human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Forced-air warming is the most commonly used and effective method of active warming . A new radiant warming device ( Suntouch ™ , Fisher and Paykel ) may provide an alternative when the skin surface available for warming is limited . We conducted a r and omized controlled trial to compare the efficacy of the Suntouch ™ radiant warmer and forced-air warming . With ethics committee approval , 60 surgical patients having procedures anticipated to be more than two hours in duration were recruited . Patients were r and omized to either radiant warming or forced-air warming . All intravenous fluids were warmed but prewarming was not used . The final intraoperative core temperatures ( ° C ) for the radiant warming and forced-air warming groups were 36.0±0.5 and 36.4±0.6 ( P=0.002 ) respectively . No other patient variables were significantly different . The Suntouch ™ is not as effective as the forced air warming for intraoperative warming during long surgical procedures . The device may be useful when forced-air warming is not possible Background : Forced-air warming is sometimes unable to maintain perioperative normothermia . Therefore , the authors compared heat transfer , regional heat distribution , and core rewarming of forced-air warming with a novel circulating-water garment . Methods : Nine volunteers were each evaluated on two r and omly ordered study days . They were anesthetized and cooled to a core temperature near 34 ° C . The volunteers were subsequently warmed for 2.5 h with either a circulating-water garment or a forced-air cover . Overall , heat balance was determined from the difference between cutaneous heat loss ( thermal flux transducers ) and metabolic heat production ( oxygen consumption ) . Average arm and leg ( peripheral ) tissue temperatures were determined from 18 intramuscular needle thermocouples , 15 skin thermal flux transducers , and “ deep ” h and and foot thermometers . Results : Heat production ( approximately 60 kcal/h ) and loss ( approximately 45 kcal/h ) were similar with each treatment before warming . The increases in heat transfer across anterior portions of the skin surface were similar with each warming system ( approximately 65 kcal/h ) . Forced-air warming had no effect on posterior heat transfer , whereas circulating-water transferred 21 ± 9 kcal/h through the posterior skin surface after a half hour of warming . Over 2.5 h , circulating water thus increased body heat content 56 % more than forced air . Core temperatures thus increased faster than with circulating water than forced air , especially during the first hour , with the result that core temperature was 1.1 ° ± 0.7 ° C greater after 2.5 h ( P < 0.001 ) . Peripheral tissue heat content increased twice as much as core heat content with each device , but the core-to-peripheral tissue temperature gradient remained positive throughout the study . Conclusions : The circulating-water system transferred more heat than forced air , with the difference result ing largely from posterior heating . Circulating water rewarmed patients 0.4 ° C/h faster than forced air . A substantial peripheral-to-core tissue temperature gradient with each device indicated that peripheral tissues insulated the core , thus slowing heat transfer BACKGROUND : We compared temperature changes in patients undergoing hip replacement during warming  with a resistive heating blanket or air-forced system . METHODS : Fifty-six patients were enrolled . Patients were r and omly allocated to the “ forced-air group ” ( forced-air system ) or to the “ heating-blanket group ” ( resistive heating under-patient blanket ) . RESULTS : Baseline tympanic temperatures were 36.0 ± 0.6 ° C in the forced-air group and 36.1 ± 0.4 ° C in the heating-blanket group ( P > 0.05 ) . At the end of surgery tympanic temperatures were 35.3 ± 0.5 ° C in the forced-air group and 35.1 ± 0.6 ° C in the heating-pad group ( P > 0.05 ) . CONCLUSIONS : We demonstrated that , using either a resistive heating-blanket or forced-air warming systems , patients ended surgery in mild hypothermia after elective total hip replacement , but without significant differences between these two warming devices Background : This study was design ed to compare the efficacy of two different sites of active forced air warming , upper body or lower body , to maintain normothermia ; and their respective effect on thenar skin temperature in relation to the accelerographic monitoring of neuromuscular blockade during long‐lasting abdominal surgery Forced-air warming is