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The Journal of Thoracic and Cardiovascular Surgery, Vol 80, 718-723, Copyright © 1980 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Reduction of operative heat loss and pulmonary secretions in neonates by use of heated and humidified anesthetic gases

EW Fonkalsrud, S Calmes, LT Barcliff and CT Barrett

Maintaining normothermia in neonates undergoing major operations remains a serious problem which may complicate the perioperative period. During the past 5 years at the UCLA Hospital, 86 infants have undergone general anesthesia for repair of congenital malformations. Heated, humidified ventilation (HHV) was used in 48 neonates and standard ventilation (SV)--that is, dry anesthetic gases--was used in the other 38. We found that loss of body heat during the period of anesthesia was significantly less when HHV was used. The mean rectal temperature of HHV infants decreased 0.2 degrees C during the first hour of anesthesia, whereas the mean temperature decreased 1.4 degrees C in SV infants (p < 0.01). By the end of anesthesia, the mean temperature of HHV infants had increased 0.3 degrees C, whereas in SV infants the mean temperature was 1.2 degrees C lower than at the beginning of anesthesia (p < 0.01). Furthermore, postoperative atelectasis was less frequent in HHV patients (three cases) than in SV infants (nine cases), and pulmonary secretions were less voluminous and tenacious in neonates receiving heated humidified anesthetic gases, although objective quantification of these observations was not done. Inasmuch as no complications were observed in any of the 48 neonates receiving HHV, and previous studies showed that HHV does not interfere with anesthetic gas uptake, it appears that HHV may be a useful adjunct to the currently used methods of neonatal anesthesia.

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