The effects of warming fluid on hypothermia, blood transfusion in hip replacement

Abstract

Aim: Inadvertent intraoperative hypothermia is a common problem but it can be avoided. Passive isolation and active heating methods are used to prevent inadvertent intraoperative hypothermia. The aim of this study was to investigate the effect of warming intravenous fluids on hypothermia, blood loss, and transfusion in total hip replacement surgery. Material and Methods: After the approval of the ethics committee was obtained, the files of 69 patients who underwent total hip replacement operation between December2014 and July2015 as well as the hospital's data system were analyzed retrospectively. Nine patients with missing data were excluded. We included in the study 60 patients aged 30-90 years, with ASA1-3,weighing 50-100kg, normal coagulation tests normal and spinal anesthesia. The patients were divided into two groups as Group1(n=28), in which the intraoperative intravenous fluids were warmed and Group2(n=32),in which liquids were not warmed. Groups were analyzed with regard to hypothermia, amount of bleeding, transfused blood, amount of fluid injected intraoperatively, and pre-postoperative hemoglobin-hematocrit changes. Results: Hypothermia was observed in both groups. In Group 1, body temperature was significantly higher than Group 2. The amount of fluid given(lt) and the amount of blood loss(ml) were both significantly lower while postoperative hemoglobin-hematocrit values were significantly higher in Group 1(p <0.05). No significant difference was found between the two groups in terms of blood transfusion. Discussion: Hypothermia is a problem in hip replacement surgery. Although we have used the convective air warming system and heated intravenous fluids, we observed intraoperative hypothermia in both groups. Therefore, we suggest that temperature monitoring and patient warming should be a routine procedure in the pre-intra-postoperative phase.