Perioperative Hypothermia-A Narrative Review

Abstract

Unintentional hypothermia (core temperature < 36 °C) is a common side effect in patients undergoing surgery. Several patient-centred and external factors, e.g., drugs, comorbidities, trauma, environmental temperature, type of anaesthesia, as well as extent and duration of surgery, influence core temperature. Perioperative hypothermia has negative effects on coagulation, blood loss and transfusion requirements, metabolization of drugs, surgical site infections, and discharge from the post-anaesthesia care unit. Therefore, active temperature management is required in the pre-, intra-, and postoperative period to diminish the risks of perioperative hypothermia. Temperature measurement should be done with accurate and continuous probes. Perioperative temperature management includes a bundle of warming tools adapted to individual needs and local circumstances. Warming blankets and mattresses as well as the administration of properly warmed infusions via dedicated devices are important for this purpose. Temperature management should follow checklists and be individualized to the patient's requirements and the local possibilities.

Keywords: body temperature regulation; hypothermia; perioperative care; perioperative hypothermia; quality of care; surgery.

Figure 1

Influence of induction of general anaesthesia on core temperature. The redistribution phase, linear phase, and plateau phase can be seen. The figure shows the mean values and standard deviation (redrawn with modifications from [54]).

Figure 2

Ten essential points to prevent perioperative hypothermia for surgery lasting >30 min. Blue boxes refer to the pre-anaesthetic period, orange boxes to the intra-anaesthetic period, and green boxes to the post-anaesthetic period. OR: operating room; PACU: post-anaesthesia care unit.