A retrospective audit to examine the effectiveness of preoperative warming on hypothermia in spine deformity surgery patients. Issue 11 (5th June 2013)

• Record Type: Journal Article
• Authors: Görges, Matthias; Ansermino, J. Mark; Whyte, Simon D.; Kurth, Dean
• Is Part Of: Paediatric anaesthesia. Volume 23:Issue 11(2013)
• Page Start: 1054
• Page End: 1061
• Publication Date: 2013-06-05
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12204
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" id="pan12204-abs-0001"> <title>Summary</title> <sec id="pan12204-sec-0001" sec-type="section"> <title>Background</title> <p>Hypothermia (core body temperature <36°C) during surgery has been associated with surgical site infection, a major risk in all spine deformity surgeries. Forced air warming is an important method of intraoperative temperature maintenance in children. In mid‐2010, we empirically introduced preoperative warming as a strategy to reduce intraoperative hypothermia.</p> </sec> <sec id="pan12204-sec-0002" sec-type="section"> <title>Objective</title> <p>We report the prevalence and extent of hypothermia during spine deformity surgeries at our institution and evaluate the effect of the introduction of preoperative warming.</p> </sec> <sec id="pan12204-sec-0003" sec-type="section"> <title>Methods</title> <p>We performed a retrospective audit of temperature data in children who underwent spine deformity surgeries during two‐seven‐month periods: November 2011 to June 2012 and 2 years prior to this period (before preoperative warming implementation). Specifically, the following data were obtained: (i) case duration; (ii) first measured temperature; (iii) last measured temperature; (iv) percentage of case spent hypothermic; (v) number of hypothermic episodes per case, and (vi) delay between case start and time of first temperature measured. Data were compared visually and using the Mann–Whitney <italic>U</italic>‐test. Confidence intervals (CI) were obtained using the Hodges–Lehmann estimator.</p> </sec> <sec id="pan12204-sec-0004" sec-type="section"> <title>Results</title> <p>Preoperative warming reduced the percentage of case duration spent hypothermic by a median of 111.1 min (<italic>P</italic> < 0.001, 95% CI 77.1–139.9 min). Additionally, it increased the first measured temperature by a median of 0.5°C (<italic>P</italic> < 0.001, 95% CI 0.3–0.7°C). The last temperature at the end of the case remained unchanged (<italic>P </italic>= 0.57, 95% CI −0.2–0.1°C).</p> </sec> <sec id="pan12204-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Preoperative warming of children undergoing spine deformity surgery significantly reduces the percentage of case spent hypothermic, thereby potentially reducing risk of perioperative complications.</p> </sec> </abstract>