The effects of warming intravenous fluids on intraoperative hypothermia and postoperative shivering during prolonged abdominal surgery

Camus, Y.; Delva, E.; Cohen, S.; Lienhart, A.

doi:10.1111/j.1399-6576.1996.tb04532.x

Cited by 80 publications

(54 citation statements)

References 19 publications

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“…In fact the infusion of crystalloid solutions at room temperature may significantly contribute to intraoperative hypothermia because warming fluids to core temperature requires body heat. Several studies had demonstrated that infusion of warmed fluids helps in the prevention of hypothermia and reduce the incidence of postoperative shivering [32,33].…”

Section: Discussionmentioning

confidence: 99%

Inadvertent Postoperative Hypothermia at Post-Anesthesia Care Unit: Incidence, Predictors and Outcome

Luís¹,

Moreno²,

Silva³

et al. 2012

OJAnes

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Background: Inadvertent postoperative hypothermia (IPH) is known to be associated with various adverse effects. The aim of this study was to evaluate the incidence, predictors and outcome of core inadvertent hypothermia on admission in the post-anesthesia care unit. Methods: Observational, prospective study in a Post-Anesthesia Care Unit. The study population consisted of adult patients after non-cardiac and non-neurologic surgery. Patients' demographics, intraoperative and postoperative data were collected. Descriptive analysis of variables was used to summarize data and the Mann-Whitney U test, Fisher's exact test or Chi-square test was used. Univariate and multivariate analyses were done with logistic binary regression with calculation of an Odds Ratio (OR) and its 95% Confidence Interval. Results: The incidence of IPH on admission was 32%. In univariate analysis: age, body mass index (BMI), high risk surgery, revised cardiac risk index (RCRI), type of anesthesia, use of forced-air warming, amount of intravenous crystalloids administrated, duration of anesthesia, duration of surgery and admission visual analogue scale (VAS) for pain > 3 were considered predictors of hypothermia. In multiple logistic regression analysis, age (OR 1.7, P = 0.045, for age > 65 years), RCRI (OR 3.18, P = 0.041, for RCRI > 2), duration of anesthesia (OR 1.52, P < 0.001) and admission VAS for pain (OR 2.05, P = 0.007) were considered independent predictors of IPH. Patients with IPH at PACU admission stay longer in the PACU. Conclusions: IPH was associated with a longer stay in the PACU. Age, comorbidities duration of anesthesia and pain at PACU admission were considered independent predictors for IPH.

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Section: Discussionmentioning

confidence: 99%

Inadvertent Postoperative Hypothermia at Post-Anesthesia Care Unit: Incidence, Predictors and Outcome

Luís¹,

Moreno²,

Silva³

et al. 2012

OJAnes

View full text Add to dashboard Cite

show abstract

“…To maintain normothermia, fluid warmers are designed to deliver fluid around body temperature (37°C), and their use has been recommended for all intra-operative infusions ≥ 500 ml in adults [1]. Administration of warmed intravenous fluids in conjunction with standard heat conservation measures has been shown to reduce the incidence of accidental peri-operative hypothermia significantly in gynaecological [8] and abdominal [9] surgery, as well as associated complications during orthopaedic lists [10]. In obstetric practice, the use of intra-operative warmed fluid is also associated with significantly higher Apgar scores in the newborn infant following caesarean section [11].…”

Section: Intravenous Fluid Warming Devicesmentioning

confidence: 99%

Peri‐operative warming devices: performance and clinical application

2014

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SummarySince the adverse consequences of accidental peri-operative hypothermia have been recognised, there has been a rapid expansion in the development of new warming equipment designed to prevent it. This is a review of peri-operative warming devices and a critique of the evidence assessing their performance. Forced-air warming is a common and extensively tested warming modality that outperforms passive insulation and water mattresses, and is at least as effective as resistive heating. More recently developed devices include circulating water garments, which have shown promising results due to their ability to cover large surface areas, and negative pressure devices aimed at improving subcutaneous perfusion for warming. We also discuss the challenge of fluid warming, looking particularly at how devices' performance varies according to flow rate. Our ultimate aim is to provide a guide through the bewildering array of devices on the market so that clinicians can make informed and accurate choices for their particular hospital environment.

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“…It has been reported that the intra-operative core temperature is maintained with an acceptably low incidence of hypothermia (9%) on admission to the postanaesthesia care unit (PACU) in grade-3 obese patients when active forced-air warming had been used during bariatric surgery [11]. Intraoperative warming strategies have minimised, but do not prevent, unintentional peri-operative hypothermia in non-obese patients [12][13][14].…”

mentioning

confidence: 99%

Comparison of peri‐operative core temperature in obese and non‐obese patients*

et al. 2012

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SummaryOur aim was to compare peri-operative core temperatures and the incidence of hypothermia in obese and non-obese women with active forced-air warming. Twenty female patients scheduled for abdominal surgery were allocated to two groups according to body mass index. Ten obese (30.0-34.9 kg.m )2) and 10 non-obese (18.5-24.9 kg.m ) women received forced-air warming on their lower limbs. At the end of surgery, the mean (SD) core temperatures were 36.7 (0.5)°C in the obese group and 36.0 (0.6)°C in the non-obese group (p < 0.001). Only in the non-obese group was there a significant decrease in the intra-operative core temperature values (p < 0.001). The incidences of intra-operative hypothermia were lower in the obese group (10%) compared with non-obese group (60%; p = 0.019). In the postoperative recovery phase, the mean (SD) core temperature data were higher in the obese group than in the nonobese group (36.2 (0.4) vs 35.6 (0.5)°C, respectively (p < 0.001)). In conclusion, obese female patients have higher perioperative core temperature and a lower incidence of hypothermia compared with non-obese female patients during abdominal surgery with active forced-air warming. Accepted: 21 August 2012Unintentional peri-operative hypothermia (core temperatures between 34.5 and 35.9°C) often leads to adverse outcomes, including cardiac events secondary to sympathetic nervous system activation [1], surgicalwound infections and prolonged hospitalisation [2], coagulopathy and increased blood loss [3], impaired drug metabolism, delayed postoperative recovery period [4,5] and shivering [6]. Therefore, maintaining perioperative normothermia reduces morbidity [1][2][3] and the use of peri-operative warming devices has become routine.The prevalence of obesity has increased markedly worldwide in recent years [7]. In clinical practice, body mass index (BMI) is used to estimate the degree of obesity, which is classified in three levels: grade 1 (BMI from 30.0 to 34.9 kg.m ) [8]. The prevalence of grade-1 obesity is higher among both female and male obese populations than are the other grades [8]. Obese patients are more likely to vasoconstrict in cooler environments [9], have reduced heat redistribution from core to peripheral tissue after

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The effects of warming intravenous fluids on intraoperative hypothermia and postoperative shivering during prolonged abdominal surgery

Abstract: In conclusion, infusion of warmed fluids, combined with skin-surface warming, helps to prevent hypothermia and reduces the incidence of postoperative shivering.

Cited by 80 publications

References 19 publications

Inadvertent Postoperative Hypothermia at Post-Anesthesia Care Unit: Incidence, Predictors and Outcome

Inadvertent Postoperative Hypothermia at Post-Anesthesia Care Unit: Incidence, Predictors and Outcome

Peri‐operative warming devices: performance and clinical application

Comparison of peri‐operative core temperature in obese and non‐obese patients*

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