Postoperative hypothermia and patient outcomes after elective cardiac surgery

Abstract

Summary Hypothermia after elective cardiac surgery is an important physiological abnormality and is associated with increased morbidity and mortality. The Australian and New Zealand intensive care adult patient database was studied to obtain the lowest and highest temperature in the first 24 h after surgery. Hypothermia was defined as core temperature < 36 °C; transient hypothermia as temperature < 36 °C that was corrected within 24 h; and persistent hypothermia as hypothermia that was not corrected within 24 h. Hypothermia occurred in 28 587 out of a total of 43 158 consecutive patients (66%) and was persistent in 111 (0.3%). Transient hypothermia was not independently associated with increased hospital mortality (OR = 0.9, 95% CI 0.8–1.1), whereas persistent hypothermia was associated with markedly increased risk of death (OR = 6.3, 95% CI = 3.3–12.0). Hypothermia is common in postoperative cardiac surgery patients during the first 24 h after ICU admission but, if transient, is not independently associated with an increased risk of death.

Concurrence of Intraoperative Hypotension, Low Minimum Alveolar Concentration, and Low Bispectral Index Is Associated with Postoperative Death

“…Perioperative hypothermia may be a confounder as it is associated with decreased BIS values during cardiopulmonary bypass and increased cardiac morbidity, coagulation dysfunction, and mortality. 28–32 This study identified a positive association between temperatures and BIS values while patients were not on cardiopulmonary bypass. However, the lack of association between temperature and postoperative mortality may be due to the fact that there were relatively few epochs of severe hypothermia.…”

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Postoperative hypothermia and outcomes after cardiac surgery

“…We read with interest the article by Karalapillai et al [1]. As the authors pointed out, the study's strength lies in its large size and integration of data from multiple centres.…”

“…A recent National Patient Safety Agency release has emphasised the importance of reliable and available airway suction equipment [1]. A common method of providing suction within the operating theatre is via a centralised vacuum system, comprising a pump, receiver and filter [2,3].…”