Prevalence of hypothermia on admission to recovery room remains high despite a large use of forced-air warming devices: Findings of a non-randomized observational multicenter and pragmatic study on perioperative hypothermia prevalence in France

Alfonsi, Pascal; Bekka, Samir; Aegerter, Philippe

doi:10.1371/journal.pone.0226038

Cited by 38 publications

(47 citation statements)

References 33 publications

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“…However, it has not been reported whether it could also decrease the rate of perioperative hypothermia when compared to an open approach [ 5 ]. Inadvertent hypothermia is common in the perioperative period, affecting 50–90% of patients undergoing surgery [ 6 , 7 , 8 , 9 ]. Perioperative hypothermia can increase intraoperative bleeding [ 10 ], surgical wound infection [ 11 ], discomfort, and length of hospital stay [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Short-Periods of Pre-Warming in Laparoscopic Surgery. A Non-Randomized Clinical Trial Evaluating Current Clinical Practice

Becerra

Valencia

Villar

et al. 2021

JCM

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Background: Pre-warming prevents perioperative hypothermia. We evaluated the current clinical practice of pre-warming and its effects on temperature drop and postoperative complications; Methods: This prospective, observational pilot study examines clinical practice in a tertiary hospital on 99 patients undergoing laparoscopic urological surgery. Pre-warming was performed in the pre-anesthesia room. Patients were classified into three groups: P 0 (non-prewarmed), P 5–15 (pre-warming 5–15 min) and P > 15 (pre-warming 15–30 min). Tympanic temperature was recorded in the pre-anesthesia room, prior to anesthesia induction, and in the PACU. Esophageal temperature was recorded intraoperatively. The occurrence of shivering, pain intensity, length of stay in PACU, and postoperative complications during hospital stay were also recorded; Results: After pre-warming, between-group difference in body temperature was higher in P > 15 than in P 0 (0.4 °C, 95% CI 0.14–0.69, p = 0.004). Between P 5–15 and P 0 difference was 0.2 °C (95% CI 0.04–0.55, p = 0.093). Temperature at the end of surgery was higher in pre-warmed groups [mean between-group difference 0.5 °C (95% CI 0.13–0.81, p = 0.007) for P 5–15; 0.9 °C (95% CI 0.55–1.19, p < 0.001) for P > 15]. Pain and shivering was less common in pre-warmed groups. Postoperative transfusions and surgical site infections were lower in P > 15; Conclusion: Short-term pre-warming prior to laparoscopic urological surgery decreased temperature perioperative drop and postoperative complications.

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Section: Introductionmentioning

confidence: 99%

Short-Periods of Pre-Warming in Laparoscopic Surgery. A Non-Randomized Clinical Trial Evaluating Current Clinical Practice

Becerra

Valencia

Villar

et al. 2021

JCM

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“… 10 , 13 , 39 Provision of non-invasive, continuous monitoring devices, such as the ZHF device, may increase willingness to monitor and record, as well as awareness of, intraoperative core temperature. 40 …”

Section: Discussionmentioning

confidence: 99%

Zero-Heat-Flux and Esophageal Temperature Monitoring in Orthopedic Surgery: An Observational Study

Munday¹,

Higgins²,

Jones³

et al. 2021

JMDH

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Perioperative hypothermia prevention requires regular, accurate, and consistent temperature monitoring. Zero-heat-flux (ZHF) thermometry offers a non-invasive, measurement method that can be applied across all surgical phases. The purpose of this study was to measure agreement between the zero-heat-flux device and esophageal monitoring, sensitivity, and specificity to detect hypothermia and patient acceptability amongst patients undergoing upper and lower limb orthopedic surgery. Patients and Methods: This prospective, observational study utilized Bland-Altman analysis and Lin's concordance coefficient to measure agreement between devices, sensitivity and specificity to detect hypothermia and assessed patient acceptability amongst 30 patients between December 2018 and June 2019. Results: Bias was observed between devices via Bland Altman, with bias dependent on actual temperature. The mean difference ranged from −0.16°C at 34.9°C (where the mean of ZHF was lower than the esophageal device) to 0.46°C at 37.25°C (where the mean of ZHF was higher than esophageal device), with 95% limits of agreement (max) upper LOA = 0.80 to 1.41, lower LOA = −1.12 to −0.50. Seventy-five percentage of zero-heat-flux measurements were within 0.5°C of esophageal readings. Patient acceptability was high; 96% (n=27) stated that the device was comfortable. Conclusion: ZHF device achieved lesser measurement accuracy with core (esophageal) temperature compared to earlier findings. Nonetheless, due to continuous capability, noninvasiveness and patient reported acceptability, the device warrants further evaluation.

