Control of body temperature and immune function in patients undergoing open surgery for gastric cancer

Abstract

The influence of mild perioperative hypothermia on the immune function and incidence of postoperative wound infections has been suggested, but the specific mechanism is unclear. This study aimed to analyze the body temperature, immune function, and wound infection rates in patients receiving open surgery for gastric cancer. Body temperature was controlled in each patient using one of four different methods: wrapping limbs, head and neck; insulated blankets; warming infusion fluids and insulated blankets; and warming fluids without insulated blankets. One hundred patients were randomly divided into four groups of 25 patients each, and every group received a different intraoperative treatment for maintaining normal body temperature. Nasopharyngeal and rectal temperatures, transforming growth factor beta (TGF-β), interleukin 10 (IL-10) levels, and cluster of differentiation (CD)3+T and CD4+/CD25+ regulatory T cell (Treg) counts were measured before surgery and at 2 and 4 hours postoperatively. Patients were evaluated at one week after surgery for signs of infection. Intraoperative body temperature and measures of immune function varied significantly between the four groups, with the largest temperature changes observed in the group in which only the limbs were wrapped in cotton pads to control the body temperature. The lowest temperature change (i.e., close to normal temperature) and cytokine response after surgery were observed in the group in which infusion fluids and transfused blood (if needed) were heated to 37℃, peritoneal irrigation fluid was heated to 37℃, and an insulation blanket was heated to 39℃ and placed under the patient. No intergroup differences were found in the infection rates at one week after surgery. In conclusion, body temperature variation during surgery affects the immune function of patients, and maintaining body temperature close to normal results in the least variation of immune function.

Effect of temperature maintenance by forced-air warming blankets of different temperatures on changes in inflammatory factors in children undergoing congenital hip dislocation surgery

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Surgical site infection following operative treatment of open fracture: Incidence and prognostic risk factors

“…Interoperative use of anaesthetic agents and intravenous solutions, especially multiple application of cold irrigation in debridement of open fractures, was due to low body temperature in anaesthetic‐surgical procedures. Hypothermia can lead to dysfunction of coagulation and contraction of vasculature around surgical site, this circumstance will compromise the immunity of tissue to pathogenic microorganism, and the underlying mechanism of low temperature affecting immune response has been reported . However, inadvertent intraoperative hypothermia is common but preventable adverse event.…”

Monitorização de complicações pós-operatórias no ambiente domiciliar

“…Alterações leves de temperatura podem resultar em desfechos desfavoráveis, sobretudo em cirurgias grandes, motivo pelo qual se configurem em um é um dos parâmetros fisiológicos que deve ser mais rigorosamente controlado. Segundo achados de um ensaio clínico chinês (18) , a variação da temperatura corporal durante o perioperatório afeta significativamente a função imunológica dos pacien-tes em um longo período pós-cirurgia, aumentando, assim, as chances de óbito.…”