|Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial.|
|PMID: 9087467 Owner: NLM Status: MEDLINE|
|OBJECTIVE: To assess the relationship between body temperature and cardiac morbidity during the perioperative period.
DESIGN: Randomized controlled trial comparing routine thermal care (hypothermic group) to additional supplemental warming care (normothermic group).
SETTING: Operating rooms and surgical intensive care unit at an academic medical center.
SUBJECTS: Three hundred patients undergoing abdominal, thoracic, or vascular surgical procedures who either had documented coronary artery disease or were at high risk for coronary disease.
OUTCOME MEASURE: The relative risk of a morbid cardiac event (unstable angina/ischemia, cardiac arrest, or myocardial infarction) according to thermal treatment. Cardiac outcomes were assessed in a double-blind fashion.
RESULTS: Mean core temperature after surgery was lower in the hypothermic group (35.4+/-0.1 degrees C) than in the normothermic group (36.7+/-0.1 degrees C) (P<.001) and remained lower during the early postoperative period. Perioperative morbid cardiac events occurred less frequently in the normothermic group than in the hypothermic group (1.4% vs 6.3%; P=.02). Hypothermia was an independent predictor of morbid cardiac events by multivariate analysis (relative risk, 2.2; 95% confidence interval, 1.1-4.7; P=.04), indicating a 55% reduction in risk when normothermia was maintained. Postoperative ventricular tachycardia also occurred less frequently in the normothermic group than in the hypothermic group (2.4% vs 7.9%; P=.04).
CONCLUSION: In patients with cardiac risk factors who are undergoing noncardiac surgery, the perioperative maintenance of normothermia is associated with a reduced incidence of morbid cardiac events and ventricular tachycardia.
|S M Frank; L A Fleisher; M J Breslow; M S Higgins; K F Olson; S Kelly; C Beattie|
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|Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.|
|Title: JAMA Volume: 277 ISSN: 0098-7484 ISO Abbreviation: JAMA Publication Date: 1997 Apr|
|Created Date: 1997-04-17 Completed Date: 1997-04-17 Revised Date: 2014-09-17|
Medline Journal Info:
|Nlm Unique ID: 7501160 Medline TA: JAMA Country: UNITED STATES|
|Languages: eng Pagination: 1127-34 Citation Subset: AIM; IM|
|APA/MLA Format Download EndNote Download BibTex|
Analysis of Variance
Coronary Disease / complications*, epidemiology
Heart Arrest* / epidemiology, etiology, prevention & control
Myocardial Ischemia* / epidemiology, etiology, prevention & control
Postoperative Complications / epidemiology, prevention & control*
Surgical Procedures, Operative*
|GM38117/GM/NIGMS NIH HHS|
JAMA. 1997 Apr 9;277(14):1165-6
JAMA. 1997 Aug 20;278(7):545; author reply 545-6 [PMID: 9268267 ]
JAMA. 1997 Aug 20;278(7):545; author reply 545-6 [PMID: 9268266 ]
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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