Perioperative Normothermia During Major Surgery: Is It Important?

PH caused by anesthesia-induced thermoregulatory inhibition and exposure to cold operating room environments still occurs in a significant proportion of patients undergoing major surgery. Although the association between specific perioperative temperatures (in and of themselves) and postoperative mo...

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Bibliographic Details
Published in:Advances in surgery (Chicago) 2011, Vol.45 (1), p.249-263
Main Authors: Esnaola, Nestor F., MD, MPH, MBA, Cole, David J., MD
Format: Article
Language:English
Subjects:
Blood Coagulation - physiology
Body Temperature Regulation - physiology
Humans
Hypothermia - physiopathology
Hypothermia - prevention & control
Perioperative Period
Surgery
Surgical Procedures, Operative
Surgical Wound Infection - physiopathology
Thermometers
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Summary:PH caused by anesthesia-induced thermoregulatory inhibition and exposure to cold operating room environments still occurs in a significant proportion of patients undergoing major surgery. Although the association between specific perioperative temperatures (in and of themselves) and postoperative morbidity remains unclear, there is fair evidence to suggest that perioperative active warming may reduce the risk of postoperative cardiac events, bleeding, and SSIs. As such, proactive efforts by surgical teams to prevent PH are warranted and have become the standard of care at many institutions. Continued intraoperative monitoring of core temperature (ideally using esophageal probes) is recommended in all cases lasting more than 30 minutes, both to detect malignant hyperthermia and to maintain normothermia. Preoperative and/or intraoperative use of warmed forced-air devices is an effective way to minimize redistribution hypothermia following induction, whereas intraoperative use of warmed i.v. fluids helps reduce the potential for fluid-induced hypothermia and, in turn, optimizes rates of perioperative normothermia.
ISSN:0065-3411
1878-0555
DOI:10.1016/j.yasu.2011.03.007