commonly used to warm patients intraoperatively , but may not achieve normothermia during a short procedure . Comparative trials of a new radiant warming device in general anaesthesia ( Suntouch ™ , Fisher and Paykel , Auckl and , New Zeal and ) have had conflicting results . We conducted a r and omized controlled trial to compare the efficacy and thermal comfort of the Suntouch ™ radiant warmer and forced-air warming in patients at high risk of hypothermia during neuraxial blockade . With ethics committee approval , 60 patients having transurethral resection of the prostate under spinal were r and omized to either radiant warming or forced-air warming . All intravenous and irrigation fluids were warmed but pre-warming was not used . The final intraoperative rectal temperatures for the radiant warming and forced-air warming groups were 36.1 ° C and 36.4 ° C respectively ( P=0.03 ) . A large proportion of patients in both groups ( 46 % and 33 % respectively , P=0.3 ) were hypothermic ( < 36 ° C ) on arrival in the post-anaesthesia care unit . No other patient variables were significantly different . Neither warming device reliably prevented hypothermia , although forced-air warming was slightly superior This study aim ed to assess factors associated to body temperature changes intraoperatively in patients undergoing elective surgery . A prospect i ve study including 70 patients was carried out in a charity hospital . A data collection instrument was developed and its face and content validity was established . The variables measured were operating room temperature and humidity and patient body temperature at different times . In the multivariate linear regression , the variables type of anesthesia , duration of anesthesia , body mass index , and operating room temperature were directly associated to mean body temperature . Nurses are responsible for planning and implementing effective interventions that can contribute to minimize costs and most importantly reduce hypothermia complications A r and omised controlled trial was conducted to compare the efficacy of upper body forced‐air warming ( Bair Hugger ™ , Augustine Medical model 500/OR , Prairie , MN ) with that of an electric heating pad ( Operatherm 202 , KanMed , Bromma , Sweden ) for maintenance of intra‐operative body temperature in 60 patients undergoing laparotomy under general anaesthesia .  The nasopharyngeal temperature was recorded throughout the operative period . The mean ( SD ) final temperatures were 36.2 ( 0.4 ) ° C with forced‐air warming and 35.5 ( 1.0 ) ° C with electric heating pad ( p < 0.01 ) . Upper body forced‐air warming is more effective than the heating pad for maintenance of body temperature during laparotomy BACKGROUND Even mild perioperative hypothermia is associated with several severe adverse effects . Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently . To assess this new warming system , we measured core temperature in patients during surgery who were warmed with circulating water mattresses , forced air covers or resistive heating covers . METHODS Twenty-four patients undergoing laparoscopic cholecystectomy were r and omly assigned to ( i ) circulating water mattress ( 38 degrees C ) , ( ii ) forced air warming ( set to ' medium ' ) or ( iii ) carbon-fibre resistive warming ( 38 degrees C ) . Warming was applied throughout anaesthesia and surgery . The groups were compared using one-way ANOVA and Student-Newman-Keuls tests . RESULTS Confounding factors were similar among the groups . Core temperatures in each group decreased for 20 min , but subsequently increased in the forced air and resistive heating groups . There was no significant difference between the forced air and resistive heating groups at any time . In contrast , core temperature in the circulating water group continued to decrease . Consequently , core temperature in the circulating water group was significantly lower than in the other groups 30 min after anaesthetic induction and at later times . CONCLUSIONS Resistive heating maintains core body temperature as well as forced air heating and both are better than circulating water . Resistive heating offers the advantage of adjustable heating pods Serious adverse outcomes from perioperative hypothermia are well documented . Consequently , intraoperative warming has become routine . We thus evaluated the efficacy of a novel , nondisposable carbon-fiber resistive-heating system .  