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Archive December 2017 XVIII, No. 12

6 Things You Might Not Know About Patient Warming

A look at the not-so-obvious details of hypothermia prevention.

Brielle Gregory

Brielle Gregory, Associate Editor


core temperature PRE-OP WARMING If the patient starts off surgery with a higher core temperature, it might not drop as low during induction.

You apply warm cotton blankets and actively warm patients before, during and after surgery without a second thought to maintaining normothermia. But there's more than you might think that goes into keeping patients' core body temperatures above 36°C. Here are a 6 things you might not know about hypothermia prevention.

1. FDA did not endorse forced air
Fearful that hospitals and surgical centers would stop warming patients altogether over concerns about the safety of forced-air warming (FAW), the FDA sent healthcare providers a letter ( in August reiterating the importance of actively warming surgical patients with "thermoregulation devices." Because the letter mentions forced air by name, it was easy to misinterpret the letter as an FDA endorsement of FAW. "The FDA continues to recommend the use of thermoregulating devices (including forced air thermal regulating systems) for surgical procedures when clinically warranted," reads the letter.

In truth, the FDA was responding to a growing number of joint replacement surgeons who have discontinued warming their hip and knee implant patients over concerns about the risks of infection due to airborne contamination from FAW.

2. About those forced-air lawsuits
3M is facing more than 4,000 product liability claims that it knew about the potential increased risk of joint infections linked with the use of Bair Hugger during hip and knee replacement surgeries. The plaintiffs claim that the forced-air system circulated airborne contamination around the surgical field, thus causing their deep-joint infections.

The federal court overseeing the lawsuits has ordered 2 knee replacement infection lawsuits prepared for a bellwether trial that could begin as early as April 30, 2018. (A bellwether trial is a small consolidation of lawsuits, taken from a larger group of similar cases, to be tried first. The bellwether trial is like a practice run to help anticipate the results of the future similar cases.) The 2 cases were filed on behalf of individuals who developed deep-joint infections allegedly related to the use of the Bair Hugger during their total knee replacements.

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