A retrospective audit to examine the effectiveness of preoperative warming on hypothermia in spine deformity surgery patients

作者：Goerges Matthias; Ansermino J Mark; Whyte Simon D

来源：Paediatric Anaesthesia, 2013, 23(11): 1054-1061.

DOI：10.1111/pan.12204

• hypothermia
• prevention and control
• anesthesia
• general
• adverse effects
• hot temperature
• therapeutic use
• monitoring
• intraoperative
• methods
• healthcare quality assurance
• scoliosis
• surgery

BackgroundHypothermia (core body temperature <36 degrees C) during surgery has been associated with surgical site infection, a major risk in all spine deformity surgeries. Forced air warming is an important method of intraoperative temperature maintenance in children. In mid-2010, we empirically introduced preoperative warming as a strategy to reduce intraoperative hypothermia.
ObjectiveWe report the prevalence and extent of hypothermia during spine deformity surgeries at our institution and evaluate the effect of the introduction of preoperative warming.
MethodsWe performed a retrospective audit of temperature data in children who underwent spine deformity surgeries during two-seven-month periods: November 2011 to June 2012 and 2years prior to this period (before preoperative warming implementation). Specifically, the following data were obtained: (i) case duration; (ii) first measured temperature; (iii) last measured temperature; (iv) percentage of case spent hypothermic; (v) number of hypothermic episodes per case, and (vi) delay between case start and time of first temperature measured. Data were compared visually and using the Mann-Whitney U-test. Confidence intervals (CI) were obtained using the Hodges-Lehmann estimator.
ResultsPreoperative warming reduced the percentage of case duration spent hypothermic by a median of 111.1min (P<0.001, 95% CI 77.1-139.9min). Additionally, it increased the first measured temperature by a median of 0.5 degrees C (P<0.001, 95% CI 0.3-0.7 degrees C). The last temperature at the end of the case remained unchanged (P=0.57, 95% CI -0.2-0.1 degrees C).
ConclusionPreoperative warming of children undergoing spine deformity surgery significantly reduces the percentage of case spent hypothermic, thereby potentially reducing risk of perioperative complications.

• 出版日期2013-11