Twenty-four patients undergoing open abdominal surgery lasting approximately 4 h were r and omly assigned to warming with 1 ) a full-length circulating water mattress set at 42 ° C , 2 ) a lower-body forced-air cover with the blower set on high , or 3 ) a three-extremity carbon-fiber resistive-heating blanket set to 42 ° C . Patients were anesthetized with a combination of continuous epidural and general anesthesia .  All fluids were warmed to 37 ° C , and ambient temperature was kept near 22 ° C . Core ( tympanic membrane ) temperature changes among the groups were compared by using factorial analysis of variance and Scheffe[Combining Acute Accent ] F tests ; results are presented as means ± SD . Potential confounding factors did not differ significantly among the groups . In the first 2 h of surgery , core temperature decreased by 1.9 ° C ± 0.5 ° C in the circulating-water group , 1.0 ° C ± 0.6 ° C in the forced-air group , and 0.8 ° C ± 0.2 ° C in the resistive-heating group . At the end of surgery , the decreases were 2.0 ° C ± 0.8 ° C in the circulating-water group , 0.6 ° C ± 1.0 ° C in the forced-air group , and 0.5 ° C ± 0.4 ° C in the resistive-heating group . Core temperature decreases were significantly greater in the circulating-water group at all times after 150 elapsed minutes ; however , temperature changes in the forced-air and resistive-heating groups never differed significantly . Even during major abdominal surgery , resistive heating maintains core temperature as effectively as forced air . IMPLICATION S : Efficacy was similar for forced-air and resistive heating , and both maintained intraoperative core temperature far better than circulating-water mattresses . We thus conclude that even during major abdominal surgery , resistive heating maintains core temperature as effectively as forced air OBJECTIVE Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery . We assessed the efficacy of the Allon thermoregulation system ( MTRE Advanced Technologies Ltd , Or-Akiva , Israel ) compared with that of routine thermal care in maintaining normothermia during and after off-pump coronary artery bypass surgery . METHODS Patients undergoing off-pump coronary artery bypass surgery were perioperatively and r and omly warmed with the 2 techniques  ( n = 45 per group ) . Core temperature , hemodynamics , and troponin I , interleukin 6 , interleukin 8 , and interleukin 10 blood levels were assessed . RESULTS The mean temperature of the patients in the Allon thermoregulation system group ( AT group ) was significantly ( P < .005 ) higher than that of the patients receiving routine thermal care ( the RTC group ) ; less than 40 % of the latter reached 36 degrees C compared with 100 % of the former . The cardiac index was higher and the systemic vascular resistance was lower ( P < .05 ) by 16 % and 25 % , respectively , in the individuals in the AT group compared with in the individuals in the RTC group during the 4 postoperative hours . End-of-surgery interleukin 6 levels and 24-hour postoperative troponin I levels were significantly ( P < .01 ) lower in the patients in the AT group than in the RTC group . The RTC group 's troponin levels closely correlated with their interleukin 6 levels at the end of the operation ( R = 0.51 , P = .002 ) . CONCLUSIONS Unlike routine thermal care , the Allon thermoregulation system maintains core normothermia in more than 80 % of patients undergoing off-pump coronary artery bypass surgery . Normothermia is associated with better cardiac and vascular conditions , a lower cardiac injury rate , and a lower inflammatory response . The close correlation between the increased interleukin 6 and troponin I levels in the routine thermal care group indicates a potential deleterious effect of lowered temperature on the patient 's outcome Background The authors compared two strategies for the maintenance of intraoperative normothermia  during orthotopic liver transplantation ( OLT ) : the routine forced-air warming system and the newly developed , whole body water garment . Methods In this prospect i ve , r and omized and open-labelled study , 24 adult patients were enrolled in one of two intraoperative temperature management groups during OLT . The water-garment group ( N = 12 ) received warming with a body temperature ( esophageal ) set point of 36.8 ° C . The forced air-warmer group ( N = 12 ) received routine warming therapy using upper- and lower-body forced-air warming system .  