Hypothermia Clinical Trial
Official title:
A Study To Determine Whether Carbon Polymer Blankets Can Reduce The During And After Short, Day Operations
Patients whose temperature drops below 36.0 degrees Centigrade during or after surgery suffer
more complications, such as wound infections and increased blood loss, resulting in more
blood transfusions and longer hospital stays than those who don't.
There is evidence that even a drop below 36.5 degrees Centigrade is sufficient to cause
significant adverse effects. Although there is much evidence regarding the effectiveness of
warming for long operations, there is nothing looking at short procedures such as those
undertaken in the daysurgery setting.
A new carbon polymer blanket (HotDog Augustine Biomedical and Design) has been shown, in
volunteer studies, to be as effective as forced air warming blankets (which are used for long
operations) in preventing hypothermia. In contrast to forced air, the carbon polymer is
reusable and has lower running−costs so is likely to be cheaper in the long term. This is
particularly relevant in the day surgery setting where high numbers of patients are operated
on. Additionally, and unlike the forced air warmers, the blanket can run on a battery so it
can be applied from the moment the patient goes to sleep to the moment they wake up so it
could actually prove more effective at preventing hypothermia in the clinical setting. This
study aims to determine whether the carbon polymer blankets can reduce the incidence of
hypothermia in the day surgery (ie. short operating time) setting.
Recently published NICE guidelines recommend using fluid warmers for all infusions of 500mls
or more and forced-air warming blankets for all main theatre operations. These guidelines
have been extrapolated from work done on longer operations.
Patients whose temperature drops below 36 degrees Centigrade during or after surgery suffer
more complications and blood loss than those whose temperature remains above 36 degrees
Centigrade. They also often require more blood transfusions and stay in hospital for longer.
Some of these complications are more common even when the temperature drops below 36.5.
Disposable forced−air warming blankets prevent hypothermia, but cannot be re−used and
therefore incur a significant expense in terms of consumables.
Re-usable carbon polymer blankets, such as the HotDog, have been shown to not only be
effective in preventing hypothermia, but have also been shown to maintain core temperature as
effectively as forced air blankets.
Carbon polymer blankets are re-usable, with the added associated benefit of lower running
costs. Therefore, in the face of limited NHS resources a reusable money saving alternative,
such as the carbon polymer HotDog, would be a preferred option to the disposable forced air
blanket.
The current data on the effectiveness of the carbon polymer blanket is from volunteers. This
study is actually powered to show a reduction in the number of patients who get cold in a
clinical setting.
References:
NICE. Perioperative hypothermia (inadvertent): the management of inadvertent peri-operative
hypothermia in adults.NICE Clinical Guideline 29. London: National Institute for Health and
Clinical Excellence, 2008. http://www.nice.org.uk/GC065.
Schmeid H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and
transfusion requirements during total hip arthroplasty. The Lancet 1996; 347:289-92.
Rajagopalan S, Mascha E, Na J, Sessler DI: The Effects of Mild Perioperative Hypothermia on
Blood Loss and Transfusion Requirement. Anesthesiology 2008;108:717.
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