Protocol for the prevention of perioperative hypothermia
A temperature management strategy based on current evidence in order to avoid issues due to hypothermia
DOI:
https://doi.org/10.30445/rear.v11i4.805Keywords:
prewarming, protocol, normothermia, HypothermiaAbstract
Perioperative hypothermia is a very frequent complication that compromises the safety of our surgical patients, increasing perioperative morbidity and mortality. Hypothermia also considerably increases health costs due to the increase in complications and hospital length of stay. Recently, the clinical practice guide for unintentional perioperative hypothermia of the Spanish Society of Anaesthesia (SEDAR) has been published. This guide presents current scientific evidence on perioperative hypothermia and recommendations on its management.
Based on this guide, we present the protocol for the prevention of perioperative hypothermia in our institution. This protocol is based on a strategy that includes central temperature monitoring and 3 measures that have shown to reduce perioperative complications and be cost-effective: the use of convective air, warming of intravenous and irrigation fluids, and active warming prior to surgery.
References
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- Schell-Chaple HM, Liu KD, Matthay MA, Puntillo KA. Rectal and Bladder Temperatures vs Forehead Core Temperatures Measured With SpotOn Monitoring System. Am J Crit Care Off Publ Am Assoc Crit-Care Nurses. 2018 Jan;27(1):43–50.
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- Kollmann Camaiora A, Brogly N, Alsina E, de Celis I, Huercio I, Gilsanz F. Validation of the Zero-Heat-Flux thermometer (SpotOn®) in major gynecological surgery to monitor intraoperative core temperature: a comparative study with esophageal core temperature. Minerva Anestesiol. 2018 Jun 26;
- Boisson M, Alaux A, Kerforne T, Mimoz O, Debaene B, Dahyot-Fizelier C, et al. Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: A prospective observational study. Eur J Anaesthesiol. 2018;35(11):825–30.
- Iden T, Horn E-P, Bein B, Böhm R, Beese J, Höcker J. Intraoperative temperature monitoring with zero heat flux technology (3M SpotOn sensor) in comparison with sublingual and nasopharyngeal temperature: An observational study. Eur J Anaesthesiol. 2015 Jun;32(6):387–91.
- Pesonen E, Silvasti-Lundell M, Niemi TT, Kivisaari R, Hernesniemi J, Mäkinen M-T. The focus of temperature monitoring with zero-heat-flux technology (3M Bair-Hugger): a clinical study with patients undergoing craniotomy. J Clin Monit Comput. 2018 Nov 22;
- Madrid E, Urrútia G, Roqué i Figuls M, Pardo-Hernandez H, Campos JM, Paniagua P, et al. Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults. Cochrane Database Syst Rev. 2016 Apr 21;4:CD009016.
- Campbell G, Alderson P, Smith AF, Warttig S. Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia. Cochrane Database Syst Rev. 2015 Apr 13;(4):CD009891.
- Grote R, Wetz AJ, Bräuer A, Menzel M. [Prewarming according to the AWMF S3 guidelines on preventing inadvertant perioperative hypothermia 2014 : Retrospective analysis of 7786 patients]. Anaesthesist. 2018 Jan;67(1):27–33.
- Melling AC, Ali B, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet Lond Engl. 2001 Sep 15;358(9285):876–80.
- Sessler DI. Perioperative heat balance. Anesthesiology. 2000 Feb;92(2):578–96.
- Torossian A, Bräuer A, Höcker J, Bein B, Wulf H, Horn E-P. Preventing inadvertent perioperative hypothermia. Dtsch Arzteblatt Int. 2015 Mar 6;112(10):166–72.
- Mahoney CB, Odom J. Maintaining intraoperative normothermia: a meta-analysis of outcomes with costs. AANA J. 1999 Apr;67(2):155–63.
- Calvo Vecino JM, Casans Francés R, Ripollés Melchor J, Marín Zaldívar C, Gómez Ríos MA, Pérez Ferrer A, et al. Guía de práctica clínica de hipotermia perioperatoria no intencionada. Rev Esp Anestesiol Reanim. 2018 Dec 1;65(10):564–88.
