Management of operating theatre ambient temperature for major burn patients in a state-wide adult burns centre

Abstract

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). Patient hypothermia was defined as core temperature below 36°C.

Results: In total, 29 patients underwent 107 surgical procedures in the operating theatre. Patient hypothermia was recorded on 45 occasions (42.1 %) and of these, between 35.1 and 36.0°C on 28 occasions (62.2 %). There was no statistically significant difference in the incidence of hypothermia, hospital LOS, ICU LOS, total operations, or mortality between the study cohort and historical cohort. Patients who suffered hypothermia had lower BMI, lower preoperative temperature, and shorter ICU LOS.

Conclusion: Increasing theatre ambient temperature to 27°C is adequate in most cases. A more nuanced approach with selective increase of theatre ambient temperature beyond 27°C, only where clinically indicated, is a refinement that will benefit both patients and staff.

Keywords: Ambient temperature; Burn injury; Heat loss; Hypothermia; Perioperative warming.