Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey

Jie Yi, Ziyong Xiang, Xiaoming Deng, Ting Fan, Runqiao Fu, Wanming Geng, Ruihong Guo, Nong He, Chenghui Li, Lei Li, Min Li, Tianzuo Li, Ming Tian, Geng Wang, Lei Wang, Tianlong Wang, Anshi Wu, Di Wu, Xiaodong Xue, Mingjun Xu, Xiaoming Yang, Zhanmin Yang, Jianhu Yuan, Qiuhua Zhao, Guoqing Zhou, Mingzhang Zuo, Shuang Pan, Lujing Zhan, Min Yao, Yuguang Huang, Jie Yi, Ziyong Xiang, Xiaoming Deng, Ting Fan, Runqiao Fu, Wanming Geng, Ruihong Guo, Nong He, Chenghui Li, Lei Li, Min Li, Tianzuo Li, Ming Tian, Geng Wang, Lei Wang, Tianlong Wang, Anshi Wu, Di Wu, Xiaodong Xue, Mingjun Xu, Xiaoming Yang, Zhanmin Yang, Jianhu Yuan, Qiuhua Zhao, Guoqing Zhou, Mingzhang Zuo, Shuang Pan, Lujing Zhan, Min Yao, Yuguang Huang

Abstract

Background/objective: Inadvertent intraoperative hypothermia (core temperature <360 C) is a recognized risk in surgery and has adverse consequences. However, no data about this complication in China are available. Our study aimed to determine the incidence of inadvertent intraoperative hypothermia and its associated risk factors in a sample of Chinese patients.

Methods: We conducted a regional cross-sectional survey in Beijing from August through December, 2013. Eight hundred thirty patients who underwent various operations under general anesthesia were randomly selected from 24 hospitals through a multistage probability sampling. Multivariate logistic regression analyses were applied to explore the risk factors of developing hypothermia.

Results: The overall incidence of intraoperative hypothermia was high, 39.9%. All patients were warmed passively with surgical sheets or cotton blankets, whereas only 10.7% of patients received active warming with space heaters or electric blankets. Pre-warmed intravenous fluid were administered to 16.9% of patients, and 34.6% of patients had irrigation of wounds with pre-warmed fluid. Active warming (OR = 0.46, 95% CI 0.26-0.81), overweight or obesity (OR = 0.39, 95% CI 0.28-0.56), high baseline core temperature before anesthesia (OR = 0.08, 95% CI 0.04-0.13), and high ambient temperature (OR = 0.89, 95% CI 0.79-0.98) were significant protective factors for hypothermia. In contrast, major-plus operations (OR = 2.00, 95% CI 1.32-3.04), duration of anesthesia (1-2 h) (OR = 3.23, 95% CI 2.19-4.78) and >2 h (OR = 3.44, 95% CI 1.90-6.22,), and intravenous un-warmed fluid (OR = 2.45, 95% CI 1.45-4.12) significantly increased the risk of hypothermia.

Conclusions: The incidence of inadvertent intraoperative hypothermia in Beijing is high, and the rate of active warming of patients during operation is low. Concern for the development of intraoperative hypothermia should be especially high in patients undergoing major operations, requiring long periods of anesthesia, and receiving un-warmed intravenous fluids.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Change of intraoperative core temperature…
Fig 1. Change of intraoperative core temperature during operations.
Patients’ core temperature was measured at the tympanic membrane beginning every 15 minutes after the induction of anesthesia and until the end of the operation. A total of 830 subjects were enrolled in the study; 89 (10.7%) received active warming, and 741(89.3%) received no warming.

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Source: PubMed

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