An open-label, randomised controlled trial on the effectiveness of the Orve + wrap® versus Forced Air Warming in restoring normothermia in the postanaesthetic care unit.

AIMS AND OBJECTIVES: To determine the clinical effectiveness and safety of the Orve + wrap® thermal blanket. BACKGROUND: Inadvertent perioperative hypothermia is a common problem in postanaesthetic care units and can have significant effects on patients' postoperative morbidity. Despite its commercial availability, there is no clinical evidence on the effectiveness of Orve + wrap®. DESIGN: A single centre prospective, open-label, noninferiority randomised controlled trial. METHODS: Postoperative hypothermic (35.0-35.9°C) patients who had undergone elective surgery were randomised to receive either Orve + wrap® or Forced Air Warming during their PACU stay. Patient temperatures were recorded every 10 min using zero-heat-flux thermometry. This study is reported using CONSORT Extension checklist for noninferiority and equivalence trials. RESULTS: Between December 2016-October 2018, 129 patients were randomised to receive either Orve + wrap® blanket (n = 65, 50.3%) or Forced Air Warming (n = 64, 49.7%). The mean 60-min postoperative temperature of patients receiving Orve + wrap® blanket was 36.2 and 36.3°C for the patients receiving Forced Air Warming. The predefined noninferiority margin of a mean difference in temperature of 0.3°C was not reached between the groups at 60 min. Additionally, there were no statistical differences between adverse event rates across these groups. CONCLUSIONS: In the context of this study, warming patients with the Orve + wrap® was noninferior to Forced Air Warming. There were comparable rates of associated postoperative consequences of warming (shivering, hypotension, arrhythmias or surgical site infections), between the groups. RELEVANCE TO CLINICAL PRACTICE: The Orve + wrap® potentially provides an alternative warming method to Forced Air Warming for patients requiring short-term postoperative warming. However, there are still a number of unknowns regarding the Orve + wrap® performance and further exploration is required.

[Accidental hypothermia, not just a clinical sign, a social alarm bell]. / L'hypothermie accidentelle, plus qu'un signe clinique, une alerte sociale.

Accidental hypothermia, even slight, affects the physiological functioning of the body. It requires all the attention of the caregivers, both in terms of prevention among vulnerable people as well as its treatment. Two types of rewarming therapy, one external and passive, the other internal and active, can be envisaged depending on the seriousness of the hypothermia to be treated.

"Caution! Contents should be cold": developing a whole-body hypothermia program.

Hypoxic-ischemic encephalopathy (HIE) is characterized as brain injury that results from lack of oxygen or blood flow to the brain in the perinatal period. Neonatal whole-body hypothermia and selective head cooling are becoming increasingly common care practices across the U.S. and Canada for infants with moderate-to-severe HIE because of the demonstrated ability of these approaches to reduce reperfusion injury to the brain. Health care professionals must develop a clinical care path for these fragile infants. For best results, induced hypothermia should be initiated within six hours of birth; therefore, care must be organized and provided without delay. This article provides bedside clinicians with care recommendations for infants being treated with these new interventions.

Postoperative rewarming: are there alternatives to warm hospital blankets.

Mild postoperative hypothermia remains a frequent complication among surgical patients during the immediate postoperative period. Current literature describes a variety of rewarming methods directed toward the treatment of this problem. In 1998, ASPAN developed a Clinical Guideline for the Prevention of Unplanned Perioperative Hypothermia. Eleven studies comparing different methods of postoperative rewarming have been published since the release of that guideline. This article introduces a systematic review of these studies to identify the most effective methods of rewarming surgical patients postoperatively.

Hypothermia: a hazard for all seasons.

Find out how to respond when your patient's body temperature takes a dive, no matter what the cause.

Proposed guidelines for skin-to-skin treatment of neonatal hypothermia.

Hypothermia is not uncommon in full-term, low-risk newborns during the first days of life. Standard care for treating hypothermia often involves the separation of the mother and the newborn while the infant is placed under a warmer and observed in the nursery. Because one important role of the postpartum nurse is to promote mother-infant attachment by encouraging the mother to spend time "getting to know" her infant, this separation can be problematic. This article proposes that skin-to-skin (STS) care, also called kangaroo care, an intervention in which the unclothed, diapered infant is placed on the mother's bare chest, be used to promote thermoregulation instead of using separation and a warmer. STS care has been recognized as a way to facilitate maternal-infant attachment and promote thermoregulation. The literature review here provides an analysis of the available evidence and the author's conclusion that the research supports the use of STS care as an alternative to traditional rewarming. The evidence was graded and organized into an evidence-based practice guideline for the use of STS care in the treatment of mild hypothermia in the low-risk infant. Suggestions for further research and outcomes measurement are included.

Therapeutic hypothermia after cardiac arrest.

Recent evidence supports the use of therapeutic hypothermia after cardiac arrest. This article reviews recent published studies and describes the pathophysiology of hypothermia. Nurses need to understand the physiology of hypothermia to provide care for patients receiving therapeutic hypothermia. A suggested protocol is included to help manage the care of these patients.

Temperature measurement in the phase I PACU.

Perioperative hypothermia remains a common occurrence in the Phase I PACU. Identification of and appropriate intervention for this complication is of prime importance in the prevention of adverse outcomes. This article provides an overview of perioperative hypothermia and offers a summary of the most common methods used to measure body temperature.

The elective re-warming of postoperative cardiac patients.

The elective re-warming of patients immediately after cardiac surgery is a core nursing procedure. Various methods can be used to perform the procedure including forced air-warming systems and radiant lights. This article discusses the evidence regarding the most efficacious method.

Warming and treatment of mild hypothermia in the trauma resuscitation room--an intervention algorithm.

As a result of the entire process awareness was heightened and the staff is now more sensitive to the need for warming patients in the trauma resuscitation room. A formal protocol for temperature monitoring and warming in the resuscitation room was developed and implemented. Our lack of documentation and embarrassment at our site verification lead us to be even more vigilant of those patients who arrive hypothermic, and institute methods of warming sooner rather than later. We continue to monitor temperature documentation and when there is lack of compliance, those individuals are counseled with expected improvement within the next monitoring period.

Hypothermia: a cold influence on trauma.

Hypothermia is a life-threatening condition and can be a significant comorbid factor in a trauma patient. Certain social and medical characteristics can put a person at high risk for hypothermia, and special care must be provided to prevent and treat lower than normal body temperatures. In this article, a literature review was used to describe etiologies, assessment, treatment, and complications of hypothermia in the trauma patient.