- National Collaborating Centre for Nursing and Supportive Care (UK). The Management of Inadvertent Perioperative Hypothermia in Adults [Internet]. London: Royal College of Nursing (UK); 2008 [cited 2019 Mar 29]. (National Institute for Health and Clinical Excellence: Guidance). Available from: http://www.ncbi.nlm.nih.gov/books/NBK53797/
- Arkiliç CF, Akça O, Taguchi A, Sessler DI, Kurz A. Temperature monitoring and management during neuraxial anesthesia: an observational study. Anesth Analg. 2000 Sep;91(3):662–6.
- Torossian A, TEMMP (Thermoregulation in Europe Monitoring and Managing Patient Temperature) Study Group. Survey on intraoperative temperature management in Europe. Eur J Anaesthesiol. 2007 Aug;24(8):668–75.
- Brogly N, Alsina E, de Celis I, Huercio I, Dominguez A, Gilsanz F. Perioperative temperature control: Survey on current practices. Rev Esp Anestesiol Reanim. 2016 Apr;63(4):207–11.
- Schell-Chaple HM, Liu KD, Matthay MA, Puntillo KA. Rectal and Bladder Temperatures vs Forehead Core Temperatures Measured With SpotOn Monitoring System. Am J Crit Care Off Publ Am Assoc Crit-Care Nurses. 2018 Jan;27(1):43–50.
- Mäkinen M-T, Pesonen A, Jousela I, Päivärinta J, Poikajärvi S, Albäck A, et al. Novel Zero-Heat-Flux Deep Body Temperature Measurement in Lower Extremity Vascular and Cardiac Surgery. J Cardiothorac Vasc Anesth. 2016 Aug;30(4):973–8.
- Eshraghi Y, Nasr V, Parra-Sanchez I, Van Duren A, Botham M, Santoscoy T, et al. An evaluation of a zero-heat-flux cutaneous thermometer in cardiac surgical patients. Anesth Analg. 2014 Sep;119(3):543–9.
- Kollmann Camaiora A, Brogly N, Alsina E, de Celis I, Huercio I, Gilsanz F. Validation of the Zero-Heat-Flux thermometer (SpotOn®) in major gynecological surgery to monitor intraoperative core temperature: a comparative study with esophageal core temperature. Minerva Anestesiol. 2018 Jun 26;
- Boisson M, Alaux A, Kerforne T, Mimoz O, Debaene B, Dahyot-Fizelier C, et al. Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: A prospective observational study. Eur J Anaesthesiol. 2018;35(11):825–30.
- Iden T, Horn E-P, Bein B, Böhm R, Beese J, Höcker J. Intraoperative temperature monitoring with zero heat flux technology (3M SpotOn sensor) in comparison with sublingual and nasopharyngeal temperature: An observational study. Eur J Anaesthesiol. 2015 Jun;32(6):387–91.
- Pesonen E, Silvasti-Lundell M, Niemi TT, Kivisaari R, Hernesniemi J, Mäkinen M-T. The focus of temperature monitoring with zero-heat-flux technology (3M Bair-Hugger): a clinical study with patients undergoing craniotomy. J Clin Monit Comput. 2018 Nov 22;
- Madrid E, Urrútia G, Roqué i Figuls M, Pardo-Hernandez H, Campos JM, Paniagua P, et al. Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults. Cochrane Database Syst Rev. 2016 Apr 21;4:CD009016.
- Campbell G, Alderson P, Smith AF, Warttig S. Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia. Cochrane Database Syst Rev. 2015 Apr 13;(4):CD009891.
- Grote R, Wetz AJ, Bräuer A, Menzel M. [Prewarming according to the AWMF S3 guidelines on preventing inadvertant perioperative hypothermia 2014 : Retrospective analysis of 7786 patients]. Anaesthesist. 2018 Jan;67(1):27–33.
- Melling AC, Ali B, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet Lond Engl. 2001 Sep 15;358(9285):876–80.
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Published
2020-09-10
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Miró Murillo, M., Recio Pérez, J., Salinero Fernández, P., & Paz Pacheco, E. M. (2020). Protocol for the prevention of perioperative hypothermia: A temperature management strategy based on current evidence in order to avoid issues due to hypothermia. Revista Electrónica AnestesiaR, 11(4), 5. https://doi.org/10.30445/rear.v11i4.805
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