Hypothermia; AnesthesiaNCT02990429
Forced Air and Intravenous Fluid Warmers in Gynecologic Laparoscopic Surgery
A study testing Forced Air warmer and Intravenous Fluid Warmer in people with Hypothermia; Anesthesia, run by Siriraj Hospital at 1 site in Thailand.
Trial summary
Perioperative hypothermia is a common problem. It has been defined as a core temperature below 36ºC. The reasons why patient undergoing gynecologic laparoscopic surgery has perioperative hypothermia because the reduced metabolic heat production, redistribution of heat from the core to the periphery and impaired… Read more about this study
- Who is it for?
- Ages 18 to 65 years, women only
- Conditions the study is for
- Hypothermia; Anesthesia
- What is being tested?
- Forced Air warmer and Intravenous Fluid Warmer
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteThailand
- Study dates
- Apr 2016to Dec 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- ASA class 1-3, 18-65 years old, BMI 25-30 kg/sq.m., core temperature 36ºC-38ºC, operation more than 90 minutes
Who cannot join
- turn operation to exploratory laparotomy
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparison Between Forced Air and Intravenous Fluid Warmers in Gynecologic Laparoscopic Surgery
Perioperative hypothermia is a common problem. It has been defined as a core temperature below 36ºC. The reasons why patient undergoing gynecologic laparoscopic surgery has perioperative hypothermia because the reduced metabolic heat production, redistribution of heat from the core to the periphery and impaired thermoregulation (due to anesthetics), use of cool carbon dioxide gas insufflations and surgical irrigation solution, as well as heat loss due to the cool environment. This perioperative problem has been linked to adverse patient outcomes such as myocardial ischemia as hypothermia increases plasma catecholamine, surgical site infection as hypothermia diminishes wound tissue O2 tension and coagulopathy as hypothermia impairs platelet function.
It claims that perioperative heat loss occurs by radiation (60%), convection (25%) and evaporation (10%). This is caused by the difference between peripheral body and ambient temperature, air circulation around the body and vasodilatation.
Read more
In daily practice, most anesthesia personnel warm patient peri-operatively by using force air warmer and intravenous fluid warmer.
This study aimed to compare the difference of core and room temperature in patients undergoing gynecologic laparoscopic surgery by using forced air and intravenous fluid warmer
Read the detailed description
The study was approved from the Siriraj Institutional Review Board (Si-IRB), COA (Certificate of Analysis): Si201/2016 (18/03/2016), and was written informed consent was obtained from all subjects. The study was conducted at the Department of Siriraj Obstetrics and Gynecology.
A total of 90 patients were enrolled in the study between April 2016 and …..2017. All patients underwent general anesthesia for elective gynecologic laparoscopic surgery. Inclusion criteria were patients aged between 18 and 65, elective case, ASA (American Society of Anesthesiologist) physical status class I-III, BMI 25-30 kg/sq.m., surgical time > 90 minutes. Exclusion criteria were the core temperature less than 36ºC or more than 38ºC. Withdrawal or termination criterion was the change of laparoscopic surgery to exploratory laparotomy.
On the day of surgery, participants signed the informed consent and were randomized equally into two groups: A = 45, receiving intraoperative forced air warming and B =45, having intraoperative intravenous fluid via a fluid warmer All patients underwent general anesthesia after application of standard monitors, anesthesia was induced with fentanyl 1-2 mcg/kg or morphine 0.1-0.2 mg/kg., propofol 1.5-2.5 mg/kg, nimbex 1-1.5 mg/kg or atracurium 0.6 mg/kg. Anesthesia was maintained with sevoflurane ,air,O2, supplemented with fentanyl or morphine.
Core temperatures were measured with an electronic thermometer via tympanic membrane. Intraoperatively, core temperatures and room temperatures were measured at 15 minute intervals until the end of surgery .
Postoperative data were measured at 15 minute intervals at the recovery room. Data consisted of vital sign, core temperature, room temperature, shivering, medication requirements and use of heating devices.
