Literature Review on Perioperative Hypothermia

This literature review explores the causes, effects, and prevention of perioperative hypothermia. It discusses the physiological mechanisms of hypothermia and the importance of monitoring and warming measures. The review also highlights the complications and risks associated with perioperative hypothermia. Suitable for medical and nursing students.

Literature Review

TABLE OF CONTENTS
LITERATURE REVIEW................................................................................................................1
REFERENCES................................................................................................................................5

LITERATURE REVIEW
Unintended Perioperative Hypothermia
Rosenkilde, Vamosi, Lauridsen, & Hasfeldt, (2017) sought to determine the fact that,
Hyperthermia in turn is referred to as the core body temperature of an individual which is less
than 96.8 degree Fahrenheit or 36 degree Celsius. This in turn is usually one of the most
common occurrence within un- warmed surgical patient. There seems to be an increase within
the frequency of surgical site who in turn tends to experience perioperative hypothermia. The
researcher of the study tends to review physiology of the temperature regulation and key
mechanisms of the Hypothermia.
On the contrary, Rosenkilde, Vamosi, Lauridsen, & Hasfeldt, (2017) established the fact
that, a mild degree of Perioperative Hypothermia tends to eventually results in mortality and
morbidity. The results tends to establish the fact that, pre- warming for the minimum of 30
minutes helps in reducing the risk associated with the subsequent hypothermia. It has been
concluded that, frequently monitoring of the body temperature and also avoiding unintended
perioperative hypothermia with the help of passive and active warming measures are useful in
the prevention of such complications.
Factors that influence effective perioperative temperature management by anesthesiologists: a
qualitative study using the Theoretical Domains Framework
Boet & et.al (2017) sought to determine the fact that, Inadvertent perioperative
hypothermia is mainly associated with the various set of adverse outcomes. Usage of the
effective and safe warming techniques which is very useful in the prevention of the Inadvertent
perioperative hypothermia. The researcher of the study tends to use qualitative approach where
semi- structured interview has been carried out with staff anesthesiologists at the Canadian
academic hospital. The interview transcripts in turn were coded with the help of direct content
management. On the contrary, Boet & et.al (2017) established the fact that, there are various set
of potential targets which in turn is considered to be very useful in improving the temperature
management practice which in turn includes intervention and helps in the improvement of the
temperature management practice. This is considered to be one of the most effective practice
which in turn is considered to be very useful in
effective perioperative temperature management by anesthesiologists.
Preventing Inadvertent Perioperative Hypothermia
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Torossian & et.al. (2015) sought to determine the fact that, there are around 25% to 90%
of the patients who in turn tends to undergo elective surgery and also suffers from Inadvertent
Perioperative Hypothermia i.e., the core body temperature of the patient is below 36 degree
Celsius. When compared with the normothermic patients, these patients in turn are usually at the
higher risk with high degree of wound infections. They tend to have high degree of relative risk,
cardiac complications and also blood transfusion. The patients who in turn tends to have
Perioperative Hypothermia tends to feel more uncomfortable and also shivering in turn results in
the rise in the level of oxygen levels by around 40%. This research guideline in turn is usually
based on the systematic review with the structured consensus by collaborating with the 5 medical
speciality societies. The results tends to evaluate that, the core temperature of the patient should
be effectively measured every 1 to 2 hours before starting off with the anaesthesia and
continuously every minutes at the time of surgery. The site associated with the temperature
measurements must be oral, esophageal, naso-/oropharyngeal, vesical, or tympanic. On the
contrary, Torossian & et.al. (2015) established the fact that, the patient must actively engage in
pre- warmed activity every 20-30 minutes before the surgery in order to counteract the decline
within the temperature. The temperature within the operating room must be at least around 21
degree Celsius for older patients and at least around 24 degree Celsius for children. Blood
transfusions and infusions in turn has been given at the rate of >500 mL/h which should be first
warmed. Postoperative hypothermia must be treated with conductive heat and also shivering of
the patient must be treated with the help of medication.
Inadvertent Perioperative Hypothermia: A Literature Review of an Old Overlooked Problem.
Fatemi, Armat, Zeydi, Soleimani, & Kiabi (2016) sought to determine the fact that,
Inadvertent Perioperative Hypothermia is considered to be as one of the most common
anaesthesia related complications when the patients undergo certain surgery. This eventually
leads to certain clinical complications which largely influence the outcomes and results of the
surgery especially in the case of high risk patient. The combination of cold operating room
environment and anaesthetic drugs are considered to be as the most common pre- disposing
factors associated with the perioperative hypothermia. The search of the specific literature has
been carried out through international database using Science direct and PubMed. On the
contrary, Fatemi, Armat, Zeydi, Soleimani, & Kiabi (2016) established the fact that,
Perioperative Hypothermia eventually leads to various set of post- operative complications
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which mainly includes drug metabolism impairment, high plasma concentration, impaired wound
healing, postoperative shivering, wound infections, decrease level of partial oxygen pressure,
