograft (36.75 ± 0.17 vs 36.09 ± 0.38°C, respectively) and during the allograft reperfusion period (36.3 ± 0.26 vs 35.52 ± 0.42°C, respectively). In addition, the core temperatures immediately after admission to the SICU (36.75 ± 0.13 vs 36.22 ± 0.3°C, respectively) and at one hr (36.95 ± 0.13 vs 36.46 ± 0.2°C, respectively) were significantly higher in the water warmer group, compared to the control group, whereas the core temperature did not differ significantly afte two hours in ICU in both groups.

Conclusions

The investigated water warming system results in better maintenance of intraoperative normothermia than routine air forced warming applied to upper- and lower body.