- Conditions
- Hypothermia; Anesthesia
- Being tested
- Forced Air warmer, Intravenous Fluid Warmer
- Keywords
- hypothermia, Shivering, Gynecologic laparoscopic surgery, Warming, General anesthesia
- Medical subject headings
- Hypothermia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Forced Air warmerProcedure or surgery
- record room temperature
- record core temperature (tympanic membrane)
- General anesthesia
- using forced air warmer (bair hugger)
- Intravenous fluid at room temperature
- room temperature and core temperature q15 minutes
- anesthesia finish, stop bair hugger
- record core temperature before recovery room
Intravenous Fluid WarmerProcedure or surgery
- record room temperature
- record core temperature (tympanic membrane)
- General anesthesia
- using ranger warmer
- Intravenous fluid at room temperature
- room temperature and core temperature q15 minutes
- anesthesia finish, stop ranger warmer
- record core temperature before recovery room
| Study group | Role | What they receive |
|---|---|---|
| Forced Air warmer (bair hugger) | Experimental | .
In groups: A = 45, receiving intraoperative forced air warming( bair hugger). The forced air was delivered at the high setting of 43ºC Receives: Procedure: Forced Air warmer |
| Intravenous Fluid Warmer(ranger warmer) | Experimental | In groups:B =45, having intraoperative intravenous fluid via a fluid warmer patients received intravenous fluid via a fluid warmer after induction anesthesia. The device automatically heated fluid up to 41ºC as set point. Receives: Procedure: Intravenous Fluid Warmer |
What is being measured
The primary outcome is the main question the study is designed to answer.
The difference of core and room temperature in patients undergoing gynecologic laparoscopic surgery (by using forced air and intravenous fluid warmer)
To study the difference between two groups
Measured: 1 Year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Dec 2016 (estimated)
- Study startApr 2016
- Primary completionDec 2018
- Study completionDec 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (16)Papers the sponsor has linked to this study.
- Other trials for Hypothermia; AnesthesiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 90 participants (actual)
Sponsor and investigators
- Lead sponsor
- Siriraj Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Warunee Boayam, Siriraj Hospital
- Investigators
- Warunee Boayam, NS, Principal investigator, Department of Anesthesiology, Faculty of Medicine, Siriraj hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02990429
- Sponsor's protocol ID
- 050/2559(EC2)
- Status last verified
- Aug 2018
- First submitted
- 3 Dec 2016
- Last updated
- 4 Apr 2019
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- Yes
Publications
Allen PB, Salyer SW, Dubick MA, Holcomb JB, Blackbourne LH. Preventing hypothermia: comparison of current devices used by the US Army in an in vitro warmed fluid model. J Trauma. 2010 Jul;69 Suppl 1:S154-61. doi: 10.1097/TA.0b013e3181e45ba5.
PubMed 20622611Brandt S, Oguz R, Huttner H, Waglechner G, Chiari A, Greif R, Kurz A, Kimberger O. Resistive-polymer versus forced-air warming: comparable efficacy in orthopedic patients. Anesth Analg. 2010 Mar 1;110(3):834-8. doi: 10.1213/ANE.0b013e3181cb3f5f. Epub 2009 Dec 30.
PubMed 20042442Wagner K, Swanson E, Raymond CJ, Smith CE. Comparison of two convective warming systems during major abdominal and orthopedic surgery. Can J Anaesth. 2008 Jun;55(6):358-63. doi: 10.1007/BF03021491.
PubMed 18566199Rein EB, Filtvedt M, Walloe L, Raeder JC. Hypothermia during laparotomy can be prevented by locally applied warm water and pulsating negative pressure. Br J Anaesth. 2007 Mar;98(3):331-6. doi: 10.1093/bja/ael369. Epub 2007 Jan 26.
PubMed 17259258Feroe DD, Augustine SD. Hypothermia in the PACU. Crit Care Nurs Clin North Am. 1991 Mar;3(1):135-44.
