Reduce potential for heart attack in surgery patients

Patients are usually kept in cool conditions during and after surgery, but new findings show that may not be the way to go. If patients with cardiac disease or risk factors have to undergo noncardiac surgery, they’ll have a 55% lower risk of experiencing a cardiac event if the surgical team maintains the normal body temperature in the perioperative period. Keeping body temperature steady, says a new study, leads to fewer cardiac events.

Researchers from Johns Hopkins in Baltimore and Vanderbilt University in Nashville, TN, wanted to assess the relationship between body temperature and cardiac morbidity. They looked at a set of elderly patients with coronary artery disease who were having thoracic, abdominal, and vascular surgery. Some, the hypothermic group, were given only routine cotton blankets, and others, the normothermic group, were given supplemental warming with forced-air warming covers during and after surgery, causing a 1.3 degrees Celsius rise in temperature.1 Cardiac events occurred less frequently in the normothermic group. Why would lower body temperature increase risk? The body’s response to hypothermia includes higher blood pressure and constriction of blood vessels.

Although active warming has been shown to attenuate the adrenergic response, reduce the incidence of shivering, and increase comfort, these finding suggest additional benefit: prevention of postoperative cardiac complications.

Reference

1. Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. JAMA 1997; 277:1,127-1,134.

Jackie Torpy, RN, BSN, Coordinator of the Alegent Health Heart Institute’s Heart Failure Center, Immanuel Medical Center, Omaha, NE. Telephone: (402) 572-3300.

Lori Heaney, RN, Program Coordinator of the Heart Failure Unit, Cardiovascular Institute, Columbia Michael Reese Hospital, Chicago. Telephone: (312) 791-8368.

John E. Strobeck, MD, PhD, Director, The Heart-Lung Center of Hawthorne (NJ). Telephone: (201) 423-9388.

Karen Manzo, RN, Clinical Director, HeartCare Centers of Ohio, Grant Riverside Methodist Hospital, Columbus, OH. Telephone: (614) 566-7664.

Robert Spina, Northeast Regional Sales Manager for Vasomedical, Westbury, NY. Telephone: (516) 997-4600.

J. Michael Jones, President of Healthcorp of America, Atlanta. Telephone: (404) 303-6656.

Anthony E. Peacock, Vice President of clinical affairs, Vasomedical, Westbury, NY. Telephone: (516) 997-4600.

Patricia Santoni, Health Educator and Director of the Cardiac Outreach Program, St. Agnes Hospital, Baltimore. Telephone: (410) 368-3216.

Dennis M. McNamara, MD, Director of the Cardiomyopathy Clinic, University of Pittsburgh. Telephone: (412) 647-2703.