Inadvertent Perioperative Hypothermia

Abstract

Temperature regulation during the perioperative period plays an essential role in keeping patients safe while optimizing their recovery. The World Health Organization recommends preserving normothermia, identified as a core body temperature greater than 36°C, to minimize morbidity and mortality. The etiology of inadvertent perioperative hypothermia (IPH) varies in origin. Preoperative exposure, decreased ambient operating room (OR) temperature, skin exposure during preparation, unwarmed skin preparation and washout solutions, and lack of warming devices all contribute to IPH. Moreover, general and regional anesthesia blunt the physiologic response to hypothermia which originates in the hypothalamus. Postoperatively, patients with temperatures < 36°C are at greater risk for surgical site infection, increased mortality, longer length of hospital stay, higher 30-day readmission rates, among other complications. Identifying preoperative risk factors and OR practices that contribute to IPH, monitoring temperatures, and use of warming devices during the perioperative period can help to prevent IPH.

Keywords: anesthesia; geriatric trauma; inadvertent hypothermia; surgery; temperature.