PubMed 2043323Witkowski W, Maj J. [Pathophysiology and management of perioperative hypothermia]. Pol Merkur Lekarski. 2006 Jun;20(120):629-34. Polish.
PubMed 17007255Turner M, Hodzovic I, Mapleson WW. Simulated clinical evaluation of four fluid warming devices*. Anaesthesia. 2006 Jun;61(6):571-5. doi: 10.1111/j.1365-2044.2006.04589.x.
PubMed 16704592Bernthal EM. Inadvertent hypothermia prevention: the anaesthetic nurses' role. Br J Nurs. 1999 Jan 14-27;8(1):17-25. doi: 10.12968/bjon.1999.8.1.17.
PubMed 10085808Bennett J, Ramachandra V, Webster J, Carli F. Prevention of hypothermia during hip surgery: effect of passive compared with active skin surface warming. Br J Anaesth. 1994 Aug;73(2):180-3. doi: 10.1093/bja/73.2.180.
PubMed 7917732Borms SF, Engelen SL, Himpe DG, Suy MR, Theunissen WJ. Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation. J Clin Anesth. 1994 Jul-Aug;6(4):303-7. doi: 10.1016/0952-8180(94)90077-9.
PubMed 7946366Giesbrecht GG, Ducharme MB, McGuire JP. Comparison of forced-air patient warming systems for perioperative use. Anesthesiology. 1994 Mar;80(3):671-9. doi: 10.1097/00000542-199403000-00026.
PubMed 8141463Bieberich MT, Van Duren AP. Thermal control and design considerations for a high-performance fluid warmer. Biomed Instrum Technol. 2003 Mar-Apr;37(2):103-12. doi: 10.2345/0899-8205(2003)37[103:TCADCF]2.0.CO;2.
PubMed 12677748Patel N, Smith CE, Pinchak AC, Hagen JF. Prospective, randomized comparison of the Flotem Iie and Hotline fluid warmers in anesthetized adults. J Clin Anesth. 1996 Jun;8(4):307-16. doi: 10.1016/0952-8180(96)00040-2.
PubMed 8695135Presson RG Jr, Bezruczko AP, Hillier SC, McNiece WL. Evaluation of a new fluid warmer effective at low to moderate flow rates. Anesthesiology. 1993 May;78(5):974-80. doi: 10.1097/00000542-199305000-00023.
PubMed 8489069Faries G, Johnston C, Pruitt KM, Plouff RT. Temperature relationship to distance and flow rate of warmed i.v. fluids. Ann Emerg Med. 1991 Nov;20(11):1198-200. doi: 10.1016/s0196-0644(05)81470-2.
PubMed 1952305
Study at a glance
From the registry record, last updated by the sponsor on 4 Apr 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison Between Forced Air and Intravenous Fluid Warmers in Gynecologic Laparoscopic Surgery
- ClinicalTrials.gov ID
- NCT02990429
- Acronym / sponsor ID
- 050/2559(EC2)
- Conditions
- Hypothermia; Anesthesia
- Keywords
- hypothermia, Shivering, Gynecologic laparoscopic surgery, Warming, General anesthesia
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 90 participants (actual)
- Lead sponsor
- Siriraj HospitalUniversity, hospital or other
- Study start
- Apr 2016
- Primary completion
- Dec 2018 (actual)
- Study completion
- Dec 2018 (actual)
- First posted
- 13 Dec 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Perioperative hypothermia is a common problem. It has been defined as a core temperature below 36ºC. The reasons why patient undergoing gynecologic laparoscopic surgery has perioperative hypothermia because the reduced metabolic heat production, redistribution of heat from the core to the periphery and impaired thermoregulation (due to anesthetics), use of cool carbon dioxide gas insufflations and surgical irrigation solution, as well as heat loss due to the cool environment. This perioperative problem has been linked to adverse patient outcomes such as myocardial ischemia as hypothermia increases plasma catecholamine, surgical site infection as hypothermia diminishes wound tissue O2 tension and coagulopathy as hypothermia impairs platelet function.
