Hipotermia no período intra-operatório: é possível evitá-la?

Abstract

The objective of this study was to identify what measures are taken to prevent hypothermia in the intraoperative period. This is a non-experimental, descriptive-exploratory prospective study. To do this, a data collection instrument was developed, which was submitted to appearance and content validations. The sample consisted of 70 patients. The measure that was most commonly used in the operation room was the passive skin heating, such as using cotton sheets (11.4%) and bandaging the patient's lower limbs (14.3%). There was only one occurrence of active skin heating (1.4%). Results show there is a need to implement effective interventions to prevent hypothermia, and nurses play an important role in this context, as patient safety and avoiding complications due to the surgical anesthetic procedure are nursing care goals.

The association between complications in patients during the anesthetic recovery period and the physiological conditions experienced in the preoperative period

“…(ASPAN, 2012) The third most frequent complication was hypothermia, with a mean of 21.7% patients. This complication is defined as a body temperature below than 36º C. (POVEDA; GALVÃO, 2011;CASTRO et al, 2012) Among the factors that may contribute to the development of hypothermia, the most common in post-surgical patients included: Temperature of the operatory room, infusion of cold solutions in body cavities or intravenously, patient's age, muscle relaxation, exposure of body cavities, length of time for the surgery, type of surgery, and ventilation without heated gases. (GALVÃO, 2011;CASTRO et al, 2012;POVEDA;DE MATTIA et al, 2013) It is extremely important that the health team involved with patient's care during the anesthetic recovery period prevent these complications.…”

“…This complication is defined as a body temperature below than 36º C. (POVEDA; GALVÃO, 2011;CASTRO et al, 2012) Among the factors that may contribute to the development of hypothermia, the most common in post-surgical patients included: Temperature of the operatory room, infusion of cold solutions in body cavities or intravenously, patient's age, muscle relaxation, exposure of body cavities, length of time for the surgery, type of surgery, and ventilation without heated gases. (GALVÃO, 2011;CASTRO et al, 2012;POVEDA;DE MATTIA et al, 2013) It is extremely important that the health team involved with patient's care during the anesthetic recovery period prevent these complications. It is especially important for the nursing team, once these complications can contribute to increase the occurrence of alterations such as cardiac morbidity, arrhythmias, elevation of catecholamine, hormonal changes, coagulopathies, increasing the surgical site infection, as well as prolonging the length of time for the patient's recovery that may extend even after the patient discharge from the PACU.…”

“…It is especially important for the nursing team, once these complications can contribute to increase the occurrence of alterations such as cardiac morbidity, arrhythmias, elevation of catecholamine, hormonal changes, coagulopathies, increasing the surgical site infection, as well as prolonging the length of time for the patient's recovery that may extend even after the patient discharge from the PACU. (DE MATTIA et al, 2010;POVEDA;GALVÃO, 2011;CASTRO et al, 2012) Thus, planning actions to control these complications should be performed throughout the perioperative period.…”

Infusão venosa aquecida relacionada à prevenção das complicações da hipotermia intraoperatória

“…A prevenção de complicações inerentes ao procedimento anestésico-cirúrgico consiste em papel crucial do Enfermeiro, o qual é responsável pelo planejamento e pela implementação de intervenções que minimizem os riscos e assegurem privacidade e segurança para o paciente cirúrgico. Neste cenário, compete ao Enfermeiro a implantação de intervenções eficazes que proporcionam a prevenção ou o tratamento da hipotermia e, consequentemente, a diminuição das complicações associadas a este evento 17,18 .…”

Hipotermia inadvertida perioperatória em pacientes cirúrgicos no Brasil: como estamos prevenindo?

“…Apesar das recomendações para utilização de métodos passivos para a manutenção da normotermia em pacientes que não apresentem fatores de risco para o desenvolvimento de hipotermia inadvertida, existe um consenso entre estudos que as medidas passivas preventivas para a manutenção da normotermia no período intraoperatório não são tão efetivas quando utilizadas como método exclusivo, sendo necessário à implementação de um método ativo associado, aumentando sua eficácia [41][42] .…”