Perioperative Hypothermia
Background
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Decrease in core body temperature which develops in nearly all unwarmed surgical patients
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Mild: 35-33℃
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Moderate: 33-27℃
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Severe: <27℃
Causes
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Thermoregulatory impairment during general & neuraxial anesthesia
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Decreased ambient room temperature
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Increased heat loss from open body cavities
Considerations
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Consequences of hypothermia
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Impaired coagulation
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Increased risk of infection
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Prolonged drug effects (prolongs NDMRs, decreases MAC)
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Delayed emergence
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Potential for shivering --> ↑ metabolic rate & patient discomfort
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Sympathetic stimulation --> ↑ risk of myocardial ischemia
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Prevention
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Pre-warm patient & use passive insulation (i.e. blanket)
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Active warming techniques:
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Forced air
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Resistive heating
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Circulating water garment devices
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Use warm IV fluids & irrigation fluids
Reference
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Riley C, Andrzejowski J. Inadvertent perioperative hypothermia. BJA Educ. 2018 Aug;18(8):227-233. doi: 10.1016/j.bjae.2018.05.003. Epub 2018 Jun 28. PMID: 33456837; PMCID: PMC7807998.