Independent, nonprofit research organization publishes guidance following literature review: "does not believe that the currently available evidence justifies discontinuing the use of forced-air warming during surgery."Independent research organization
“Before the development of forced-air warming, there was no good way to keep surgical patients warm. Forced-air is safe, effective, easy to use and inexpensive. It has thus become the most common way of keeping patients warm during surgery.”Anesthesiologist Dr. Daniel Sessler
“I’m confident in the use of forced-air warming blankets at my institution for patients undergoing total joint arthroplasty in laminar flow equipped ORs. Normothermia maintenance plays a critical role in minimizing complications following any surgery and should be exercised whenever possible.”Dr. Javad Parvizi
Forced-air warming is the most used and studied method of surgical warming in the U.S., with more than 170 studies and more than 60 randomized controlled trials supporting its use.
Keeping patients warm throughout the perioperative process is integral to providing optimal clinical care and patient comfort. A meta-analysis of 18 published studies demonstrates that maintaining normothermia in some general types of surgeries may improve patient outcomes and reduce cost.1 With one simple step, you can make a big difference.
The choice of warming method depends on the type and length of surgery, as not all warming modalities are effective at warming patients throughout the entire perioperative process.
Forced-air warming has generally been found to be the most effective warming therapy2, but not all forced-air warming systems are the same. It is important to keep in mind product-specific features like delivering consistent, even patient warming; ensuring optimized airflow through air channels; and offering useful features like drainage holes for managing fluids. These attributes can help streamline the surgical experience for clinicians.
2. Sessler DI. Current concepts: Mild Perioperative Hypothermia. New England Journal of Medicine, 1997; 336:1730-1737.
Forced-air warming is a trusted, effective method for warming surgical patients and an important component of high quality patient care. The world was introduced to forced-air warming technology 25+ years ago through 3M™ Bair Hugger™ therapy, which has since safely warmed more than 180 million patients.
U.S. News & World Report recently released its list of the top-50 U.S. orthopedic hospitals and nine of the top 10 orthopedic hospitals1 (and 13 of the top 15) currently warm their surgical patients with Bair Hugger forced-air warming products.
Some manufacturers of conductive warming technologies have suggested that forced-air warming may increase the risk of wound infection or operating room contamination. In fact, research shows the opposite. Published studies have demonstrated that the use of forced-air warming does not increase either the risk of wound contamination in the operating room, or bacterial contamination of the operating room.2,3 When tested during actual surgical conditions, forced-air warming was shown to decrease the bacterial count at the surgical site.4-6
In addition, thorough examination by multiple sources has conclusively determined there is no significant disruption of laminar airflow tied to the use of forced-air warming units.
The air in a laminar-equipped operating room is already filtered. The Bair Hugger warming unit simply re-filters this air with a high-efficiency 0.2 micron filter before it reaches the blanket. A recent study showed that for all units tested, air exiting from the hose was always cleaner than the air going in.9
Normothermia’s relationship to surgical site infections (SSIs) has garnered special attention in recent years, with numerous evidence-based initiatives, like SCIP-Inf-10, citing normothermia maintenance as a tool in SSI reduction efforts. Maintaining normothermia is one of the easiest, least expensive and most effective benefits you can offer to patients.
An editorial published in Anesthesia and Analgesia stated that, “Maintaining normothermia is usually easy… furthermore, the most commonly used warming systems are remarkably safe. There are few, if any, anesthetic interventions that have been proven to so markedly improve the outcome of surgery with so little effort, risk and cost…”1
The U.S. Centers for Disease Control and Prevention specifically recommends the use of disposable products for patients with known or suspected infections requiring contact precautions.2 3M™ Bair Hugger™ blankets and 3M™ Bair Paws™ gowns are single-use only, helping avoid the risk of cross contamination, as may be possible with reusable patient warming devices.
Managing optimum patient care in a restricted-budget environment is an increasingly pressing challenge in healthcare. As you are asked to do more with less while ensuring patients receive exceptional care, make sure you pursue smart investments that will benefit your facility for years to come.