imp[aired function associated with macrophages and neutrophils, variation in the potassium
levels, pulmonary vasoconstriction, impaired wound healing, etc. Shivering in turn is considered
to be as one of the most common complication associated with the Perioperative Hypothermia
which in turn tends to increase total body oxygen consumption because of the increase in the rate
of metabolism by 400 to 500%. This is highly detrimental for the high risk patients.
Approach to Perioperative Hypothermia by Anaesthesiology and Reanimation Specialist in
Turkey: A Survey Investigation.
İnal, Ural, Çakmak, Arslan & Polat,. (2017) sought to determine the fact that, 26% of the
physicians tend to use temperature monitoring. There are various range of temperature
monitoring. However, skin/axilla in turn is considered to be as the preferred monitoring site and
forced air warming device in turn is considered to be as the most commonly preferred heating
system. The researcher of the study will use questionnaire which mainly comprise of 25
questions and the data was collected through such questionnaires. New born are the most
commonly monitored group by effectively using Turkish Anaesthesiology and Reanimation
Society guideline.
Inadvertent Hypothermia After Procedural Sedation and Analgesia in a Cardiac
Catheterization Laboratory: A Prospective Observational Study.
Conway, Kennedy, & Sutherland, (2015) established the fact that, the researcher of the
study in turn uses single centre observational study in order to critically identify various set of
risk factors associated with the inadvertent hypothermia after the procedure has been performed
with analgesia and procedural sedation in a cardiac catheterization laboratory. Around 399
patients gas undergone elective procedures with analgesia and procedural sedation. On the
contrary, Conway, Kennedy, & Sutherland, (2015) sought to determine the fact that,
Pharmalogical management of the shivering tends to focus on pharmalogical treatment.
Shivering in turn can be effectively treated by IV administration of the pethidine in 90% of the
postoperative patients.
Perioperative warming therapy for preventing surgical site infection in adults undergoing
surgery (Protocol)
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Ousey, & et.al. (2015) sought to determine the fact that, Perioperative hypothermia is
referred to as the core temperature of the body which is less than 36 degree Celsius. However,
the unintended perioperative hypothermia is considered to be very common and usually
Perioperative hypothermia in turn is usually caused due to various factors which includes the
injury of thermoregulation which results from a core to periphery thermal redistribution.
Reduced metabolic heat creation due to the effects of anaesthetic agents, and also noteworthy
heat loss, etc. are considered to be as the causes of perioperative hypothermia. This study has
been further carried out using randomized control trials and also tends to include clusters.
Patients tends to undergo surgery within general anaesthesia in turn are included while carrying
out the study. On the contrary, Ousey, & et.al. (2015) established the fact that, the key
available interventions associated with the perioperative hypothermia in turn includes passive
and active warming, use of the warmed IV fluids and increase in the OR temperature under
certain set of circumstances.
Meta‐analysis: effectiveness of forced‐air warming for prevention of perioperative
hypothermia in surgical patients.
Nieh, & Su, (2016) sought to determine the fact that, perioperative hypothermia in turn is
considered to be as one of the most commonly occurred illness who in turn has been receiving
anaesthesia at the time of surgery. The researcher will carry out the specific study using meta-
analysis. The key data sources used were Cochrane Library, Medline, OVID, PubMed, CINAHL,
CETD and CEPS databases for the random control trials. On the contrary, Nieh, & Su, (2016)
established the fact that, forced air warming in turn is considered to be as the most effective
strategy rather than circulating water mattresses and passive insulation. There seems to be no
statistically significant difference between forced‐air warming, radiant warming systems,
resistive heating blankets and circulating‐water garments. Hence, it has been concluded that,
Forced‐air warming is very useful in preventing perioperative hypothermia more effectively and
efficiently.
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REFERENCES
Books and Journals
Boet, S & et.al (2017). Factors that influence effective perioperative temperature management by
anesthesiologists: a qualitative study using the Theoretical Domains Framework. Canadian
Journal of Anesthesia/Journal canadien d'anesthésie, 64(6), 581-596.
Conway, A., Kennedy, W., & Sutherland, J. (2015). Inadvertent hypothermia after procedural
sedation and analgesia in a cardiac catheterization laboratory: A prospective observational
study. Journal of cardiothoracic and vascular anesthesia, 29(5), 1285-1290.
Fatemi, S. N. L., Armat, M. R., Zeydi, A. E., Soleimani, A., & Kiabi, F. H. (2016). Inadvertent
perioperative hypothermia: a literature review of an old overlooked problem. Acta facultatis
medicae Naissensis, 33(1), 5-11.
İnal, M. A., Ural, S. G., Çakmak, H. Ş., Arslan, M., & Polat, R. (2017). Approach to
perioperative hypothermia by anaesthesiology and reanimation specialist in Turkey: a survey
investigation. Turkish journal of anaesthesiology and reanimation, 45(3), 139.
Nieh, H. C., & Su, S. F. (2016). Meta‐analysis: effectiveness of forced‐air warming for
prevention of perioperative hypothermia in surgical patients. Journal of advanced
nursing, 72(10), 2294-2314.
Ousey, K. J & et.al. (2015). Perioperative warming therapy for preventing surgical site infection
in adults undergoing surgery. Cochrane Database of Systematic Reviews, (6).
Rosenkilde, C., Vamosi, M., Lauridsen, J. T., & Hasfeldt, D. (2017). Efficacy of prewarming
with a self-warming blanket for the prevention of unintended perioperative hypothermia in
patients undergoing hip or knee arthroplasty. Journal of PeriAnesthesia Nursing, 32(5),
419-428.
Torossian, A & et.al. (2015). Preventing inadvertent perioperative hypothermia. Deutsches
Ärzteblatt International, 112(10), 166.
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