It claims that perioperative heat loss occurs by radiation (60%), convection (25%) and evaporation (10%). This is caused by the difference between peripheral body and ambient temperature, air circulation around the body and vasodilatation.
In daily practice, most anesthesia personnel warm patient peri-operatively by using force air warmer and intravenous fluid warmer.
This study aimed to compare the difference of core and room temperature in patients undergoing gynecologic laparoscopic surgery by using forced air and intravenous fluid warmer
Detailed description
The study was approved from the Siriraj Institutional Review Board (Si-IRB), COA (Certificate of Analysis): Si201/2016 (18/03/2016), and was written informed consent was obtained from all subjects. The study was conducted at the Department of Siriraj Obstetrics and Gynecology.
A total of 90 patients were enrolled in the study between April 2016 and …..2017. All patients underwent general anesthesia for elective gynecologic laparoscopic surgery. Inclusion criteria were patients aged between 18 and 65, elective case, ASA (American Society of Anesthesiologist) physical status class I-III, BMI 25-30 kg/sq.m., surgical time > 90 minutes. Exclusion criteria were the core temperature less than 36ºC or more than 38ºC. Withdrawal or termination criterion was the change of laparoscopic surgery to exploratory laparotomy.
On the day of surgery, participants signed the informed consent and were randomized equally into two groups: A = 45, receiving intraoperative forced air warming and B =45, having intraoperative intravenous fluid via a fluid warmer All patients underwent general anesthesia after application of standard monitors, anesthesia was induced with fentanyl 1-2 mcg/kg or morphine 0.1-0.2 mg/kg., propofol 1.5-2.5 mg/kg, nimbex 1-1.5 mg/kg or atracurium 0.6 mg/kg. Anesthesia was maintained with sevoflurane ,air,O2, supplemented with fentanyl or morphine.
Core temperatures were measured with an electronic thermometer via tympanic membrane. Intraoperatively, core temperatures and room temperatures were measured at 15 minute intervals until the end of surgery .
Postoperative data were measured at 15 minute intervals at the recovery room. Data consisted of vital sign, core temperature, room temperature, shivering, medication requirements and use of heating devices.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Forced Air warmer (bair hugger) | Experimental | Procedure: Forced Air warmer. In groups: A = 45, receiving intraoperative forced air warming( bair hugger). The forced air was delivered at the high setting of 43ºC |
| Intravenous Fluid Warmer(ranger warmer) | Experimental | Procedure: Intravenous Fluid WarmerIn groups:B =45, having intraoperative intravenous fluid via a fluid warmer patients received intravenous fluid via a fluid warmer after induction anesthesia. The device automatically heated fluid up to 41ºC as set point. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- ASA class 1-3, 18-65 years old, BMI 25-30 kg/sq.m., core temperature 36ºC-38ºC, operation more than 90 minutes
Key exclusion criteria (1 listed)
- turn operation to exploratory laparotomy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Forced Air warmer* record room temperature * record core temperature (tympanic membrane) * General anesthesia * using forced air warmer (bair hugger) * Intravenous fluid at room temperature * room temperature and core temperature q15 minutes * anesthesia finish, stop bair hugger * record core temperature before recovery room | Procedure or surgery | Forced Air warmer (bair hugger) |
| Intravenous Fluid Warmer* record room temperature * record core temperature (tympanic membrane) * General anesthesia * using ranger warmer * Intravenous fluid at room temperature * room temperature and core temperature q15 minutes * anesthesia finish, stop ranger warmer * record core temperature before recovery room | Procedure or surgery | Intravenous Fluid Warmer(ranger warmer) |
Primary outcome
The difference of core and room temperature in patients undergoing gynecologic laparoscopic surgery (by using forced air and intravenous fluid warmer)
Time frame: 1 Year
To study the difference between two groups
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Apr 2019.
