Comparing New‐Technology Passive Warming Versus Traditional Passive Warming Methods for Optimizing Perioperative Body Core Temperature

Abstract

Hypothermia puts surgical patients at risk for adverse outcomes. Traditional passive warming methods are mostly ineffective in reducing hypothermia. New-technology passive warming holds promise as an effective method for promoting and sustaining normothermia throughout surgery. The purpose of this retrospective cohort study was to compare the effectiveness of new-technology passive warming with traditional methods. We measured core body temperature at anesthesia induction and at the end of surgery for patients undergoing robotic-assisted prostatectomy/hysterectomy in the lithotomy position who received either new-technology passive warming (n ¼ 30) or traditional linens and gel pads (n ¼ 35). The traditionally warmed cohort had no change in temperature (35.9 C AE 0.6 C presurgery vs 35.9 C AE 0.7 C postsurgery; t ¼ 0.47; P ¼ .66). The intervention cohort showed a significant increase in temperature (35.75 C AE 0.52 C presurgery vs 36.30 C AE 0.53 C postsurgery; t ¼ 4.64; P < .001). A repeated-measure analysis of variance adjusting for surgery duration and fluid administration confirmed the significance (F ¼ 17.254; P < .001), suggesting that new-technology passive warming may effectively complement active warming to reduce perioperative hypothermia. AORN J 102 (August 2015) 183.e1-183.e8. ª AORN, Inc, 2015. http://dx

Preventing Unplanned Perioperative Hypothermia in Children

“…Unplanned perioperative hypothermia has been identified as one cause of adverse outcomes in adult surgical patients 1‐3,6,7,13 . These adverse outcomes result in prolonged hospitalization, an increased need for transfusion, an increased risk of surgical site infection, increased health care costs, and increased mortality 1,2,9,10,13 . Reports of adverse outcomes in adult patients cite a 4‐fold increase in mortality and doubled rates of complications resulting in sepsis, myocardial infarction, stroke, and death 2 .…”

“…The quality of care and safety of children undergoing surgery are ever‐present concerns in the perioperative clinical area. Unplanned hypothermia can contribute to surgical complications including surgical site infections, increased need for oxygen, altered pharmacokinetics of medications, impaired coagulation, and cardiac arrhythmias 1‐3 . Perioperative nurses at a Midwestern tertiary pediatric hospital noticed an increase in unplanned hypothermia in children and initiated a quality improvement (QI) project to address this concern.…”

Effect of active warming during general anaesthesia on post-operative body temperature, shivering, thermal comfort, pain, nausea and vomiting in adult patients: a randomized clinical trials protocol

“…In this context, perioperative nurses are critical in determining the best practice in preventing hypothermia and achieving normothermia. 39…”

Is Normothermia Maintained in the Operating Room?

“…Many patients experience hypothermia during their surgical procedures, and the incidence in surgical patients varies between 17 and 88.6% depending on the procedure (total hip arthroplasty and colorectal surgery) [1, 9]. Hypothermia in surgical patients can lead to negative consequences such as cardiac problems (ventricular tachycardia and angina pectoris), delayed wound healing, surgical site infection, acute lung injury, bleeding, increased blood and blood product transfusion requirements, prolonged duration of neuromuscular blocking agents’ effect, tremor, nausea, decrease in patient comfort, prolonged extubation time, prolonged post-anesthesia care unit (PACU) and hospital stay, loss of life, and cost [1, 4-6, 8, 10-17].…”