Forced Air Speeds Rewarming in Accidental Hypothermia☆,☆☆,★,★★
Section snippets
INTRODUCTION
Hypothermia is defined as a core temperature less than 35°C. Core temperatures greater than 32°C, however, are rarely associated with morbidity unrelated to underlying pathology and are considered mild hypothermia. In contrast, lower temperatures are considered moderate to severe hypothermia because such temperatures can cause morbidity and mortality even in the absence of underlying pathology.1 Moderate to severe hypothermia causes about 600 deaths each year in the United States.2, 3
Patients
MATERIALS AND METHODS
The study protocol was approved by the University of Missouri-Kansas City Adult Health Sciences Institutional Review Board and by the Cook County Hospital Scientific Committee. Because of the nature of the study, informed consent was waived.
Patients 18 years and older who presented to the emergency department of Truman Medical Center or Cook County Hospital between January 1, 1991, and April 1, 1993, with moderate to severe hypothermia were evaluated for study inclusion. Those who presented
RESULTS
Seventeen patients were initially enrolled in the study. However, one patient assigned to forced-air warming was withdrawn from the protocol when it was determined that he had panhypopituitarism. Among the remaining 16 study patients, 5 were enrolled at Cook County Hospital and 11 at Truman Medical Center. Two of the patients assigned to forced-air rewarming and one given blankets were intubated. One of the patients rewarmed with forced air did not receive warmed oxygen by mask because of
DISCUSSION
Core temperature during forced-air warming increased by about 1°C/hour faster than in patients warmed only with passive insulation. The difference is consistent with findings of previous studies that have quantified heat transfer during forced-air warming7, 8 and in subjects covered with one or three cotton blankets.15 Although we report results from only 16 patients, rewarming rates were similar in each group and the results were highly statistically significant. Such uniform results are
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Cited by (103)
Environmental Hypothermia
2024, Emergency Medicine Clinics of North AmericaIatrogenic third-degree burn caused by off-label use of an infrared radiant heat lamp in a patient with accidental hypothermia
2021, Burns OpenCitation Excerpt :Active external rewarming involves the direct exposure of the patient’s skin to an exogenous heat source, which has the potential for thermal injury [1]. Forced-air rewarming blankets (Bair Hugger™) have been shown to be effective for the treatment of accidental hypothermia without causing thermal injury [20–22] and for maintenance of core temperature during surgery [23]. Whole-body immersion in hot water, which causes massive vasodilatation and hypotension, is contraindicated as a rewarming method in hypothermic patients [24].
Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update
2019, Wilderness and Environmental MedicineNormothermia in Arthroplasty
2017, Journal of ArthroplastyCitation Excerpt :There were no significant differences in total heat transfer found between forced-air warming devices when only lower body blankets were used [61]. Forced-air systems surpass passive insulation and provide considerably more heat than circulating water [51,62,63]. Preoperative warming with forced air has been demonstrated to increase the heat content of peripheral tissues by more than what is normally lost through temperature redistribution during the hour following induction of anesthesia [64].
Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia
2017, Emergency Medicine Clinics of North America
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From the Department of Emergency Medicine, Truman Medical Centerm Universitiy of Missouri–Kansas City School of Medicine, Kansas City, Missouri*;Thermoregulation Researach Laboratory, Department of Anesthesia, University of California, San Francisco, California‡; and the Department of Emergency Medicine, University of Illinois at Chicago, Chicago, Illinois.§
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Supported by Augustine Medical, Incorporated, Eden Prairie, Minnesota; by National Institutes of Health grant GM49670; and by the Joseph Drown Foundation. The authors do not consult for, accept honoraria from, or own stock or stock options in any rewarming-related company.
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Address for reprints: Mark T Steele, MD, Department of Emergency Medicine, Truman Medical Center, 2301 Holmes, Kansas City, Missouri 64108, 816-556-3127, Fax 816-881-6282
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Reprint no. 47/1/71693