Changes in normothermia during surgery

Česká verzia

Authors: A.benešová ^1,2; J. Škvrňáková ^1,3
Authors place of work: Fakulta zdravotnických studií, Katedra ošetřovatelství, Univerzita Pardubice, Pardubice ¹; Centrální operační sály, Pardubická nemocnice, Pardubice ²; Klinika otorinolaryngologie a chirurgie hlavy a krku, Pardubická nemocnice ³
Published in the journal: Rozhl. Chir., 2020, roč. 99, č. 9, s. 397-403.
Category: Původní práce
doi: https://doi.org/10.33699/PIS.2020.99.9.397–403

Summary

Introduction: The aim of the study was to monitor changes in normothermia in patients undergoing surgery under general anaesthesia.

Methods: Prospective, observational survey, where standardized, intentional observations, medical record statements and semi-structured interviews with patients and healthcare professionals were used for data collection. The group consisted of 95 patients, 18 years and older, undergoing surgery lasting 30 minutes and longer under general anaesthesia. The collection of data took place from October 2018 to March 2019 in operating theatres of the otorhinolaryngological department (40 patients), central operating theatres (55 patients), and in recovery rooms and intensive care units.

Results: Perioperative hypothermia (body temperature below 36°C) was demonstrated in 11 (11.6%) patients. A temperature lower than comfortable body temperature (36.0–36.5°C) occurred in 47, i.e. almost half of the patients (49.5%), and no relationship was demonstrated between hypothermia and the value of the Body Mass Index. The duration of surgery and its effect on the decrease in body temperature was confirmed in patients operated on in the otorhinolaryngology theatres. A relationship was confirmed between hypothermia and the length of the surgery (correlation coefficient -0.452; p=0.003).

Conclusion: The incidence of perioperative hypothermia was demonstrated in 11.6% patients. No relationship was demonstrated between BMI and the development of hypothermia in our patients. A record sheet proposal for monitoring perioperative body temperature was published.

Keywords:

perioperative care – normothermia – perioperative hypothermia – Body temperature

Zdroje

Gabriel P, Höcker J, Steinfath M, et al. Prevention of inadvertent perioperative hypothermia – Guideline compliance in German hospitals. GMS German Medical Science – an Interdisciplinary Journal 2019; 17(07):1–10. doi:10.3205/000273.
Pyszková O, Nevtípilová M, Žáčková D, et al. Výskyt hypotermie v perioperačním období – unicentrická observační studie. Anesteziologie a intenzivní medicína 2014;25(4):267–273.
Maleki A, Soltani A, Goudarzi M, et al. Assessing the effect of warming up the patient with forced air on the body central temperature during general anesthesia in patients aged 20-70 years under eye surgery in Farabi Hospital. World Family Medicine 2018;16(1):48−54. doi:10.5742/MEWFM.2018.93196.
Bindu B, Bindra A, Rath G. Temperature management under general anesthesia: Compulsion or option. Journal of anaesthesiology, clinical pharmacology 2017;33(3):306–316.
Yi J, Liang H, Song R, et al. Mantaining intraoperative normothermia reduces blood loss in patients undergoing major operations: a pilot randomized controlled clinical trial. BMC Anesthesiology 2018;18(126):1−7. doi:10.1186/s12871-018-0582-9.
Dostálová V, Dostál P. Perioperační hypotermie u plánovaných terapeutických a diagnostických výkonů. Anesteziologie a intenzivní medicína 2015;26(1):8–16.
Zangmo K, Chatmongkolchart S, Sangsupawanich P. Perioperative risk factors for intraoperative hypothermia in adult patients undergoing elective surgery at a National Referral Hospital in Bhutan: A prospective observational study. Journal of Health Science and Medical Research 2019;37(4):1−8. doi: 10.31584/jhsmr.201966.
Heitz WJ. Pooperační stavy: příznaky, diagnostika, postupy. 1. vydání, Praha, Grada Publishing 2019. ISBN: 978-80-271-0873-2.
Liu S, Pan Y, Zhao Q, et al. The effectiveness of air-free warming systems on perioperative hypothermia in total hip and knee arthroplasty. Medicine 2019; 98(19):1–8. doi:10.1097/MD.0000000000015630.
Halide A, Tuncer S, Yavuz D. Effects of inadvertent perioperative hypothermia on metabolic and inflammatory mediators. Turkish Journal of Anaesthesiology and Reanimation 2019;47(6):448.
Munday J, Delaforce A, Forbes G, et al. Barriers and enablers to the implementation of perioperative hypothermia prevention practices from the perspectives of the multidisciplinary team: a qualitative study using the Theoretical Domains Framework. Journal of Multidisciplinary Healthcare 2019;19(12):337–345. doi: 10.2147/JMDH.S209687.
Benešová A. Hodnocení normotermie u operačních výkonů na ORL pracovišti. Pardubice, 2019. 107 s. Diplomová práce. Univerzita Pardubice. Fakulta zdravotnických studií. Vedoucí práce Škvrňáková Jana.
American Society of Anesthesiologists. standards for basic anesthetic monitoring. In: asahq.org [online]. 2015 [cit. 14. 11. 2019]. https://www.asahq.org/standards-and-guidelines/standards-for-basic-anesthetic-monitoring.
National Institute for Health Care Excellence (NICE). Clinical practice guideline: Hypothermia: prevention and management in adults having surgery. In: nice.org.uk [online]. 2016 [cit. 14. 11. 2019]. https://www.nice.org.uk/guidance/cg65.
Fatemi SNL, Armat MR, Emami ZA, et al. Inadvertent perioperative hypothermia: A literature review of an old overlooked problem. Acta Facultatis Medicae Naissensis 2016;33(1):5–11. doi:10.1515/afmnai-2016-0001.
Yi J, Lei Y, Xu S, et al. Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China. Plos One 2017;12(6):1−13. doi:10.1371/journal.pone.0177221.
Boddu Ch, Cushner J, Scudery GR. Inadvertent perioperative hypothermia during orthopedic surgery. The American Journal of Orthopedics 2018;47(7):1–10. doi:10.12788/ajo.2018.0056.
Moola S, Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia with in the adult perioperative environment. International Journal of Evidence-Based Healthcare 2011;9(4):395−417. doi:10.1111/j.1744-1609.2011.00227.x.
Özer AB, Altun AY, Ömer LE, et al. The effect of body mass index on perioperativ thermoregulation. Therapeutics and Clinical Risk Management 2016;16(12):1717–1720. doi:10.2147/TCRM.S122700.
Sessler D. Temperature monitoring: the consequences and prevention of mild perioperative hypothermia. African Journals OnLine 2014;20(1):25–31. doi:10.1080/22201173.2014.10844560.
Yanaral T, Ertugrul G. Effect of perioperative hypothermia on anesthetic outcomes. Surgery Clinics Journal 2019;1(1010):23–25.
Pereira NHC, Mattia ALD. Postoperative complications related to intraoperative hypothermia. Enfermería Global 2019;18(3):300−313. doi:10.6018/eglobal.18.3.328791.