Inadvertent perioperative hypothermia
DOI:
https://doi.org/10.14739/2310-1210.2025.2.317814Keywords:
hypothermia, hypothermia accidental, perioperative period, perioperative medicineAbstract
Inadvertent perioperative hypothermia (IPH) is a reduction in body temperature during the perioperative period defined as a loss in core temperature to below +36.0 °C. The development of hypothermia is associated with pharmacological blockade of thermoregulatory mechanisms, increased heat loss from a surgical wound, infusion of unwarmed solutions, low temperature in the operating room, and exposed surgical areas.
Aim: to analyze the issues of risk factors, pathophysiology, complications, prevention, and treatment of IPH based on literature sources.
Materials and methods. A search was carried out for scientific articles over the past 10 years in electronic databases of medical publications, in particular PubMed, Google Scholar, Scopus and Web of Science, using the keywords “hypothermia accidental”, “perioperative hypothermia”, “perioperative hypothermia management”, “perioperative period”, “perioperative medicine”, etc. For analysis, articles were selected that provided data on the impact of IPH on organs and systems, the causes of its development, complications and methods of prevention and treatment.
Results. IPH negatively effects numerous organs and systems of the body inhibiting coagulation and metabolism, reducing oxygen supply to tissues, increasing plasma catecholamine concentrations and the risk of cardiovascular complications, elevating the risk of postoperative wound infection, reducing cerebral metabolism, increasing the incidence of postoperative pain exacerbation, nausea and vomiting as compared to normothermic patients. The causes of hypothermia in the perioperative period can be low-temperature operating room environment, cold solutions, inhibition of thermoregulation by anesthetic drugs, prolonged exposure of body cavities and surgery duration. Heat loss during anesthesia causes a three-phase pattern of hypothermia. In the first phase, there is a rapid decrease in body temperature with peripheral vasodilation, in the second phase, the decrease becomes more gradual, followed by vasoconstriction, and the third phase occurs – “plateau” phase, when heat production and heat loss are balanced. Current principles of prevention and management of IPH include perioperative temperature regulation, measures to reduce heat loss by thermal insulation of the skin, active preoperative patient warming. Respect for these principles helps to reduce the number of blood transfusions, the risk of purulent-septic complications, the duration of mechanical ventilation as well as the intensive care unit and hospital length of stay.
Conclusions. Inadvertent perioperative hypothermia is a common condition linked to numerous risks for patients. Monitoring the patient’s body temperature and preventing the development of hypothermia are among the key perioperative concerns for anesthesiologists. To prevent inadvertent perioperative hypothermia, it is essential to follow the recommended temperature regime for patients at all perioperative stages. Particular attention should be paid to patients in medical emergencies requiring urgent surgical interventions.
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