Document Detail


Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial.
MedLine Citation:
PMID:  9087467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S M Frank; L A Fleisher; M J Breslow; M S Higgins; K F Olson; S Kelly; C Beattie
Related Documents :
11932177 - Vascular complications of intra-aortic balloon insertion in patients undergoing coronar...
19169177 - Transitory myocardial ischemia in patients with vascular lower limb amputation: relatio...
9420747 - Risk stratification of patients with coronary artery disease and left ventricular dysfu...
23729007 - Two chromosome 9p21 haplotype blocks distinguish between coronary artery disease and my...
18638777 - Tissue rescue therapy for acute ischaemic stroke.
3298357 - Contrast echo washout curves from the left ventricle: application of basic principles o...
Publication Detail:
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:
Title:  JAMA : the journal of the American Medical Association     Volume:  277     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-04-17     Completed Date:  1997-04-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1127-34     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Md, USA. sfrank@welchlink.welch.jhu.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
GM38117/GM/NIGMS NIH HHS
Comments/Corrections
Comment In:
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


Previous Document:  Integrin-mediated activation of MAP kinase is independent of FAK: evidence for dual integrin signali...
Next Document:  Pervasive occult gastrointestinal bleeding in an Alaska native population with prevalent iron defici...