Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Cardiac Catheter Theatres, The Wesley Hospital, Brisbane, Queensland, Australia.
Heart. 2018 Apr;104(8):685-690. doi: 10.1136/heartjnl-2017-312191. Epub 2017 Oct 7.
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.
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°C measured with a sublingual digital thermometer after procedures, was the primary outcome. Other outcomes were postprocedure temperature, shivering, thermal comfort and major complications.
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°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.
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.
ACTRN12616000013460.
全身麻醉期间使用空气加热（FAW）是一种安全有效的干预措施，可用于减少低体温。本研究的目的是确定 FAW 在心脏导管室镇静下进行的手术中是否可减少低体温。
进行了一项平行组随机对照试验。在两个地点的心脏导管室接受镇静的成年人被随机分配接受 FAW 或常规护理，常规护理涉及使用加热的棉毯进行被动加热。主要结局是手术后测量的舌下数字温度计显示的体温低于 36°C 的低体温。其他结局包括术后体温、寒战、热舒适度和主要并发症。
共有 140 名参与者被随机分配。接受 FAW 的参与者中出现低体温的人数较少（39/70，56% vs 48/69，70%，差异 14%；调整 RR 0.75，95%CI=0.60 至 0.94），体温高 0.3°C（95%CI=0.1 至 0.5，p=0.004）。FAW 增加了热舒适度（63/70，90% vs 51/69，74%，差异 16%，RR 1.21，95%CI=1.04 至 1.42）。寒战的发生率相似（3/69，4% vs 0/71，0%，差异 4%，95%CI=-1.1 至 9.8）。对照组中有 1 名患者因出血需要再次介入治疗。未发生其他重大并发症。
FAW 减少了低体温并提高了热舒适度。两组之间的体温差异适中，低于先前研究中使用 FAW 降低手术并发症风险的差异。因此，这不应被认为具有临床意义。
ACTRN12616000013460。
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