Student Research Committee, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran.
Assistant Professor, Department of Anesthesiology and Operating Room, School of Allied Medical Sciences and Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran.
Ann Card Anaesth. 2023 Oct-Dec;26(4):386-392. doi: 10.4103/aca.aca_20_23.
As one of the most common postoperative complications, hypothermia is the main cause of numerous problems during treatment, especially in elderly patients with decreased cardiac reserves.
The aim of the present study was to compare the effects of forced-air warming system (FAWS), warmed intravenous fluids (WIVFs) and routine method on hemodynamic parameters, arterial blood gases (ABGs), shivering, and time to awakening in elderly patients undergoing open cardiac surgery (OCS).
This clinical randomized controlled trial was conducted on 94 elderly patients who underwent OCS at Ayatollah Rouhani Hospital, Babol, Iran. They were divided into three groups, namely FAWS (n=31), WIVFs (n=31) and routine rewarming method (RRWM, with a blanket) (n=32). The data were then recorded in a checklist. Descriptive and inferential statistics were performed using SPSS 26 at a significance level of less than 0.05.
The findings demonstrated that the degree of hypothermia had a significant decreasing trend in the groups receiving FAWS and WIVFs (P=0.002). Additionally, increased respiratory rate (P=0.013), higher bicarbonate (HCO3-) levels on arrival up to 4 hours after surgery (P=0.045), reduced lactate level (P=0.005), normal base excess (BE) and accelerated time to awakening (P=0.004) were observed in patients receiving FAWS. There was no significant difference in the study groups regarding shivering.
The results revealed that FAWS could mitigate the degree of hypothermia, increase body temperature and decrease the postoperative serum lactate levels. Moreover, BE as one of the most important parameters for ABGs, could remain at a normal level. Besides, the use of FAWS could lead to early awakening, and thus facilitate weaning and extubation of these patients.
作为最常见的术后并发症之一，低体温是治疗过程中出现诸多问题的主要原因，尤其是在心脏储备能力下降的老年患者中。
本研究旨在比较空气强制加热系统（FAWS）、加温静脉输液（WIVFs）和常规方法对行心脏直视手术（OCS）老年患者的血流动力学参数、动脉血气（ABGs）、寒战和苏醒时间的影响。
这是一项在伊朗阿亚图拉鲁哈尼医院进行的临床随机对照试验，共纳入 94 例行 OCS 的老年患者，将其分为 FAWS 组（n=31）、WIVFs 组（n=31）和常规复温方法（RRWM，盖毯子）组（n=32）。将数据记录在检查表中。采用 SPSS 26 进行描述性和推断性统计分析，显著性水平设为 0.05。
研究结果表明，FAWS 和 WIVFs 组的低体温程度呈显著下降趋势（P=0.002）。此外，FAWS 组患者的呼吸频率增加（P=0.013）、术后 4 小时内到达时碳酸氢盐（HCO3-）水平升高（P=0.045）、乳酸水平降低（P=0.005）、碱剩余（BE）正常，苏醒时间加快（P=0.004）。各组患者的寒战无显著差异。
FAWS 可减轻低体温程度、提高体温并降低术后血清乳酸水平。此外，BE 作为 ABGs 的最重要参数之一，可以保持在正常水平。此外，FAWS 的使用可以使患者早期苏醒，从而便于这些患者的脱机和拔管。
