Perioperative temperature measurement and management: moving beyond the Surgical Care Improvement Project

Abstract

Intraoperative management of patient body temperature is a standard of care for practicing anesthesiologists. Merely complying with the Surgical Care Improvement Project (SCIP) measurement is inadequate for optimizing perioperative outcomes. Clinicians should have a sound understanding of available temperature monitoring sites, deleterious effects of hypothermia, and indications for therapeutic hypothermia. This foundation will help physicians use indicated modalities to improve patient outcomes throughout the perioperative period. The purpose of this paper is to review appropriate intraoperative temperature monitoring, the importance of maintaining normothermia, and indications for intraoperative hypothermia.

Incidence of postoperative hypothermia and its risk factors in adults undergoing orthopedic surgery under brachial plexus block: A retrospective cohort study

“…Because infrared tympanic thermometers often measure only the temperature of the aural canal or the area near the temporal artery, and not that of the tympanic membrane, temperatures measured using these thermometers may show differences > 1°C from the actual core temperature 12 , 28 . Accuracy can also be affected by the user, structure of the aural canal, skin temperature on the face, and exudate and fluid in the ears 12 , 29 . In recent studies 30 , 31 , new non-invasive thermometers, such as the 3M SpotOn® and Dräger Tcore®, have shown high accuracy and precision for measuring core temperature in patients undergoing general anesthesia.…”

Effect of post-storage filters vs. pre-storage filters for leukoreduction of blood components on clinical outcomes: A systematic review

“…Notably, only one study raised the issue of premedication, in this case, for anesthetized patients, and discarded premedication in patients with a history of previous reactions 20 . TR identi cation is more complicated in anesthetized patients, mainly due to the possibility of developing an adverse reaction to the drugs used 52 and even hypothermia associated with exposure during surgical procedures 53,54 . Pre transfusion medication to minimize some TR symptoms is still used but is controversial and may mask the side effects of transfusion 55,56 .…”

Initial treatment priorities for the physiological optimization of patients with severe traumatic brain injury

“…The association between trauma and the administration of anticoagulant medications is difficult to assess because patients may have one or more medical comorbidities that could influence outcome. Trauma patients who are hypothermic at admission also have an increased risk of mortality even in the setting of isolated severe brain injury 3 . A large portion of the care of the patient with a traumatic brain injury (TBI) is nonsurgical.…”

“…Of the patients who die from severe brain injury, 60% will die before they reach the hospital and about another quarter will die in the first 24 h 2 . Risk factors associated with an increase in mortality include older age, higher injury severity scores, loss of consciousness, the consumption of anticoagulants and/or antiplatelet medications and hypothermia [1][2][3][4][5][6][7] Although the consumption of an antiplatelet medication increases the risk of mortality, each additional antiplatelet medication does not confer a larger increase in risk 4,5 . The association between trauma and the administration of anticoagulant medications is difficult to assess because patients may have one or more medical comorbidities that could influence outcome.…”