Examination of intra-operative core temperature in joint arthroplasty: a single-institution prospective observational study

Matos, Jennifer R.; McSwain, Julie R.; Wolf, Bethany J.; Doty, J. Wesley; Wilson, Sylvia H.

doi:10.1007/s00264-018-3967-y

Cited by 13 publications

(12 citation statements)

References 27 publications

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“…Hannan et al (4) retrospectively analyzed 2,294 OPCAB patients in New York in 2007 and found that postoperative respiratory complications in patients with perioperative hypothermia were associated with increased incidence of reoperating, prolonged hospital stay, and increased mortality. A similar conclusion was also reached by a prospective observational study this year: perioperative hypothermia associates with increased blood loss, delayed wound healing, increased surgical-related infection, and prolonged hospital stay (28). The study followed up the short-term prognosis of patients (Table 5).…”

Section: Discussionsupporting

confidence: 58%

Intraoperative thermal insulation in off-pump coronary artery bypass grafting surgery: a prospective, double blind, randomized controlled, single-center study

Lin¹,

Han²,

Li³

et al. 2020

Ann Transl Med

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Background: About 50% patients who underwent off-pump coronary artery bypass grafting (OPCAB) experienced perioperative hypothermia. Pre-warming and intraoperative infusion of amino acid injection are the most popular perioperative insulation measures in recent years, but neither of them can completely prevent intraoperative hypothermia. The objective is to investigate the effect of preoperative warming and/ or intraoperative infusion of amino acid injection on body temperature in patients undergoing OPCAB.Methods: A prospective, double blind, randomized controlled, single-center study. Seventy-two patients were randomly divided into 4 groups: control group, pre-warming group, amino-acid group and multi-mode group. Pre-warming and multi-mode group were pre-heated with warming blankets and forced-air warming system before induction. After that, amino-acid and multi-mode group were infused with 18-amino acid solution. The perioperative temperature and complications were monitored.Results: The temperature of control and amino-acid group decreased significantly, but amino-acid group recovered to preoperative level faster. The temperature of pre-warming group was stable, and that in multimode group increased at 60 min after the start of surgery. There was a significant difference in temperature at each time, and no difference in the incidence of complications between the groups.Conclusions: Preoperative warming and/or intraoperative infusion of amino acid injection can effectively reduce hypothermia in OPCAB surgery. Pre-warming before anesthesia is more effective, and the combination of the two methods has the best effect.

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Section: Discussionsupporting

confidence: 58%

Intraoperative thermal insulation in off-pump coronary artery bypass grafting surgery: a prospective, double blind, randomized controlled, single-center study

Lin¹,

Han²,

Li³

et al. 2020

Ann Transl Med

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“…The incidence of hypothermia reported by previous studies varied widely from 11.2% to 43.9% [11][12][13], which may be caused by different warming methods, anesthesia procedure, and operating room environment. According to previous studies, female gender, lower BMI, knee arthroplasty, neuraxial anesthesia, lower preoperative temperature, lower operating room temperature, and longer operation time are the risk factors for hypothermia in TJA [11,13,16]. Therefore, measures improving the control of modifiable risk factors may be able to reduce the rate of hypothermia.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Intraoperative Hypothermia on Blood Loss and Allogenic Blood Transfusion in Total Knee and Hip Arthroplasty: A Retrospective Study

Pan

Song

Yao

et al. 2020

BioMed Research International

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Background. Total joint arthroplasty (TJA) usually leads to substantial blood loss, which may cause allogenic blood transfusion. Hypothermia occurring during operation has been reported to increase blood loss and transfusion rates in nonorthopedic cohorts. However, the relationship between intraoperative hypothermia and blood loss remains controversial in patients undergoing orthopedic surgeries. The aims of this study were to investigate the incidence of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty (TKA and THA, respectively). Methods. This retrospective study enrolled 616 consecutive patients, who underwent primary unilateral TKA or THA at our institution during the period from April 2012 to July 2014. The occurrence of a temperature below 36°C during the operation was documented to identify the incidence of hypothermia. Univariate analysis was performed to find the risk factors for hypothermia. Multiple regression analysis and multivariate logistic regression analysis were employed to explore the association of intraoperative temperature and hypothermia with intraoperative blood loss and perioperative blood transfusion. Results. The incidence of intraoperative hypothermia was 13.5%, 14.0%, and 13.1% in TJA, TKA, and THA, respectively. Intraoperative temperature (P=0.045, P=0.006) and hypothermia (P=0.042, P<0.001) were associated with intraoperative blood loss and perioperative transfusion in TKA. Intraoperative temperature (P=0.002) was negatively related to the amount of blood loss, and hypothermia (P=0.031) was the independent risk factor for transfusion in THA. Conclusion. Intraoperative hypothermia is associated with increased blood loss and transfusion rates in TJA. Efforts should be made to maintain normothermia during operation in these patients.

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“…Of relevant factors, the most important is organ/tissue perfusion and oxygenation. Perioperative hypothermia induces poor tissue perfusion, and several strategies have been proposed to avoid it, including preoperative or intraoperative warming [164,165]. A benefit of perioperative hyperoxia in non-critically ill adults has not been demonstrated [166].…”

Section: Intraoperative Care For Tja Patientsmentioning

confidence: 99%

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

Gallo

Nieslanikova

2020

JCM

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A projected increased use of total joint arthroplasties will naturally result in a related increase in the number of prosthetic joint infections (PJIs). Suppression of the local peri-implant immune response counters efforts to eradicate bacteria, allowing the formation of biofilms and compromising preventive measures taken in the operating room. For these reasons, the prevention of PJI should focus concurrently on the following targets: (i) identifying at-risk patients; (ii) reducing “bacterial load” perioperatively; (iii) creating an antibacterial/antibiofilm environment at the site of surgery; and (iv) stimulating the local immune response. Despite considerable recent progress made in experimental and clinical research, a large discrepancy persists between proposed and clinically implemented preventative strategies. The ultimate anti-infective strategy lies in an optimal combination of all preventative approaches into a single “clinical pack”, applied rigorously in all settings involving prosthetic joint implantation. In addition, “anti-infective” implants might be a choice in patients who have an increased risk for PJI. However, further progress in the prevention of PJI is not imaginable without a close commitment to using quality improvement tools in combination with continual data mining, reflecting the efficacy of the preventative strategy in a particular clinical setting.

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Examination of intra-operative core temperature in joint arthroplasty: a single-institution prospective observational study

Cited by 13 publications

References 27 publications

Intraoperative thermal insulation in off-pump coronary artery bypass grafting surgery: a prospective, double blind, randomized controlled, single-center study

Intraoperative thermal insulation in off-pump coronary artery bypass grafting surgery: a prospective, double blind, randomized controlled, single-center study

The Impact of Intraoperative Hypothermia on Blood Loss and Allogenic Blood Transfusion in Total Knee and Hip Arthroplasty: A Retrospective Study

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

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