A host of national healthcare initiatives designed to reduce costs and accelerate improvements in the quality of care and safety are placing hospitals under a microscope. This increased visibility into hospital quality, patient satisfaction and cost-effectiveness – or the overall value they provide – is forcing facilities to re-think how they operate.
An analysis of outcomes and costs found that unintended hypothermia is associated with a significant increase in adverse outcomes, which can result in prolonged hospital stays and increased health expenditures by $2,500 to $7,000 per patient.1 By taking the simple step of utilizing forced-air warming technology, facilities may prevent hypothermia in their surgical patients and avoid the dangerous and costly complications of hypothermia.
For more than 25 years, forced-air warming has been the gold standard for managing perioperative normothermia in surgical patients worldwide.1-4 Professional organizations such as the Association of periOperative Registered Nurses (AORN), the American Society of Anesthesiologists (ASA) and the American Society of Peri-Anesthesia Nurses (ASPAN), all note the important role of normothermia maintenance in SSI reduction—as do national quality initiatives including those developed by the Institute for Healthcare Improvement (IHI) and the Surgical Care Improvement Project (SCIP). Several of these organizations and initiatives specifically name forced-air warming as a key means of maintaining normothermia.
High-quality randomized trials show that maintaining normothermia may:5
The more you know about the problems associated with unintended hypothermia and the ways to maintain normothermia, the better able you will be to ensure optimal outcomes for your patients. Visit this site often for current information and news on forced-air warming.
Do convective and conductive warming methods have the same warming efficiency?
Research has shown 3M™ Bair Hugger™ therapy warms patients significantly better than conductive resistive electric-type blankets and mattresses1,2 In fact, one clinical trial showed that a Bair Hugger full body blanket rewarmed patients two times faster than a resistive electric full body blanket.1 In addition, one study found the Bair Hugger full access underbody blanket to be significantly better in reducing post-bypass temperature afterdrop than a resistive heating mattress.2
What types of warming options are available on the marketplace?
From warmed cotton blankets to forced-air warming blankets, a wide array of methods with varying degrees of effectiveness are available to help prevent unintended hypothermia. Active warming modalities included in the current CMS normothermia measure are forced-air warming, conductive warming, warm-water garments and resistive warming.
How should I choose the best warming modality for my facility?
Ultimately, it comes down to a question of what technology will best position the hospital to warm every surgical patient, achieve the guideline goal of perioperative normothermia and even improve patient satisfaction – all in a cost-effective way.
In order to decide which warming modality is the best fit for a particular facility, there are several key considerations to keep in mind, including:
How is patient satisfaction linked to the financial strength of my facility?
Patient satisfaction and the entire care experience are increasingly emphasized in consumer-directed healthcare plans and pay-for-performance reimbursement arrangements. A positive patient experience can become a distinct competitive advantage for a healthcare facility. Research conducted by Press Ganey show a direct correlation between patient satisfaction scores and financial strength. The findings revealed that the higher the patient satisfaction score, the more profitable the hospital.3 High patient satisfaction can set a hospital apart from competition, driving traffic and feeding the revenue stream.
Clearly patient satisfaction is a potent mechanism for increasing and sustaining market share and the bottom line.4 Working to improve patient satisfaction more than pays for itself, 4which is another great reason to comply with SCIP-Inf-10 in an effort to keep patients healthy, and therefore happy.
We welcome your questions
We know forced-air warming. We created the category. It’s at the core of who we are and what we do. We have seen the benefits of forced-air warming at work for more than 25 years—and more importantly, clinicians across the globe have witnessed the contributions forced-air warming makes to patient care. We have absolute confidence in the safety and efficacy of our products, as will anyone who has the complete story.
Questions? Please contact Customer Service at 1-800-228-3957.
Arizant Healthcare Inc., a 3M company
3M Infection Prevention Division
3M Center, 275-4E-01
St. Paul, MN 55144