Response to Letter to the Editor on “Hypothermia in Total Joint Arthroplasty: A Wake-Up Call”

Abstract

with spinal anesthesia, and whether this leads to falsely decreased temperature readings in the OR setting. In our hospital, the anesthesia team will sometimes obtain oral temperatures in patients with laryngeal mask airway or spinal anesthesia and enter these in the EHR, and these are often inaccurate (often a degree or more lower) when used as a proxy for core temperatures.We too found cooling during transition from the preoperative holding area to the OR and from OR to postoperative recovery area (Fig. 1) and agree with the other conclusions outlined in the manuscript. However, using a single validated temperature gauge throughout the OR experience in our smaller, prospective sample, we found no hypothermia. Ambient room temperature was 19 C during our study.In conclusion, I am concerned that use of a retrospective analysis of patient temperatures from the EHR, and comparing core temperatures obtained with different measurement devices, has led to the incorrect conclusion that hypothermia is rampant in total joint surgery. Furthermore, the investigators' solution of increasing the ambient temperature the OR may not be warranted or advisable and may have unintended consequences. Further research in this area should be considered before making this recommendation universal.