Determinants of core temperature at the time of admission to intensive care following cardiac surgery

Post-operative Hypothermia in Surgical Patients at University of Gondar Hospital, Ethiopia

“…Accordingly, those who took general anesthesia had lower temperatures than spinal anesthesia (AOR, 1.84; 95% CI, 1.17; 3.24). This finding corroborates with literature, indicating that general anesthesia poses higher risk of postoperative hypothermia [20,26,40,41]. Regardless of the type of anesthesia selected, derangement of pre and intra-operative body temperature may have an impact on postoperative temperature.…”

“…This may cause prolonged hospital stay, surgical site infection, postoperative blood transfusions, pressure ulcers, subjective discomfort and mortality [13][14][15][16]. The occurrence of postoperative hypothermia is associated with older age [16], female, emergency surgery [19], higher American Society of Anesthesiology physical status, major surgical procedure, amount of intravenous or blood replaced, longer duration of anesthesia or surgery, operating room temperature [20,21], preoperative body temperature and anesthetic technique [22].…”

Low cardiopulmonary bypass perfusion temperatures are associated with acute kidney injury following coronary artery bypass surgery

“…However, examination of nasopharyngeal temperature as an independent variable for postoperative renal function, although clinically relevant, has a limited pathophysiological significance. It is the temperature of the perfusate interacting with nephrons, which may be protective or injurious to the kidney, as core temperature is dependent on other parameters, including ambient temperature, body habitus and percent body fat and total intraoperative crystalloid administration [17]. This significant limitation was also present in a large cohort analysis of normothermia (37 8C, n = 2585) versus hypothermia (25-30 8C, n = 1605) based on bladder temperature measurement [18].…”

Pulmonary artery blood temperature at admission to the intensive care unit is predictive of outcome after on‐pump coronary artery bypass surgery

“…Interestingly, the authors attempted to determine the cause of afterdrop and residual hypothermia after cardiac surgery by randomizing patients to different ambient (16-18°C vs 21-23°C) and perfusion rewarming strategies (bladder temperature !34.0°C vs !36°C) and then evaluating the correlation between temperature monitoring sites at the time of separation from cardiopulmonary and PA temperature at admission to the ICU. Despite such different rewarming strategies achieved significantly different bladder temperature on separation from CPB (mean bladder temperature in each of the four randomized groups ranging from 35.1 to 36.8°C, p < 0.0001), the PA temperature at admission to the ICU did not differ significantly in the study groups (50). This observation confirms that PA temperature at admission to the ICU can be rather low despite an aggressive rewarming in the operating room.…”

“…Insler et al (2) referred to the bladder temperature as the core temperature, but this does not necessarily reflect the PA temperature which is generally considered as the core temperature. El-Rahmany et al (50) observed that the correlation coefficient between PA temperature at admission to the ICU and other core (nasopharynx or esophagus) and peripheral sites (urinary bladder or rectum) temperatures as measured at the time of separation from CPB were somewhat low. Interestingly, the authors attempted to determine the cause of afterdrop and residual hypothermia after cardiac surgery by randomizing patients to different ambient (16-18°C vs 21-23°C) and perfusion rewarming strategies (bladder temperature !34.0°C vs !36°C) and then evaluating the correlation between temperature monitoring sites at the time of separation from cardiopulmonary and PA temperature at admission to the ICU.…”