Clinical Guidance for Patient Warming
The UK’s National Institute for Health and Clinical Excellence (NICE) clinical guideline 65 ‘Inadvertent perioperative hypothermia’ recommends active intraoperative warming for all patients undergoing anaesthesia for longer than 30 minutes and for patients at higher risk of hypothermia undergoing anaesthesia for less than 30 minutes.
In August 2011, further medical technology guidance was released to support the use of Inditherm patient warming systems for patients undergoing operations which carry risk of inadvertent hypothermia.
After rigorous evaluation of the clinical evidence, the following was concluded:
· The case for adopting the Inditherm patient warming mattress in the NHS is supported by the evidence. The clinical evidence suggests that the effectiveness of the Inditherm patient warming mattress in maintaining patient core body temperature above 36°C is similar to that of forced air warming, and that the Inditherm mattress may have practical advantages.
· The Inditherm patient warming mattress should be considered for use in patients undergoing operations that carry a risk of inadvertent hypothermia.
· The annual cost saving when the Inditherm patient warming system is compared with forced air warming is estimated to be £9800 per operating theatre (operating room) (assuming that all eligible patients are warmed). This is based on an annual cost of £1300 for an Inditherm patient warming system comprising one full-length and one half-length mattress, two blankets and three controllers, and including maintenance costs.
NICE considerations on NHS impact:
· Avoidance of inadvertent hypothermia has been demonstrated to reduce the incidence of postoperative infections, with consequent savings in cost to the NHS.
· The Inditherm mattress can be left in place on an operating table throughout a theatre operating list with low running costs. This may allow faster turnaround times for patients compared with the use of forced air warming.
· The Inditherm mattress is a re-usable device and no consumables are needed. This limits the need for disposal of consumables and any impact that might have on the environment.
· The Inditherm mattress is silent, has low energy consumption and specifically warms the patient without inadvertently warming the surgical team.
· The Committee considered the claims for practical advantages of the Inditherm mattress compared with forced air warming to be plausible and likely to be realised in clinical practice.
The Committee concluded that the available clinical and cost evidence supported the case for adopting the Inditherm patient warming mattress in the NHS for patients undergoing operations which carry risk of inadvertent hypothermia.
For more information:
For the full guidance document, download the pdf here
To view the NICE slideshow, click here.
Related NICE guidance:
Perioperative hypothermia (inadvertent): management of inadvertent perioperative hypothermia in adults. NICE clinical guideline 65 (2008). Available from www.nice.org.uk/guidance/CG65
Surgical site infection: prevention and treatment of surgical site infection. NICE clinical guideline 74 (2008). Available from www.nice.org.uk/guidance/CG74