Forced-Air Warming in Patients Undergoing Endovascular Procedures: Comparison between 2 Thermal Blanket Models.

BACKGROUND: The purpose of this study was to compare the efficiency between 2 thermal blanket models: the upper blanket and the underbody blanket in patient heating and hypothermia prevention during endovascular surgery. METHODS: Fifty patients, American Society of Anesthesiologists physical status 2-4, receiving endovascular surgery repair of infrarenal abdominal aortic aneurysm or lower limb angioplasty by endovascular technique were studied. Primary outcome was to determine which forced-air blanket is more warming effective during the surgeries. Age, type of surgery, gender, body mass index, surgery duration, and initial patient temperature were analyzed to determine possible hypothermia association as secondary outcomes. Patients were randomized and split into 2 groups based on blanket model. All patients received general anesthesia, and temperature was obtained by an esophageal thermometer inserted after tracheal intubation and registered at intervals of 15 min until extubation. RESULTS: Groups significantly differed in body temperature (P = 0.006) and hypothermia occurrence (P = 0.020). The underbody blanket group hada higher ratio of hypothermic patients and a lower average temperature at the end of surgery. The average temperature after 60 min in the underbody blanket group was lower than the upper blanket group,although this difference was only significant after 150 min (P = 0.020). CONCLUSIONS: We conclude that upper thermal blanket is more effective thanunderbody thermal blanket in patient warming and hypothermia prevention during endovascular abdominal aortic aneurysm repair and lower limb angioplasty after 150 min of anesthetic-surgical time duration.

Acute immune response to Mycobacterium massiliense in C57BL/6 and BALB/c mice.

Mycobacterium massiliense is an environmental opportunistic pathogen that has been associated with soft tissue infection after minor surgery. We studied the acute immune response of C57BL/6 and BALB/c mice infected intravenously with 10(6) CFU of an M. massiliense strain isolated from a nosocomial infection in Brazil. The results presented here show that M. massiliense is virulent and pathogenic to both C57BL/6 and BALB/c mice, inducing a granulomatous inflammatory reaction that involves the activation of macrophages, dendritic cells, and natural killer cells induced by gamma interferon and interleukin-17 (IL-17) in C57BL/6 mice and by IL-12 in BALB/c mice.

Emergence of nosocomial Mycobacterium massiliense infection in Goiás, Brazil.

A cluster of surgical site infection cases after arthroscopic and laparoscopic procedures occurred between 2005 and 2007 in Goiânia, in the central region of Brazil. Nontuberculous mycobacteria (NTM) were isolated from samples (exudates from cutaneous abscesses) from 18 patients of seven private hospitals. There were no reports of post-surgical arthroscopic and laparoscopic mycobacterial infections in Goiânia apart from this period. The 18 isolates were identified as Mycobacterium massiliense by PCR-restriction digestion of the hsp65 gene, pulsed-field gel electrophoresis (PFGE) comparisons, and rpoB partial gene sequencing. All isolates were typed as a single clone, indicating that they have the same origin, which suggests a common source of infection for all patients.