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“…A previous study showed that benzodiazepines could influence the balance between heat production and cutaneous heat loss, and produce a concentration-dependent decrease in core temperature by 0.3°C to 0.6°C, which impaired tonic thermoregulatory vasoconstriction. [ 25 ] Likewise, patients with a tympanic temperature of less than 36.0°C were excluded from the study, even though a core temperature <36.0°C could be considered as normal in a subset of normal individuals. [ 26 ] Consistent with previous studies, patients in the prewarming group experienced a smaller drop in core temperature after induction of anesthesia in our study.…”

Section: Discussionmentioning

confidence: 99%

Effects of a preoperative forced-air warming system for patients undergoing video-assisted thoracic surgery

Xiao¹,

Zhang²,

Lv³

et al. 2020

Medicine

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Background: The incidence of intraoperative hypothermia is still high despite the proposal of different preventive measures during thoracoscopic surgery. This randomized control study evaluated the effects of 30-minute prewarming combined with a forced-air warming system during surgery to prevent intraoperative hypothermia in patients undergoing video-assisted thoracic surgery under general anesthesia combined with erector spinae nerve block. Methods: Ninety-eight patients were randomly and equally allocated to prewarming or warming groups (n = 49 each). The primary outcome was the incidence of intraoperative hypothermia. Secondary outcomes were core temperature, irrigation and infused fluid, estimated blood loss, urine output, type of surgery, intraoperative anesthetic dosage, hemodynamics, recovery time, the incidence of postoperative shivering, thermal comfort, postoperative sufentanil consumption and pain intensity, patient satisfaction, and adverse events. Results: The incidence of intraoperative hypothermia was significantly lower in the prewarming group than the warming group (12.24% vs 32.65%, P = .015). Core temperature showed the highest decrease 30 minutes after surgery start in both groups; however, the rate was lower in the prewarming than in the warming group (0.31 ± 0.04°C vs 0.42 ± 0.06°C, P < .05). Compared with the warming group, higher core temperatures were recorded for patients in the prewarming group from T1 to T6 ( P < .05). Significantly fewer patients with mild hypothermia were in the prewarming group (5 vs 13, P = .037) and recovery time was significantly reduced in the prewarming group ( P < .05). Although the incidence of postoperative shivering was lower in the prewarming group, it was not statistically significant (6.12% vs 18.37%, P = .064). Likewise, the shivering severity was similar for both groups. Thermal comfort was significantly increased in the prewarming group, although patient satisfaction was comparable between the 2 groups ( P > .05). No adverse events occurred associated with the forced-air warming system. Both groups shared similar baseline demographics, type of surgery, total irrigation fluid, total infused fluid, estimated blood loss, urine output, intraoperative anesthetic dosage, hemodynamics, duration of anesthesia and operation time, postoperative sufentanil consumption, and pain intensity. Conclusion: In patients undergoing video-assisted thoracic surgery, prewarming for 30 minutes before the induction of anesthesia combined with a forced-air warming system may improve perioperative core temperature and the thermal comfort, although the incidence of p...

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Prevalence of hypothermia on admission to recovery room remains high despite a large use of forced-air warming devices: Findings of a non-randomized observational multicenter and pragmatic study on perioperative hypothermia prevalence in France

Cited by 38 publications

References 33 publications

Short-Periods of Pre-Warming in Laparoscopic Surgery. A Non-Randomized Clinical Trial Evaluating Current Clinical Practice

Short-Periods of Pre-Warming in Laparoscopic Surgery. A Non-Randomized Clinical Trial Evaluating Current Clinical Practice

Zero-Heat-Flux and Esophageal Temperature Monitoring in Orthopedic Surgery: An Observational Study

Effects of a preoperative forced-air warming system for patients undergoing video-assisted thoracic surgery

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