Body core temperature ( primary outcome ) was recorded intraoperatively and during the two hours after surgery in both groups . Results The mean core temperatures during incision , one hour after incision and during the skin closing were significantly higher ( p < 0.05 , 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Forced-air warming is the most commonly used and effective method of active warming . A new radiant warming device ( Suntouch ™ , Fisher and Paykel ) may provide an alternative when the skin surface available for warming is limited . We conducted a r and omized controlled trial to compare the efficacy of the Suntouch ™ radiant warmer and forced-air warming . With ethics committee approval , 60 surgical patients having procedures anticipated to be more than two hours in duration were recruited . Patients were r and omized to either radiant warming or forced-air warming . All intravenous fluids were warmed but prewarming was not used . The final intraoperative core temperatures ( ° C ) for the radiant warming and forced-air warming groups were 36.0±0.5 and 36.4±0.6 ( P=0.002 ) respectively . No other patient variables were significantly different . The Suntouch ™ is not as effective as the forced air warming for intraoperative warming during long surgical procedures . The device may be useful when forced-air warming is not possible Background : Forced-air warming is sometimes unable to maintain perioperative normothermia . Therefore , the authors compared heat transfer , regional heat distribution , and core rewarming of forced-air warming with a novel circulating-water garment . Methods : Nine volunteers were each evaluated on two r and omly ordered study days . They were anesthetized and cooled to a core temperature near 34 ° C . The volunteers were subsequently warmed for 2.5 h with either a circulating-water garment or a forced-air cover . Overall , heat balance was determined from the difference between cutaneous heat loss ( thermal flux transducers ) and metabolic heat production ( oxygen consumption ) . Average arm and leg ( peripheral ) tissue temperatures were determined from 18 intramuscular needle thermocouples , 15 skin thermal flux transducers , and “ deep ” h and and foot thermometers . Results : Heat production ( approximately 60 kcal/h ) and loss ( approximately 45 kcal/h ) were similar with each treatment before warming . The increases in heat transfer across anterior portions of the skin surface were similar with each warming system ( approximately 65 kcal/h ) . Forced-air warming had no effect on posterior heat transfer , whereas circulating-water transferred 21 ± 9 kcal/h through the posterior skin surface after a half hour of warming . Over 2.5 h , circulating water thus increased body heat content 56 % more than forced air . Core temperatures thus increased faster than with circulating water than forced air , especially during the first hour , with the result that core temperature was 1.1 ° ± 0.7 ° C greater after 2.5 h ( P < 0.001 ) . Peripheral tissue heat content increased twice as much as core heat content with each device , but the core-to-peripheral tissue temperature gradient remained positive throughout the study . Conclusions : The circulating-water system transferred more heat than forced air , with the difference result ing largely from posterior heating . Circulating water rewarmed patients 0.4 ° C/h faster than forced air . A substantial peripheral-to-core tissue temperature gradient with each device indicated that peripheral tissues insulated the core , thus slowing heat transfer BACKGROUND : We compared temperature changes in patients undergoing hip replacement during warming  with a resistive heating blanket or air-forced system . METHODS : Fifty-six patients were enrolled . Patients were r and omly allocated to the “ forced-air group ” ( forced-air system ) or to the “ heating-blanket group ” ( resistive heating under-patient blanket ) . RESULTS : Baseline tympanic temperatures were 36.0 ± 0.6 ° C in the forced-air group and 36.1 ± 0.4 ° C in the heating-blanket group ( P > 0.05 ) . At the end of surgery tympanic temperatures were 35.3 ± 0.5 ° C in the forced-air group and 35.1 ± 0.6 ° C in the heating-pad group ( P > 0.05 ) . CONCLUSIONS : We demonstrated that , using either a resistive heating-blanket or forced-air warming systems , patients ended surgery in mild hypothermia after elective total hip replacement , but without significant differences between these two warming devices Background : This study was design ed to compare the efficacy of two different sites of active forced air warming , upper body or lower body , to maintain normothermia ; and their respective effect on thenar skin temperature in relation to the accelerographic monitoring of neuromuscular blockade during long‐lasting abdominal surgery Forced-air warming is commonly used