Perioperative Thermal Insulation
Anselm Bräuer M.D., PhD, D.E.A.A.
Specialist in Anesthesiology
Department of Anesthesiology, Emergency and Intensive Care Medicine
University of Göttingen, Göttingen, Germany
Thorsten Perl, M.D.
Specialist in Anesthesiology
Department of Anesthesiology, Emergency and Intensive Care Medicine
University of Göttingen, Göttingen, Germany
Michael J.M. English, M.D., F.R.C.A.
Professor
Department of Anaesthesia, Montreal General Hospital and McGill University
Montreal, Canada
Michael Quintel, M.D., Ph.D.
Head of Department
Department of Anesthesiology, Emergency and Intensive Care Medicine
University of Göttingen, Göttingen, Germany
Perioperative hypothermia remains a common problem during anesthesia and surgery. Unfortunately, the implementation of new minimally invasive surgical procedures has not lead to a reduction of this problem. Heat losses from the skin can be reduced by thermal insulation to avoid perioperative hypothermia. However, only a small amount of information is available regarding the physical properties of insulating materials used in the Operating Room (OR). Therefore, several materials using validated manikins were tested. Heat loss from the surface of the manikin can be described as: “Q• = h · DT · A” where Q• = heat flux, h = heat exchange coefficient, DT = temperature gradient between the environment and surface, and A = covered area. Heat flux per unit area and surface temperature were measured with calibrated heat flux transducers. Environmental temperature was measured using a thermoanemometer. The temperature gradient between the surface and environment (DT) was varied and “h” was determined by linear regression analysis as the slope of “DT” versus heat flux per unit area. The reciprocal of the heat exchange coefficient defines the insulation. The insulation values of the materials varied between 0.01 Clo (plastic bag) to 2.79 Clo (2 layers of a hospital duvet). Given the range of insulating materials available for outdoor activities, significant improvement in insulation of patients in the OR is both possible and desirable.