- Background: PubMed 20622611Allen PB, Salyer SW, Dubick MA, Holcomb JB, Blackbourne LH. Preventing hypothermia: comparison of current devices used by the US Army in an in vitro warmed fluid model. J Trauma. 2010 Jul;69 Suppl 1:S154-61. doi: 10.1097/TA.0b013e3181e45ba5.
- Background: PubMed 20042442Brandt S, Oguz R, Huttner H, Waglechner G, Chiari A, Greif R, Kurz A, Kimberger O. Resistive-polymer versus forced-air warming: comparable efficacy in orthopedic patients. Anesth Analg. 2010 Mar 1;110(3):834-8. doi: 10.1213/ANE.0b013e3181cb3f5f. Epub 2009 Dec 30.
- Background: PubMed 18566199Wagner K, Swanson E, Raymond CJ, Smith CE. Comparison of two convective warming systems during major abdominal and orthopedic surgery. Can J Anaesth. 2008 Jun;55(6):358-63. doi: 10.1007/BF03021491.
- Background: PubMed 17259258Rein EB, Filtvedt M, Walloe L, Raeder JC. Hypothermia during laparotomy can be prevented by locally applied warm water and pulsating negative pressure. Br J Anaesth. 2007 Mar;98(3):331-6. doi: 10.1093/bja/ael369. Epub 2007 Jan 26.
- Background: PubMed 2043323Feroe DD, Augustine SD. Hypothermia in the PACU. Crit Care Nurs Clin North Am. 1991 Mar;3(1):135-44.
- Background: PubMed 17007255Witkowski W, Maj J. [Pathophysiology and management of perioperative hypothermia]. Pol Merkur Lekarski. 2006 Jun;20(120):629-34. Polish.
- Background: PubMed 16704592Turner M, Hodzovic I, Mapleson WW. Simulated clinical evaluation of four fluid warming devices*. Anaesthesia. 2006 Jun;61(6):571-5. doi: 10.1111/j.1365-2044.2006.04589.x.
- Background: PubMed 10085808Bernthal EM. Inadvertent hypothermia prevention: the anaesthetic nurses' role. Br J Nurs. 1999 Jan 14-27;8(1):17-25. doi: 10.12968/bjon.1999.8.1.17.
- Background: PubMed 7917732Bennett J, Ramachandra V, Webster J, Carli F. Prevention of hypothermia during hip surgery: effect of passive compared with active skin surface warming. Br J Anaesth. 1994 Aug;73(2):180-3. doi: 10.1093/bja/73.2.180.
- Background: PubMed 7946366Borms SF, Engelen SL, Himpe DG, Suy MR, Theunissen WJ. Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation. J Clin Anesth. 1994 Jul-Aug;6(4):303-7. doi: 10.1016/0952-8180(94)90077-9.
- Background: PubMed 8141463Giesbrecht GG, Ducharme MB, McGuire JP. Comparison of forced-air patient warming systems for perioperative use. Anesthesiology. 1994 Mar;80(3):671-9. doi: 10.1097/00000542-199403000-00026.
- Background: PubMed 12677748Bieberich MT, Van Duren AP. Thermal control and design considerations for a high-performance fluid warmer. Biomed Instrum Technol. 2003 Mar-Apr;37(2):103-12. doi: 10.2345/0899-8205(2003)37[103:TCADCF]2.0.CO;2.
- Individual participant dataSharing planned: Yes
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Warunee Boayam, NS principal investigator
Department of Anesthesiology, Faculty of Medicine, Siriraj hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Forced Air warmer and Intravenous Fluid Warmer in people with Hypothermia; Anesthesia, run by Siriraj Hospital at 1 site in Thailand.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Apr 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Thailand. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The difference of core and room temperature in patients undergoing gynecologic laparoscopic surgery (by using forced air and intravenous fluid warmer) (time frame: 1 Year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02990429, which also lists 16 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Apr 2019.