Recent A & A study: “These findings warrant future research into the effects of forced air warming…during contamination-sensitive surgery.”

August 2013
 
Research in the August edition of Anesthesia & Analgesia, a publication of the International Anesthesia Research Society, and appearing under the name of the Anesthesia Patient Safety Foundation stated:

 “[F]orced air warming was found to establish convection currents that mobilized resident air from nonsterile areas (under the anesthesia drape) upward and into the surgical site.”

The clinical concern, according to the article, is that the convection currents created by Bair Hugger will mobilize contaminants and/or impede the ventilation systems’ ability to clear contaminants from the surgical site.  The concerns, they stated, “are most relevant for smaller airborne particles…such as free-floating bacteria and skin cell fragments.”

The study compared the impact of Bair Hugger warming with air-free HotDog conductive fabric warming.  No convective currents were detected when HotDog warming was applied.  In explanation, the scientists stated:

 “Because conductive blankets (like HotDog) are localized in their application, they tend to have higher thermal efficiencies and contribute less excess heat to the environment than forced air.”

In contrast, Bair Hugger “was found to have a significant disruptive impact on clean airflow patterns over the surgical site….”

Evidence of the risks of forced-air warming just keeps growing.

A study published online ahead of print in Anesthesia & Analgesia concludes that forced-air patient warming produces waste heat that disrupts operating room ventilation airflows over the surgical site, transporting non-sterile air to the area and hindering the ventilation system’s ability to clear potential airborne contaminants.

“There are some in our industry that would like you to believe that hot air doesn’t rise,” says Dr. Scott Augustine, “this study proves, once again, that that argument is insulting to science and common sense.”

Belani, et al, focused on contamination-sensitive surgery at the University of Minnesota, using a mannequin draped for total knee replacement.  Introducing neutral buoyancy bubbles near the mannequin’s head, researchers found a significant increase in bubble-count over the surgical site when forced air warming was used, as opposed to conductive fabric or the control.  The study states: