The effect of intraoperative hypothermia upon blood transfusion needs and length of stay among gastrointestinal system cancer surgery

Abstract

This cross-sectional study was performed to evaluate the relationship between intraoperative body temperature and the need for blood transfusion and length of stay in the post-anaesthetic care unit (PACU) or in the intensive care unit (ICU) among 79 patients undergoing elective oncology surgery of the digestive system. There was a statistically significant correlation between a lower temperature during surgery and medical diagnosis (p = .009), the use of bupivacaine anaesthesia (p = .016), anaesthesia time (p = .003) and anaesthesia type (p = .033), surgery time (p = .021) and surgery type (p = .002), volumes infused during the intraoperative period (p = .006), admission to the ICU (p = .032) and length of stay in PACU (p = .029). The lower the temperature when the patient is admitted to the operating room, the lower the temperature during the procedure (p ˂ .001). There was no association between the body temperature of patients and blood transfusion (p = .619). Hypothermia was associated with increased length of stay in the PACU, but was not associated with the need for blood transfusion during the intra- and postoperative periods. The use of preoperative passive warming methods allows patients to reach the operating room hypothermic.

Guideline for prevention of hypothermia

“…When indicated by the patient evaluation, at least one passive warming method, including a cotton blanket, a surgical drape, plastic sheeting, thermal clothing, a nonlinting wrap, or a reflective‐composite fabric blanket or clothing, should be used during all phases of perioperative care . High‐quality evidence supports using active warming to prevent unplanned perioperative hypothermia . Therefore, when indicated by the patient evaluation, patients should be warmed with at least one of the following active warming methods throughout the course of their perioperative care:…”

“…1 High-quality evidence supports using active warming to prevent unplanned perioperative hypothermia. [6][7][8] When active warming is indicated, patients should be prewarmed with the selected method, 1 with moderate-quality evidence supporting a minimum duration of 10 minutes of prewarming before anesthesia induction. 9,10 "Prewarming warms you up, so that you have a higher temperature when you get to the OR and are given anesthesia, which is when redistribution of body heat from the core to the periphery occurs," Burlingame said.…”

Hipotermia intraoperatória e ocorrência de infecção do sítio cirúrgico entre pacientes oncológicos: coorte retrospectiva

“…Trata-se de um estudo quantitativo, tipo coorte retrospectiva, realizado a partir dos prontuários eletrônicos de pacientes submetidos a cirurgias oncológicas do trato gastrointestinal atendidos em um hospital especializado no diagnóstico e no tratamento oncológico no município de São Paulo (SP) a partir de uma amostragem por conveniência, incluindo 79 pacientes adultos, de ambos os sexos, submetidos a cirurgia oncológica eletiva do sistema digestório, curativa ou paliativa, com duração da anestesia de, no mínimo, uma hora, nos anos de 2014 e 2015, que participaram de investigação prospectiva anterior, em que foi avaliada a ocorrência de hipotermia intraoperatória 9 .…”

Incidence and Risk factors for Intraoperative Hypothermia during Cancer Surgery of Gastrointestinal Tracts: a single-center retrospective study

“…Thus, intraoperative maintenance of normothermia is strongly recommended by several versions of the enhanced recovery after surgery (ERAS) guidelines as one of the major elements of perioperative care in colorectal surgery [8] . Compared to the other cancer patients, the gastrointestinal tracts cancer patients suffer its interference in food intake, digestion and absorption, a large area of the patient's body surface being exposed, the temperature of the operating room (OR) between 18℃ and 23℃ [9] . Therefore, the purpose of this study was to determine the incidence and risk factors associated with inadvertent intraoperative hypothermia in patients during gastrointestinal tracts cancer surgery under general anesthesia.…”