Titre du document / Document title

Prävention intraoperativer Hypothermie bei Kindern = Warming devices in pediatric anaesthesia

Auteur(s) / Author(s)

LEBEN J. ⁽¹⁾ ; TRYBA M. ⁽²⁾ ; KURZ-MÜLLER K. ⁽¹⁾ ; SCHREGEL W. ⁽³⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Klinik für Anaesthesiologie, Intensiv- und Schmerztherapie, Universitätsklinik Bergmannsheil, Bochum, ALLEMAGNE
⁽²⁾ Klinik für Anaesthesiologie, Intensivmedizin und Schmerztherapie, Städtische Kliniken Kassel, ALLEMAGNE
⁽³⁾ Abteilung für Anästhesie und Intensivmedizin, St.Josefshospital Uerdingen, ALLEMAGNE

Résumé / Abstract

Children are very sensible to the occurrence of intraoperative hypothermia (HT) (core temperature ≤36.0 °C) during general anaesthesia because their regulation capacity is less effective than in adults and due to a large skin-surface area compared with their body mass. We compared the efficacy of different heating devices to prevent HT in children during surgery. Methods: With approval of the local ethics committee 50 children between one and seven years, scheduled for peripheral surgery lasting at least 2 hours were included in this studie.Anaesthesia was standardized in all patients. Patients were randomly divided into 5 groups. In group 1, in addition to the usual cotton blankets, room temperature was elevated to 27-28 °C. In group 2, room temperature was maintained at 27-28 °C, and the patients were additionally wrapped into an aluminum blanket. In group 3, elevated room temperature was combined with a convective heating blanket. Patients in group 4 were warmed with an aluminum blanket,while the room temperature was maintained at 22 °C. In group 5, room temperature was maintained at 22 °C and patients were warmed with a convective heating device (Tab. 1). Room and core body temperature (tympanon membran) were continuously measured. ANOVA and Fisher's exact Test (significance level:p<0.05) were performed for the statistical analysis of the results. Results: The demographic data of all 5 groups,the infused fluid volume and the anaesthetic technique were similar.There were no significant differences concerning age, hight and weight of the pediatric patients (Tab. 2).The core temperature decreased by -1.7 °C in group 1. In group 4 core temperature decreased by -1.6 °C. Using a convective warming system in normal ambient temperature (group 5) core temperature increased by 0.2 °C and was as effective in the prevention of HT as group 2. A significant increase in core temperture occurred in group 3 +0.7 °C (Tab. 3 and Fig. 1). Discussion: OR temperature seems to be a critical factor influencing heat loss. Increasing OR temperature and covering with cotton sheets was not effective in preventing the heat loss. Increasing room temperature in combination with aluminum sheets is one alternative to prevent HT. Our study shows that the use ofa convective warming device prevents HT during a 2-hour surgery in young children even at a OR temperature of about 22 °C.In conclusion, in pediatric patients the use ofa convective heating system proved to be an effective alternative to room heating.

Revue / Journal Title

Der Anaesthesist   ISSN 0003-2417   CODEN ANATAE 

Source / Source

1998, vol. 47, n^o6, pp. 475-478 (14 ref.)

Langue / Language

Allemand

Editeur / Publisher

Springer, Berlin, ALLEMAGNE  (1952) (Revue)

Mots-clés anglais / English Keywords

General anesthesia ; Complication ; Thermoregulation ; Hypothermia ; Child ; Patient warming ; Temperature ; Operating room ; Coverage ; Aluminium ; Heating appliance ; Postoperative ; Prevention ; Human ;

Mots-clés français / French Keywords

Anesthésie générale ; Complication ; Thermorégulation ; Hypothermie ; Enfant ; Réchauffement malade ; Température ; Bloc opératoire ; Couverture ; Aluminium ; Appareil chauffage ; Postopératoire ; Prévention ; Homme ;

Mots-clés espagnols / Spanish Keywords

Anestesia general ; Complicación ; Termoregulación ; Hipotermia ; Niño ; Reanimación enfermo ; Temperatura ; Quirófano ; Cobertura ; Aluminio ; Aparato calefacción ; Postoperatorio ; Prevención ; Hombre ;

Localisation / Location

INIST-CNRS, Cote INIST : 8047, 35400007217434.0040