Witt Lars, Dennhardt Nils, Eich Christoph, Mader Thomas, Fischer Thomas, Bräuer Anselm, Sümpelmann Robert
Department of Anaesthesiology and Intensive Care Medicine, Hanover Medical School, Hanover, Germany.
Paediatr Anaesth. 2013 Jun;23(6):469-74. doi: 10.1111/pan.12169. Epub 2013 Apr 9.
Neonates and infants are at the highest risk of developing perioperative hypothermia. A number of methods to prevent hypothermia during pediatric anesthesia are in use, and despite the fact that conventional forced-air warmers are the most effective devices, they are not always sufficient enough to maintain body temperature. Therefore, recently a new forced-air warming system with an increased warm air flow was introduced to the market.
The aim of this study was to evaluate this new forced-air warming system in neonates and infants during pediatric anesthesia. We hypothesized that the new blanket alone is sufficient enough to prevent neonates and infants from intraoperative hypothermia.
Neonates and infants (body weight <10 kg) were enrolled in this prospective multicenter observational study. After admission to the operating room, the children were placed on the new forced-air warming blanket. Body temperature was measured continuously until admission to the recovery room or pediatric intensive care unit (PICU).
Hundred and nineteen children with a median body weight of 4.1 kg (range: 0.7-9.8) were enrolled and received their intended treatment. Median body temperature at the induction of anesthesia was 36.5 °C (range: 35.3-38.2 °C) and increased with the length of the operation up to 37.8 °C (37.1-38.2 °C) after 180 min. Median body temperature after admission to the recovery room or PICU was 37.2 °C (36.0-38.6 °C) and remained significantly above baseline (P < 0.05).
The new forced-air warming system as a sole warming device is effective in preventing perioperative hypothermia during pediatric anesthesia in neonates and infants.
新生儿和婴儿发生围手术期体温过低的风险最高。目前有多种在小儿麻醉期间预防体温过低的方法，尽管传统的强制空气暖风机是最有效的设备，但它们并不总是足以维持体温。因此，最近一种具有更高暖空气流量的新型强制空气升温系统被推向市场。
本研究的目的是评估这种新型强制空气升温系统在小儿麻醉期间对新生儿和婴儿的效果。我们假设仅使用这种新型毛毯就足以防止新生儿和婴儿术中体温过低。
将体重<10 kg的新生儿和婴儿纳入这项前瞻性多中心观察性研究。进入手术室后，将患儿置于新型强制空气升温毛毯上。持续测量体温，直至进入恢复室或儿科重症监护病房（PICU）。
119名体重中位数为4.1 kg（范围：0.7 - 9.8 kg）的儿童入组并接受了预期治疗。麻醉诱导时的体温中位数为36.5℃（范围：35.3 - 38.2℃），并随着手术时间延长，在180分钟后升至37.8℃（37.1 - 38.2℃）。进入恢复室或PICU后的体温中位数为37.2℃（36.0 - 38.6℃），且仍显著高于基线水平（P < 0.05）。
新型强制空气升温系统作为唯一的升温设备，在预防新生儿和婴儿小儿麻醉期间的围手术期体温过低方面是有效的。
