Magnitude and associated factors of intra operative hypothermia among pediatric patients undergoing elective surgery atXX Comprehensive Specialized Hospital 2023: prospective observational cross sectional study Tigray, Ethiopia

Abstract

Background: Hypothermia is characterized by a drop in core body temperature of less than 36 °C. It occurs frequently throughout the operating period and affects surgical patient outcomes differently in terms of morbidity and mortality. Because of coagulopathy, metabolic acidosis, multiple organ failure, hemodynamic instability, and infections, a core temperature below 34 °C is strongly associated with mortality. Objective: This study aimed to assess the magnitude and associated factors of intra-operative hypothermia in pediatric patients undergoing elective surgery at the Ayder Comprehensive Specialized Hospital. Method: A prospective observational cross-sectional study was conducted on 399 pediatric patients undergoing elective surgery at Ayder Comprehensive Specialized Hospital in Tigray, Ethiopia, from May 1, 2023, to July 30, 2023. Participants in the study were selected by a systematic random sampling technique. The data collection procedure was chart review and intra-operative temperature measurement, and the collected data were analyzed by SPSS version 23. The independent variables were analyzed using binary and multi-logistic regression. The odds ratio, 95% confidence interval, and p-value of <0.05 were considered statistical significance. Result: The magnitude of intra-operative hypothermia was 52.9%. Neonate and infant [AOR: 6, 95% CI: 3.7, 9.8], (AOR=4.5, 95% CI: 2.9, 7) respectively, volume of fluid administered greater than half liter [AOR: 4.37, (95% CI, 3, 6.4)], patients who underwent surgery during the morning [AOR: 5.3, (95% CI: 3.8, 7.4)], and duration of surgery and anesthesia greater than 120 minutes [AOR: 2.7, (95% CI, 1.8, 4)] and (AOR=3.4, 95% CI, 2.4, 4.9], respectively, were factors significantly associated with intra-operative hypothermia. Conclusion and Recommendation: This study revealed a high magnitude of intraoperative hypothermia among pediatric patients. Being neonates and infants, having a cold volume of IV fluid administered greater than half a liter, entering surgery during the morning, the duration of surgery, and the anesthesia time were significantly associated with intra-operative hypothermia. We would like to advise anesthetists to use warm intravenous fluids, calculate IV fluids, and maintain room temperature.