当前位置： SCI文献检索 > ANESTHESIA AND ANALGESIA期刊下所有文献 > Aggressive warming reduces blood loss during hip arthroplasty.

Aggressive warming reduces blood loss during hip arthroplasty.

Abstract：

UNLABELLED:We evaluated the effects of aggressive warming and maintenance of normothermia on surgical blood loss and allogeneic transfusion requirement. We randomly assigned 150 patients undergoing total hip arthroplasty with spinal anesthesia to aggressive warming (to maintain a tympanic membrane temperature of 36.5 degrees C) or conventional warming (36 degrees C). Autologous and allogeneic blood were given to maintain a priori designated hematocrits. Blood loss was determined by a blinded investigator based on sponge weight and scavenged cells; postoperative loss was determined from drain output. Results were analyzed on an intention-to-treat basis. Average intraoperative core temperatures were warmer in the patients assigned to aggressive warming (36.5 degrees +/- 0.3 degrees vs 36.1 degrees +/- 0.3 degrees C, P< 0.001). Mean arterial pressure was similar in each group preoperatively, but was greater intraoperatively in the conventionally warmed patients: 86+/-12 vs 80+/-9 mm Hg, P<0.001. Intraoperative blood loss was significantly greater in the conventional warming (618 mL; interquartile range, 480-864 mL) than the aggressive warming group (488 mL; interquartile range, 368-721 mL; P: = 0.002), whereas postoperative blood loss did not differ in the two groups. Total blood loss during surgery and over the first two postoperative days was also significantly greater in the conventional warming group (1678 mL; interquartile range, 1366-1965 mL) than in the aggressively warmed group (1,531 mL; interquartile range, 1055-1746 mL, P = 0.031). A total of 40 conventionally warmed patients required 86 units of allogeneic red blood cells, whereas 29 aggressively warmed patients required 62 units (P = 0.051 and 0.061, respectively). We conclude that aggressive intraoperative warming reduces blood loss during hip arthroplasty. IMPLICATIONS:Aggressive warming better maintained core temperature (36.5 degrees vs 36.1 degrees C) and slightly decreased intraoperative blood pressure. Aggressive warming also decreased blood loss by approximately 200 mL. Aggressive warming may thus, be beneficial in patients undergoing hip arthroplasty.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Winkler M,Akça O,Birkenberg B,Hetz H,Scheck T,Arkiliç CF,Kabon B,Marker E,Grübl A,Czepan R,Greher M,Goll V,Gottsauner-Wolf F,Kurz A,Sessler DI

doi

10.1097/00000539-200010000-00039

subject

Has Abstract

pub_date

2000-10-01 00:00:00

pages

978-84

issue

eissn

0003-2999

issn

1526-7598

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

在线工具

Aggressive warming reduces blood loss during hip arthroplasty.