Preventing perioperative hypothermia: an integrative literature review

Abstract

Context: During surgery, many patients become hypothermic. Health complications resulting from hypothermia lead to longer hospital stays and increased healthcare costs. Objective: To identify in empirical research results the active warming systems that proved to be most effective in the pre and intraoperative periods to prevent perioperative hypothermia. Methodology: The search was performed using the following keywords: Hypothermia, perioperative nursing, anaesthesia and rewarming. Publications from the last five years (2007-2012), with full text, and written in English, Spanish or Portuguese were included. Articles on pregnant women, neurocritical patients, induced hypothermia and the variables affecting hypothermia were excluded. Results: A total of 30 articles were obtained, seven of which were selected for analysis. Conclusion: Active warming methods are effective measures for the prevention of hypothermia; the combination of warming methods is more effective than an isolated use; and, finally, the forced-air system and circulating water garments proved to be the most effective active warming methods.

Hipotermia no pós-operatório imediato: percepção de técnicos de enfermagem

“…A hipotermia pode ser responsável por complicações severas no organismo, principalmente no paciente que se encontra no POI. O paciente cirúrgico passa por situações que exigem o bom funcionamento das funções metabólicas, as quais podem ser alteradas pela hipotermia 3,4,14 .…”

“…Entre as complicações pós-operatórias a que o paciente cirúrgico está sujeito, destaca-se a hipotermia 2 . Grande parte dos pacientes submetidos à anestesia a apresenta, em virtude de alterações na termorregulação provocadas pelo efeito anestésico que pode reduzir até 20% da produção metabólica de calor 3,4 , mas também por outros fatores, como baixa temperatura da SO, infusão de líquidos frios, perda de sangue, tempo prolongado de cirurgia, entre outros 5 .…”

Determining the Knowledge and Interventions by Surgical Nurses for Inadvertent Perioperative Hypothermia Care

“…37 Lopes ve ark.nın çalışmasında, aktif ısıtma yöntemlerinin hipoterminin önlenmesinde en etkili yöntem olduğu ve ısıtma yöntemlerinin kombine uygulanmasının tek başına pasif ısıtma yöntemlerinden daha etkili olduğu saptanmıştır. 38 Hemşirelerin vakaya göre ameliyat öncesi ve sırası dönemdeki hastada İPH risk faktörlerini doğru bilme oranları sırasıyla %55 ve %76,8 iken, ameliyat sonrası dönemde %29,5'tir. Benzer şekilde, vakaya göre ameliyat öncesi ve sırası dönemde hastadaki İPH risk faktörleri yönetimi bilgi sorularına verilen doğru yanıt oranları sırasıyla %65,7 ve %62,7 iken, ameliyat sonrası dönemde %32,4'tür.…”

Preoperative Forced-Air Warming of Patients to Minimize Inadvertent Perioperative Hypothermia: A Systematic Review

“…Vasoconstriction is inhibited at the induction of anesthesia due to volatile anesthetics and core body temperature cannot be maintained (Guedes Lopes, Sousa Magalhães, Abreu de Sousa, & Batista de Araújo, 2015). Temperature of the operating room based on the surgeon's preference, temperature of intravenous fluids and the length of surgery are factors that can also contribute to hypothermia in the perioperative period (Guedes Lopes et al).…”

“…Young or old age, low body mass index, trauma, sepsis, burns and perioperative hypotension are elements that carry a greater risk of hypothermia (Guedes Lopes et al, 2015). During the perioperative period, many characteristics and factors may be present that can increase the incidence of IPH in patients undergoing general anesthesia and surgery…”