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"Warming"

Original Articles
Analysis of Researches on the Warming Therapy for Surgical Patients
Jumyi Jun
J Korean Acad Adult Nurs 2010;22(3):260-270.   Published online June 30, 2010
PURPOSE
The main question is systematic review of the published in Korea and foreign countries on warming therapy for surgical patients.
METHODS
The researchers searched at Medline, CINAHL, KERIS, Adult Nursing Association, Korean Society of Nursing Science, Korean Academy of fundamentals of Nursing, and National Assembly Library web site for the published on warming therapy for surgical patients from 1980 to 2008. Words for search were operation/surgery, warming, operation/surgery and warming. Studies were included randomized controlled trial, and there were no restrictions regarding operative phase and outcome measures.
RESULTS
36 published researches that met the criteria were mostly published in foreign countries between 2000 and 2008 and focused on surgery with general anesthesia. Sample size ranged from 21 to 60 subjects, age range between 21 and 60 years of age. Thirty different warming therapies were reported, fifty-two different dependent variables. Outcome indicators included active external warming, intra-operative, and body temperature. 'Positive effects' and 'no effects' equaled. The most frequently reported 'positive effects' were body temperature, shivering, and acid-base balance. No effects were more likely to be heart rate, blood pressure, and hemodynamics.
CONCLUSION
Many types of warming therapy, are reported in the literature with little information about the efficacy of each, many different dependant variables were studied. There were no consistent reports as to length of time used for warming procedures. Overall, the effects of warming therapy are inconsistent. And additional research must be down before any particular method of warming can be used with confidence as to its effectiveness. Attention must be made as to the research design, better measurement of the dependent variables. This review may serve as a base.
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Comparison of Forced Air Warming and Radiant Heating on Body Temperature and Shivering of Post-operative Patients
Kyoung Hee Choi
J Korean Acad Adult Nurs 2008;20(1):135-148.   Published online February 29, 2008
PURPOSE
This study compared the effects of forced air warming and radiant heating on body temperature and shivering of patients with postoperative hypothermia.
METHODS
The quasi-experimental study was conducted with two experimental groups who had surgery under general anesthesia; 20 patients of group 1 experimented with the Bair Hugger as a forced air warming and 20 patients of group 2 experimented with the Radiant heater. The study was performed from July 3 to August 31, 2006 in a recovery room of an university hospital in a city. The effects of the experiment were measured by postoperative body temperature and chilling score at arrival and after every 10 minutes. The data were analyzed by t-test or chi-square-test, repeated measures ANCOVA using SPSS/WIN 12.0.
RESULTS
The mean body temperature showed differences between the Bair Hugger group and Radiant Heater group at 40 minutes(F=-2.579, p=.034), 50minutes(F=-2.752, p=.027), and 60 minutes(F=-2.470, p=.047) after arrival to the recovery room. So, hypothesis 1 was partially accepted. The mean score of shivering showed differences between the Bair Hugger group and the Radiant Heater group, but it had no significant meaning. Hypothesis 2 was not accepted.
CONCLUSION
We need more study to explore the effects and side effects of heating modalities to select a more effective heat treatment. The efficiency of heat modalities with regards to cost benefit, time consumption, and patients' discomfort such as burns should be considered.
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The Effect of Warming Patients Before or During the Surgical Operations on the Patients' Body Temperature and Shivering
Ji Yeon Lee, Hyang Yeon Lee
J Korean Acad Adult Nurs 2002;14(3):428-437.   Published online September 30, 2002
PURPOSE
The purpose of this study is to examine the changes of surgical patients' body temperature in applying warming to patients. The study of an effective nursing intervention, which aims to prevent hypothermia during surgical operations, use of anesthesia, and to remove dermal discomforts. The nonequivalent control group pre-test/post-test design was used for this quasi-experimental study.
