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    
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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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     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:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1127-34     Citation Subset:  AIM; IM    
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MeSH Terms
Analysis of Variance
Body Temperature*
Coronary Disease / complications*,  epidemiology
Heart Arrest* / epidemiology,  etiology,  prevention & control
Hospitals, University
Intraoperative Period
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
Comment In:
JAMA. 1997 Apr 9;277(14):1165-6   [PMID:  9087474 ]
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 ]

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