EVALUATION OF 2 WARMING SYSTEMS AFTER CARDIOPULMONARY BYPASS

We have compared the Thermomat electric under-mattress (JMW Systems, E dinburgh, UK) and the Bair Hugger (Augustine Medical, Courtelary, Swit zerland) forced-air warming blanket in 30 adult patients after cardiac surgery. All patients were warmed to an oesophageal temperature of 38 degrees C before termination of cardiopulmonary bypass (CPB); those w ith oesophageal temperatures < 35.5 degrees C at skin closure were all ocated randomly to be rewarmed in the intensive care unit either on th e Thermomat (n = 15) or under the Bair Hugger blanket (n = 15), at the ir highest settings. Oesophageal and lateral thigh skin temperatures w ere recorded every 15 min for 4 h. There was a significantly faster in crease in core temperature (0.5 vs 0.75 degrees C h(-1); P < 0.0002) a nd skin temperature (0.86 vs 1.3 degrees C h(-1); P < 0.001) in the Ba ir Hugger group. However, there was no difference in the number of pat ients who reached a core temperature of 36 degrees C (15 Bair Hugger, 14 Thermomat) or 37 degrees C (11 Bair Hugger, seven Thermomat), or in the number of patients who reached a skin temperature of 37 degrees C in 4 h (four Bair Hugger, one Thermomat). Twelve patients in the Bair Hugger group reached a skin temperature of 36 degrees C compared with two in the Thermomat group (P < 0.001). The Bair Hugger warmed faster than the Thermomat both centrally and peripherally, and warmed more p atients to a core temperature of 37 degrees C in 4 h, bur did not redu ce the time to tracheal extubation or alter important clinical aspects of postoperative course.