to warm patients intraoperatively , but may not achieve normothermia during a short procedure . Comparative trials of a new radiant warming device in general anaesthesia ( Suntouch ™ , Fisher and Paykel , Auckl and , New Zeal and ) have had conflicting results . We conducted a r and omized controlled trial to compare the efficacy and thermal comfort of the Suntouch ™ radiant warmer and forced-air warming in patients at high risk of hypothermia during neuraxial blockade . With ethics committee approval , 60 patients having transurethral resection of the prostate under spinal were r and omized to either radiant warming or forced-air warming . All intravenous and irrigation fluids were warmed but pre-warming was not used . The final intraoperative rectal temperatures for the radiant warming and forced-air warming groups were 36.1 ° C and 36.4 ° C respectively ( P=0.03 ) . A large proportion of patients in both groups ( 46 % and 33 % respectively , P=0.3 ) were hypothermic ( < 36 ° C ) on arrival in the post-anaesthesia care unit . No other patient variables were significantly different . Neither warming device reliably prevented hypothermia , although forced-air warming was slightly superior This study aim ed to assess factors associated to body temperature changes intraoperatively in patients undergoing elective surgery . A prospect i ve study including 70 patients was carried out in a charity hospital . A data collection instrument was developed and its face and content validity was established . The variables measured were operating room temperature and humidity and patient body temperature at different times . In the multivariate linear regression , the variables type of anesthesia , duration of anesthesia , body mass index , and operating room temperature were directly associated to mean body temperature . Nurses are responsible for planning and implementing effective interventions that can contribute to minimize costs and most importantly reduce hypothermia complications A r and omised controlled trial was conducted to compare the efficacy of upper body forced‐air warming ( Bair Hugger ™ , Augustine Medical model 500/OR , Prairie , MN ) with that of an electric heating pad ( Operatherm 202 , KanMed , Bromma , Sweden ) for maintenance of intra‐operative body temperature in 60 patients undergoing laparotomy under general anaesthesia .  The nasopharyngeal temperature was recorded throughout the operative period . The mean ( SD ) final temperatures were 36.2 ( 0.4 ) ° C with forced‐air warming and 35.5 ( 1.0 ) ° C with electric heating pad ( p < 0.01 ) . Upper body forced‐air warming is more effective than the heating pad for maintenance of body temperature during laparotomy BACKGROUND Even mild perioperative hypothermia is associated with several severe adverse effects . Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently . To assess this new warming system , we measured core temperature in patients during surgery who were warmed with circulating water mattresses , forced air covers or resistive heating covers . METHODS Twenty-four patients undergoing laparoscopic cholecystectomy were r and omly assigned to ( i ) circulating water mattress ( 38 degrees C ) , ( ii ) forced air warming ( set to ' medium ' ) or ( iii ) carbon-fibre resistive warming ( 38 degrees C ) . Warming was applied throughout anaesthesia and surgery . The groups were compared using one-way ANOVA and Student-Newman-Keuls tests . RESULTS Confounding factors were similar among the groups . Core temperatures in each group decreased for 20 min , but subsequently increased in the forced air and resistive heating groups . There was no significant difference between the forced air and resistive heating groups at any time . In contrast , core temperature in the circulating water group continued to decrease . Consequently , core temperature in the circulating water group was significantly lower than in the other groups 30 min after anaesthetic induction and at later times . CONCLUSIONS Resistive heating maintains core body temperature as well as forced air heating and both are better than circulating water . Resistive heating offers the advantage of adjustable heating pods Serious adverse outcomes from perioperative hypothermia are well documented . Consequently , intraoperative warming has become routine . We thus evaluated the efficacy of a novel , nondisposable carbon-fiber resistive-heating system .  