| Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. | |
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MedLine Citation:
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PMID: 9087467 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S M Frank; L A Fleisher; M J Breslow; M S Higgins; K F Olson; S Kelly; C Beattie |
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Publication Detail:
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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. |
Journal Detail:
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Title: JAMA : the journal of the American Medical Association Volume: 277 ISSN: 0098-7484 ISO Abbreviation: JAMA Publication Date: 1997 Apr |
Date Detail:
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Created Date: 1997-04-17 Completed Date: 1997-04-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7501160 Medline TA: JAMA Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1127-34 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Md, USA. sfrank@welchlink.welch.jhu.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Anesthesia Baltimore Body Temperature* Coronary Disease / complications*, epidemiology Electrocardiography Female Heart Arrest* / epidemiology, etiology, prevention & control Hemodynamics Hospitals, University Humans Hypothermia Incidence Intraoperative Period Male Middle Aged Monitoring, Physiologic Multivariate Analysis Myocardial Ischemia* / epidemiology, etiology, prevention & control Postoperative Complications / epidemiology, prevention & control* Postoperative Period Prospective Studies Regression Analysis Risk Factors Surgical Procedures, Operative* |
| Grant Support | |
ID/Acronym/Agency:
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GM38117/GM/NIGMS NIH HHS |
| Comments/Corrections | |
Comment In:
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JAMA. 1997 Aug 20;278(7):545; author reply 545-6
[PMID:
9268266
]
JAMA. 1997 Apr 9;277(14):1165-6 [PMID: 9087474 ] JAMA. 1997 Aug 20;278(7):545; author reply 545-6 [PMID: 9268267 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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