Prewarming: Preventing Intraoperative Hypothermia

Abstract

Perioperative hypothermia can be followed by severe complications. The greatest proportion of temperature decrease is attributed to heat redistribution, which mainly occurs during the first hour of anaesthesia and is difficult to treat intraoperatively. Prewarming, based on active warming techniques, has been proposed. Even a short period of prewarming may significantly increase peripheral tissue temperature, minimise normal core-to-peripheral temperature gradient, and keep core temperature within normal limits.

Unintentional Hypothermia: Implications for Perianesthesia Nurses

“…The physiological effects reflect an overall depression of metabolism affecting all body systems (Table 2). 4,5,8,[10][11][12][13] In addition to the physiological effects of hypothermia, other potentially deleterious effects include alteration in wound healing, myocardial infarction, coagulopathy, increased infection rates, and prolonged emergence after anesthesia because of decreased drug metabolism, as well as psychological effects including pain, stress, and altered cognitive functioning (Table 3). 12 Although all patients are potentially affected by the adverse physiological responses associated with hypothermia, infants, the elderly and debilitated, patients with burns and trauma, and the malnourished represent patient categories at greatest risk for developing physiological alterations (Table 4).…”

“…1,11 In contrast, regional anesthesia produces a centrally mediated vasodilatation and inhibits vasoconstriction peripherally, causing a redistribution of internal body heat, resulting in heat loss. 1,10 Research demonstrates a predictable pattern of heat loss for most patients as a result of the anesthetic-induced impairment of thermoregulation combined with exposure to the cold operating room (OR). 1,3,6 Anesthesia-induced heat loss occurs in three phases.…”

Factors Influencing Body Temperature in Elderly Surgical Patients

“…또 체온변화에 대한 감지 의 둔화로 체열의 생산 및 보존 능력이 감소되어 노인수술 환자는 저체온에 매우 취약하다 (Kongsayreepong et al, 2003). (Kiekkas & Karga, 2005).…”

Hypothermia in cardiac surgery

“…Eine Wärmezufuhr über dorsale Wärme-matten, die Anwendung von angewärm-ten Infusionslösungen, die Erhöhung der (im Herz-OP meist niedrigen) Saaltemperatur u. a. sind teilweise zwar effektiv [6], reichen als alleinige Maßnahmen zur vollständigen Kompensation auftretender Wärmeverluste jedoch nicht aus. Als besonders effektiv hat sich eine Vorwär-mung ("prewarming") erwiesen, die vor und während der präoperativen anästhe-siologischen Maßnahmen durchgeführt wird [6,16]. Sie ist zwar aufwendig und erfordert eine gute Organisation, kann aber auch im Herz-OP ohne Verlängerung der präoperativen Vorbereitungszeit eingesetzt werden.…”