Twenty-four patients undergoing open abdominal surgery lasting approximately 4 h were r and omly assigned to warming with 1 ) a full-length circulating water mattress set at 42 ° C , 2 ) a lower-body forced-air cover with the blower set on high , or 3 ) a three-extremity carbon-fiber resistive-heating blanket set to 42 ° C . Patients were anesthetized with a combination of continuous epidural and general anesthesia .  All fluids were warmed to 37 ° C , and ambient temperature was kept near 22 ° C . Core ( tympanic membrane ) temperature changes among the groups were compared by using factorial analysis of variance and Scheffe[Combining Acute Accent ] F tests ; results are presented as means ± SD . Potential confounding factors did not differ significantly among the groups . In the first 2 h of surgery , core temperature decreased by 1.9 ° C ± 0.5 ° C in the circulating-water group , 1.0 ° C ± 0.6 ° C in the forced-air group , and 0.8 ° C ± 0.2 ° C in the resistive-heating group . At the end of surgery , the decreases were 2.0 ° C ± 0.8 ° C in the circulating-water group , 0.6 ° C ± 1.0 ° C in the forced-air group , and 0.5 ° C ± 0.4 ° C in the resistive-heating group . Core temperature decreases were significantly greater in the circulating-water group at all times after 150 elapsed minutes ; however , temperature changes in the forced-air and resistive-heating groups never differed significantly . Even during major abdominal surgery , resistive heating maintains core temperature as effectively as forced air . IMPLICATION S : Efficacy was similar for forced-air and resistive heating , and both maintained intraoperative core temperature far better than circulating-water mattresses . We thus conclude that even during major abdominal surgery , resistive heating maintains core temperature as effectively as forced air OBJECTIVE Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery . We assessed the efficacy of the Allon thermoregulation system ( MTRE Advanced Technologies Ltd , Or-Akiva , Israel ) compared with that of routine thermal care in maintaining normothermia during and after off-pump coronary artery bypass surgery . METHODS Patients undergoing off-pump coronary artery bypass surgery were perioperatively and r and omly warmed with the 2 techniques  ( n = 45 per group ) . Core temperature , hemodynamics , and troponin I , interleukin 6 , interleukin 8 , and interleukin 10 blood levels were assessed . RESULTS The mean temperature of the patients in the Allon thermoregulation system group ( AT group ) was significantly ( P < .005 ) higher than that of the patients receiving routine thermal care ( the RTC group ) ; less than 40 % of the latter reached 36 degrees C compared with 100 % of the former . The cardiac index was higher and the systemic vascular resistance was lower ( P < .05 ) by 16 % and 25 % , respectively , in the individuals in the AT group compared with in the individuals in the RTC group during the 4 postoperative hours . End-of-surgery interleukin 6 levels and 24-hour postoperative troponin I levels were significantly ( P < .01 ) lower in the patients in the AT group than in the RTC group . The RTC group 's troponin levels closely correlated with their interleukin 6 levels at the end of the operation ( R = 0.51 , P = .002 ) . CONCLUSIONS Unlike routine thermal care , the Allon thermoregulation system maintains core normothermia in more than 80 % of patients undergoing off-pump coronary artery bypass surgery . Normothermia is associated with better cardiac and vascular conditions , a lower cardiac injury rate , and a lower inflammatory response . The close correlation between the increased interleukin 6 and troponin I levels in the routine thermal care group indicates a potential deleterious effect of lowered temperature on the patient 's outcome Background The authors compared two strategies for the maintenance of intraoperative normothermia  during orthotopic liver transplantation ( OLT ) : the routine forced-air warming system and the newly developed , whole body water garment . Methods In this prospect i ve , r and omized and open-labelled study , 24 adult patients were enrolled in one of two intraoperative temperature management groups during OLT . The water-garment group ( N = 12 ) received warming with a body temperature ( esophageal ) set point of 36.8 ° C . The forced air-warmer group ( N = 12 ) received routine warming therapy using upper- and lower-body forced-air warming system .  Body core temperature ( primary outcome ) was recorded intraoperatively and during the two hours after surgery in both groups . Results The mean core temperatures during incision , one hour after incision and during the skin closing were significantly higher ( p < 0.05 , 
    Output:
    