Effect of electrically heated humidifier on intraoperative core body temperature decrease in elderly patients: a prospective observational study

BACKGROUND: Core body temperature (TC) can decrease during general anesthesia. Particularly in elderly patients, more aggressive strategies to prevent intraoperative hypothermia may be required. Here, we investigated the effect of a heated humidifier on intraoperative TC decrease in the elderly. METHODS: Twenty-four elderly patients were randomly assigned into two groups: those who used a heated humidifier (group H) and those who used a conventional ventilator circuit with a heat moisture exchanger (group C). TC was measured continuously at the esophagus at several time-points during surgery. RESULTS: In group C, TC significantly decreased 90 minutes after skin incision (P < 0.001), while significant differences were not noted in group H during surgery. Comparing the two groups, TC decreased more in group C than in group H at 60, 90, 120, and 150 minutes after skin incision (group C vs. group H: -0.6℃ vs. -0.3℃, P = 0.025; -0.7℃ vs. -0.4℃, P = 0.012; -0.9℃ vs. -0.4℃, P = 0.006; and -1.0℃ vs. -0.5℃, P = 0.013, respectively). There were no significant differences between the two groups for any other parameters. CONCLUSIONS: A heated humidifier is more effective in preventing intraoperative TC decrease in elderly patients than a heat moisture exchanger. However, further studies with a larger population are required to substantiate its clinical use.

Validation of the Korean Version of the Children's Revised Impact of Event Scale

OBJECTIVE: This study examined the psychometric properties of the Korean version of the Children's Revised Impact of Event Scale (CRIES) and its validity as a screening instrument for the post-traumatic stress disorder (PTSD). METHODS: The study population consisted of two samples. The clinical sample consisted of 60 child and adolescent patients from the Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine. The normal sample consisted of 291 students from four schools (primary, middle, and high schools). We administered four self-report questionnaires (the CRIES, Child Reports of Post-traumatic Symptoms [CROPS], State-Trait Anxiety Inventory for Children [STAI-C], and Children's Depression Inventory [CDI]) to 351 children and adolescents after obtaining informed consent from all participants and their parents. RESULTS: The CRIES showed good reliability (Cronbach's alpha for the full scale and subscales ranged from 0.85 to 0.93). The total CRIES score was positively correlated with CROPS, STAI-C, and CDI. Confirmatory factor analysis indicated that a three-factor structure for the CRIES (intrusion, avoidance, and hyper-arousal) had a significantly better fit than a two-factor model (intrusion/hyper-arousal and avoidance). Receiver operating characteristic curve analysis indicated that a cutoff of 26 offered the optimum predictive point. That is, this cutoff maximized the balance between sensitivity (0.88) and specificity (0.85). Using this cutoff, the positive predictive value was 0.86, and the negative predictive value was 0.99. CONCLUSION: These findings imply that the CRIES is a highly accurate diagnostic test in clinical settings.