British journal of anaesthesia
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Case Reports
Thermal softening of tracheal tubes: an unrecognized hazard of the Bair Hugger active patient warming system.
The Bair Hugger system is a new and highly effective active patient warming system which produces a layer of warm air between the patient and the warming system. We report an instance of marked softening and distortion of a polyvinyl chloride tracheal tube caused by this layer. We also present laboratory data indicating that this is a likely problem under routine theatre conditions, with suggestions for prevention.
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A retrospective review over 6 yr of patients presenting to the hand clinic was performed to identify cases of postoperative brachial plexopathy (PBP) and to assess both prognosis and early indices of prognosis. Over this period (1989-1995), 22 patients were referred by the hospital's surgical departments to the hand clinic because of PBP. Eight cases followed open heart surgery (OHS) and 14 followed non-cardiac surgery (NCS). ⋯ At a 1 week "prognostic milestone", 79% of NCS patients with significant symptomatology enjoyed complete recovery although this took as long as 5 months to 1 yr in 50% of patients. At a 6-8 week "prognostic milestone", 50% of those who had not yet had improvement in the motor deficit suffered residual neurological deficit. All patients recovered to a significant extent even when recovery was not complete and none suffered from late deterioration or chronic pain.