METHOD
The study subjects were adult patients who would take a surgical operation under general anesthesia in C Hospital; the surgical operations done were, total abdominal hysterectomy or Myomectomy; 20 patients were included in experimental group I, 20 patients were included in experimental group II, and 20 patients were in the comparative group. The total number of study subjects was 60. The data was collected from September the 1st, 2001 to October the 20th, 2001. The data was analyzed by SPSS program, F-test and Repeated measures of ANOVA. Multi-comparison method of DUNCAN was used for the sections that show the significant differences at the level of p<.05, which was a posterior examination.
RESULT
1) "The body temperatures of the three groups of patients will be respectively different at the end of the operations; experimental group I to which warming was applied before the operations, experimental group II to which warming was applied during the operations, and the comparative group with no warming being given," showed (F=12.609, p=.000). 2) "Degrees of shivering symptoms for the three groups will be respectively different at the end of the operations; experimental group I which applied warming before operations, experimental group II which applied warming during operations and the comparative group with no warming." Showed assumed (F=6.626, p=.000).
CONCLUSION
Summing up the above study, the warming assumed during operations was a more effective nursing intervention for preventing patients' hypothermia than the warming assumed before operations.
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The Effect of Preoperative Warming On Reducing Rectal Temperature Drop in Surgical Patients
Seung Hwa Lim, Moon Su Cho, Kyung Sook Choi
J Korean Acad Adult Nurs 1997;9(1):55-69.   Published online April 30, 1997
Although there are many peri-operative measures to reduce core temperature loss during operation, rapid drop has been experienced in the first sixty minutes following induction of general anesthesia. Recently, preoperative warming has been emphasized to prevent inadvertant hypothermia during operation. The purpose of this study is to find the effect of preoperative warming on reducing rectal temperature drop in surgical patients. With informed consent, 46 female adult patients, scheduled for total abdominal hysterectomy or salpingo-oophorectomy in the Seoul National University Hospital from September 3, 1996 to September 19, 1996 were divided into two groups. The variables of age and body surface were matched between the two groups as possible. Among them, 24 patients were preparatively covered up to the shoulders with a forced-air warming blanket(WARM TOUCHTM). set between 36-40degrees C for prewarming, and the other 22 patients(control group)were not before the induction of anesthesia. Rectal temperature was measured by mercury thermometer for rectum after admission to the operating room and by rectal probe which was inserted in the rectum just before the induction during the operation. The rectal temperature was monitored and recorded at every fifteen minutes for the first sixty minutes after the induction and each step during the surgery(intubation, surgical draping, peritoneum opening, one hour and the end of the operation) Collected data were analyzed by means of t-test, Repeated Measures Analysis of Variance with PC-SAS. The results of this study are as following. (1) There was no significant difference between the two groups in age, weight, height, room temperature, basal rectal temperature, operation time. (2) Temperature gradient of the rectal temperature in the warming group was less steeper than that in the control roup during the first sixty minutes after general anesthesia. (3) The rectal temperature measured at every fifteen minutes for the first sixty minutes and the end of surgery after the general anesthesia showed the difference between the two groups during surgery. (4) There was no rectal temperature difference during the intubation, however there was significant temperature difference between the two groups from draping to the end of surgery. In conclusion, prewarming of the surgical patient before induction resulted in increased the skin temperature and heat content, which relieved the dangerous core temperature drop which is potential to be provoked within one hour after induction of the surgical patients and kept the rectal temperature higher than that of the control group during surgery. The suggestions from this study shown below : First, further study is needed to find the preventive effect of the core temperature drop in the first sixth minutes after anesthetic induction by preoperative warming for gastrorectal, thoracic surgery patients who man have the core temperature drop during the operation. Second, in other to keep patient normothermia during the surgery, it needs to study whether using pre-and peri-operative warming can prevent hypothermia or not. Finally, the study of the peroperative warming effect on surgical patients' relaxation and thermal discomfort before the operation is needed because most patients in the case group said to have felt thermal comfort ; 'comfortable' and 'good'.
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