Intensified thermal management for patients undergoing transcatheter aortic valve implantation (TAVI)

Journal of Cardiothoracic Surgery

Anselm Bräuer²  Michael Quintel²  Ralf Seipelt¹  Aron F Popov¹  Marc Jipp²  Ivo F Brandes² 

[1] Department of Thoracic and Cardiovascular Surgery, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany;Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany

关键词: forced air warming;    prewarming;    core temperature;    thermal management;    hypothermia;    Transcatheter aortic valve implantation;   

Others  :  1153867
DOI  :  10.1186/1749-8090-6-117

 received in 2011-04-14, accepted in 2011-09-25,  发布年份 2011

【 摘 要 】

Background

Transcatheter aortic valve implantation via the transapical approach (TAVI-TA) without cardiopulmonary bypass (CPB) is a minimally invasive alternative to open-heart valve replacement. Despite minimal exposure and extensive draping perioperative hypothermia still remains a problem.

Methods

In this observational study, we compared the effects of two methods of thermal management on the perioperative course of core temperature. The methods were standard thermal management (STM) with a circulating hot water blanket under the patient, forced-air warming with a lower body blanket and warmed infused fluids, and an intensified thermal management (ITM) with additional prewarming using forced-air in the pre-operative holding area on the awake patient.

Results

Nineteen patients received STM and 20 were treated with ITM. On ICU admission, ITM-patients had a higher core temperature (36.4 ± 0.7°C vs. 35.5 ± 0.9°C, p = 0.001), required less time to achieve normothermia (median (IQR) in min: 0 (0-15) vs. 150 (0-300), p = 0.003) and a shorter period of ventilatory support (median (IQR) in min: 0 (0-0) vs. 246 (0-451), p = 0.001).

Conclusion

ITM during TAVI-TA reduces the incidence of hypothermia and allows for faster recovery with less need of ventilatory support.

【 授权许可】

   
2011 Brandes et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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