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Warming And Cooling Critical For Temperature Management

Wed, 07/07/2010 - 7:30am
Andy Fleishacker, Director of Business and Market Development and Xia Luo, M.D., Director of Clinical for Zoll Medical Corporation

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Managing patient temperature in the operating room has always been a critical part of any surgical procedure. When patients undergo large open surgical procedures, such as liver, cardiovascular, burn  or any large abdominal incision, heat loss is common due to the patient being exposed to the cold OR temperature and the cooling effect of the anesthesia and mechanical ventilation. Temperature management systems have been designed to maintain normothermia in theses surgical patients.  Additionally, at times during a surgical procedure that require the surgeon to induce a hypothermic state, systems can be placed in a cooling mode of operation. A system that is designed to provide both warming and cooling technology would be ideal in these situations. 

A critical feature of any temperature management system is the ability to quickly achieve the desired target temperature.  Once this temperature is achieved, whether it be normothermia or an induced hypothermic state, the system should precisely maintain the chosen target temperature easily. 

An intravascular temperature management system will warm or cool the patient from inside the body.  A family of intravascular catheters can be inserted into the femoral, subclavian or internal jugular veins. Once inside the blood vessel, warm or cold saline is circulated through the balloons that are part of the catheter design. Fluid never enters the patient and remains in a sterile “closed loop.”

This solution can be extremely effective in maintaining normothermia during burn surgeries since alternative technologies such as blankets and pads cannot be directly applied to the patient’s skin.  In most surgical debridements, the operating room temperature can be raised to 120ºF. By placing the warming catheter in these patients, you will be able to keep the patient warm without having to elevate the ambient temperature of the operating room.

Surgeons can extend operating time, minimize chances of infection and maintain a more tolerable work environment by allowing an intravascular temperature management system to maintain the patient’s temperature. In many situations elevating the operating room temperature above 100º F could still result in the  patient’s core temperature dropping below 35º C, which can cause more bleeding and require additional transfusions and ultimately result in a higher hospital costs.

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