Background: Hypothermia, defined as a core body temperature less than 36°C (96.8°F), is a relatively common occurrence in the unwarmed surgical patient. A mild degree of perioperative hypothermia can be associated with significant morbidity and mortality. A threefold increase in the frequency of surgical site infections is reported in colorectal surgery patients who experience perioperative hypothermia. As part of the Surgical Care Improvement Project, guidelines aim to decrease the incidence of this complication.
Methods: We review the physiology of temperature regulation, mechanisms of hypothermia, effects of anesthetics on thermoregulation, and consequences of hypothermia and summarize recent recommendations for maintaining perioperative normothermia.
Results: Evidence suggests that prewarming for a minimum of 30 minutes may reduce the risk of subsequent hypothermia.
Conclusions: Monitoring of body temperature and avoidance of unintended perioperative hypothermia through active and passive warming measures are the keys to preventing its complications.
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World J Emerg Surg
January 2025
Federation of Anesthesiology, Intensive Care Unit, Burns and Operating Theater, Percy Military Training Hospital, 2 Rue Lieutenant Raoul Batany, 92140, Clamart, France.
Background: To reduce the number of deaths caused by exsanguination, the initial management of severe trauma aims to prevent, if not limit, the lethal triad, which consists of acidosis, coagulopathy, and hypothermia. Recently, several studies have suggested adding hypocalcemia to the lethal triad to form the lethal diamond, but the evidence supporting this change is limited. Therefore, the aim of this study was to compare the lethal triad and lethal diamond for their respective associations with 24-h mortality in severe trauma patients receiving transfusion.
View Article and Find Full Text PDFBurns
December 2024
Victorian Adults Burns Service, The Alfred, 55 Commercial Rd., Melbourne, VIC 3004, Australia; Department of Surgery, Central Clinical School, Monash University, 99 Commercial Rd, Melbourne, Victoria 3004, Australia. Electronic address:
Introduction: The aim of this study was to investigate the efficacy of limiting increases in theatre ambient temperature to 27°C to prevent intraoperative patient hypothermia.
Methods: This single-centre, comparative cohort clinical study investigated the management of theatre ambient temperatures involving patients with ≥ 20 % TBSA burn injuries at Victorian Adult Burns Service (Melbourne, Australia). Data from the intervention group (August 2021 - February 2023, theatre ambient temperature increase limited to 27°C) was compared with a historical cohort (August 2019 - August 2021).
BMC Surg
December 2024
Department of Nursing, Lanzhou University Second Hospital, Lanzhou University, No. 82 Cuiyingmen, Lanzhou, China.
Perioperative hypothermia is a frequent clinical complication resulting from the cold environment of the operating room and prolonged skin exposure, leading to adverse outcomes and increased healthcare burdens. To address this issue, this narrative review discusses in detail the currently common warming strategies for perioperative hypothermia .Forced air warming (FAW) systems are widely recognized as the most effective intervention for maintaining core body temperature.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Neuroscience and Cell Biology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan.
This study investigated the impact of multiple nerve block methods (local anesthesia, conventional radiofrequency thermocoagulation [CRF], and pulsed radiofrequency [PRF]) on thermoregulation. Focusing on hypothalamic function, the effects of local anesthesia, CRF, and PRF on central and peripheral temperatures were analyzed and compared. Our findings revealed that all three nerve block groups cause a decrease in central temperature, with the CRF group exhibiting the most pronounced effect.
View Article and Find Full Text PDFJ Craniofac Surg
January 2025
Department of Plastic Surgery, University of California, Irvine.
Enhanced recovery after surgery (ERAS) protocols have informed perioperative care across multiple surgical specialties, optimizing patient outcomes through surgical stress management and accelerated recovery. This study evaluates the familiarity and adoption of ERAS elements among craniofacial and oral and maxillofacial surgeons in pediatric orthognathic surgery, a field where a formal ERAS protocol has not been established. A closed-ended survey of 102 surgeons was conducted to assess familiarity with and utilization of 14 ERAS elements.
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