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A combination of convective and conductive warming ensures pre- and post-bypass normothermia in paediatric cardiac anaesthesia

C. Eich1, W. Zink1, S. K. W. Schwarz2, O. Radke1,3, A. Bräuer1
1Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Germany; 2Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver,B.C., Canada; 3Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA
[Applied Cardiopulmonary Pathophysiology 13: 3-10, 2009]


Background: We conducted an audit to investigate the efficacy of a proposed standard operating procedure (SOP) on convective and conductive perioperative thermal management during paediatric cardiac anaesthesia.
Methods: We retrospectively studied 26 consecutive children who underwent cardiac surgery under cardiopulmonary bypass (CPB). We applied a heating mattress and a forced-air blanket during anaesthesia induction, before CPB, during the rewarming period, and after discontinuation of CPB. Core body temperatures were recorded continuously.
Results: All children (aged 1 day to 13.5 yr, median 25 months) were divided into three groups: < 5 kg (group I, n = 9), 5–15 kg (II, n = 8), and > 15 kg (III, n = 9). Mean (± SD) core body temperatures were as follows: at the start of surgery 35.8 ± 1.0°C (I), 35.9 ± 0.6°C (II), and 36.3 ± 0.3°C (III); at the start of bypass 35.9 ± 1.1°C (I), 36.4 ± 1.1°C (II), and 36.5 ± 0.7 °C (III). Temperatures after rewarming were 36.4 ± 0.4 °C (I), 36.2 ± 0.4 °C (II), and 36.0 ± 0.4°C (III). After weaning from bypass, core body temperatures were 36.7 ± 0.9°C (I), 37.3 ± 0.7°C (II), and 37.1 ± 0.7°C (III). Normothermia on admission to ICU was maintained in all but three small infants.
Conclusions: In children undergoing cardiac surgery, a combination of convective and conductive warming can effectively ensure perioperative normothermia before and after CPB.

Keywords: anaesthesia: paediatric cardiac; circulatory arrest: deep hypothermia induced; hypothermia: induced; warming: conductive; warming: convective

Address for corresponding: Christoph Eich, M.D., DEAA, Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany; Öffnet ein Fenster zum Versenden einer

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