Forced-air prewarming prevents hypothermia during living donor liver transplantation: a randomized controlled trialopen access
- Authors
- Oh, E.J.; Han, S.; Lee, S.; Choi, E.A.; Ko, J.S.; Gwak, M.S.; Kim, G.S.
- Issue Date
- Apr-2023
- Publisher
- NLM (Medline)
- Citation
- Scientific reports, v.13, no.1
- Journal Title
- Scientific reports
- Volume
- 13
- Number
- 1
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74307
- DOI
- 10.1038/s41598-022-23930-2
- ISSN
- 2045-2322
- Abstract
- Despite various intraoperative thermal strategies, core heat loss is considerable during liver transplantation and hypothermia is common. We tested whether forced-air prewarming prevents hypothermia during liver transplantation. Adult patients undergoing living donor liver transplantation were randomly assigned to non-prewarming group (n = 20) or prewarming group (n = 20). Patients in prewarming group underwent 30-min forced-air warming before anesthetic induction. During surgery, core temperature was measured in the pulmonary artery. The primary outcome was intraoperative hypothermia (< 36.0 °C). The secondary outcomes included plasma lactate concentration. Intraoperative hypothermia risk was significantly lower in prewarming group than in non-prewarming group (60.0% vs. 95.0%, P = 0.020). The difference in hypothermia incidence between groups was greater in the post-induction phase (20.0% vs. 85.0%, P < 0.001) than in the anhepatic or post-reperfusion phase, suggesting that prewarming mainly acts on preventing post-induction core-to-peripheral heat redistribution. Hypothermia duration was significantly shorter in prewarming group (60 [0-221] min vs. 383 [108-426] min, P = 0.001). Lactate concentration decreased during 3 h after graft reperfusion in prewarming group, whereas it continuously increased in non-prewarming group (- 0.19 [- 0.48 to 0.13] mmol/L vs. 1.17 [3.31-0.77] mmol/L, P = 0.034). In conclusion, forced-air prewarming decreases the incidence and duration of intraoperative hypothermia with potential clinical benefit while mainly acting by preventing the core-to-peripheral heat redistribution.Clinical trial registration: Registered at the Clinical Research Information Service ( https://cris.nih.go.kr , [KCT0003230]) on 01/10/2018. © 2023. The Author(s).
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