Risk Factors for Inadvertent Hypothermia During Adult Living-Donor Liver Transplantation

Han, Seok Joo; Gwak, Mi Sook; Choi, Soo Joo; Ko, Justin Sangwook; Kim, G.S.; Son, Hyo Jung; Shin, Jae‐Hoon

doi:10.1016/j.transproceed.2013.11.091

Cited by 17 publications

(13 citation statements)

References 11 publications

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“…Clinical variables associated with perioperative hypothermia have differed among studies [ 29 – 31 ]. In this study, major-plus surgery and duration of anesthesia, either 1–2 hours or longer than 2 hours, were significant risk factors in predicting hypothermia, a finding consistent with those of a previous study [ 32 ] but different from others’ findings [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey

Xiang²,

Deng

et al. 2015

PLoS ONE

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Background/ObjectiveInadvertent intraoperative hypothermia (core temperature <360 C) is a recognized risk in surgery and has adverse consequences. However, no data about this complication in China are available. Our study aimed to determine the incidence of inadvertent intraoperative hypothermia and its associated risk factors in a sample of Chinese patients.MethodsWe conducted a regional cross-sectional survey in Beijing from August through December, 2013. Eight hundred thirty patients who underwent various operations under general anesthesia were randomly selected from 24 hospitals through a multistage probability sampling. Multivariate logistic regression analyses were applied to explore the risk factors of developing hypothermia.ResultsThe overall incidence of intraoperative hypothermia was high, 39.9%. All patients were warmed passively with surgical sheets or cotton blankets, whereas only 10.7% of patients received active warming with space heaters or electric blankets. Pre-warmed intravenous fluid were administered to 16.9% of patients, and 34.6% of patients had irrigation of wounds with pre-warmed fluid. Active warming (OR = 0.46, 95% CI 0.26–0.81), overweight or obesity (OR = 0.39, 95% CI 0.28–0.56), high baseline core temperature before anesthesia (OR = 0.08, 95% CI 0.04–0.13), and high ambient temperature (OR = 0.89, 95% CI 0.79–0.98) were significant protective factors for hypothermia. In contrast, major-plus operations (OR = 2.00, 95% CI 1.32–3.04), duration of anesthesia (1–2 h) (OR = 3.23, 95% CI 2.19–4.78) and >2 h (OR = 3.44, 95% CI 1.90–6.22,), and intravenous un-warmed fluid (OR = 2.45, 95% CI 1.45–4.12) significantly increased the risk of hypothermia.ConclusionsThe incidence of inadvertent intraoperative hypothermia in Beijing is high, and the rate of active warming of patients during operation is low. Concern for the development of intraoperative hypothermia should be especially high in patients undergoing major operations, requiring long periods of anesthesia, and receiving un-warmed intravenous fluids.

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Section: Discussionmentioning

confidence: 99%

Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey

Xiang²,

Deng

et al. 2015

PLoS ONE

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“…These results are not surprising since oxytocin acts on uterine contractions and thermoregulation 30 while increased body mass index is associated with a reduced incidence of hypothermia in surgical patients. 23,31 In fact, redistribution hypothermia (reduction in maternal temperature during the first hour of anesthesia) may be inversely proportional to the percentage of body fat. 32 Core hypothermia during CD performed under spinal, epidural, or general anesthesia is mainly related to core-toperipheral redistribution of body heat.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of maternal hypothermia during Cesarean delivery: a prospective cohort study

Desgranges

Bapteste

Riffard

et al. 2017

Can J Anesth/J Can Anesth

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“…Second, the bioreactance signal was still affected by patient body temperatures despite the improvement of the processing algorithm. Transplant recipients face challenging thermal environments and significant intraoperative body core/skin temperature changes during surgery [ 21 , 22 ]. It can be assumed that the changes in underlying body temperatures and the difference between skin and core temperature affected the results of this study.…”

Section: Discussionmentioning

confidence: 99%

Bioreactance Is Not Interchangeable with Thermodilution for Measuring Cardiac Output during Adult Liver Transplantation

et al. 2015

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BackgroundThermodilution technique using a pulmonary artery catheter is widely used for the assessment of cardiac output (CO) in patients undergoing liver transplantation. However, the unclearness of the risk-benefit ratio of this method has led to an interest in less invasive modalities. Thus, we evaluated whether noninvasive bioreactance CO monitoring is interchangeable with thermodilution technique.MethodsNineteen recipients undergoing adult-to-adult living donor liver transplantation were enrolled in this prospective observational study. COs were recorded automatically by the two devices and compared simultaneously at 3-minute intervals. The Bland–Altman plot was used to evaluate the agreement between bioreactance and thermodilution. Clinically acceptable agreement was defined as a percentage error of limits of agreement <30%. The four quadrant plot was used to evaluate concordance between bioreactance and thermodilution. Clinically acceptable concordance was defined as a concordance rate >92%.ResultsA total of 2640 datasets were collected. The mean CO difference between the two techniques was 0.9 l/min, and the 95% limits of agreement were -3.5 l/min and 5.4 l/min with a percentage error of 53.9%. The percentage errors in the dissection, anhepatic, and reperfusion phase were 50.6%, 56.1%, and 53.5%, respectively. The concordance rate between the two techniques was 54.8%.ConclusionBioreactance and thermodilution failed to show acceptable interchangeability in terms of both estimating CO and tracking CO changes in patients undergoing liver transplantation. Thus, the use of bioreactance as an alternative CO monitoring to thermodilution, in spite of its noninvasiveness, would be hard to recommend in these surgical patients.

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Risk Factors for Inadvertent Hypothermia During Adult Living-Donor Liver Transplantation

Cited by 17 publications

References 11 publications

Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey

Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey

Predictive factors of maternal hypothermia during Cesarean delivery: a prospective cohort study

Bioreactance Is Not Interchangeable with Thermodilution for Measuring Cardiac Output during Adult Liver Transplantation

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