术前保温和术中保温之间短暂中断与术中低体温发生率有关

术前保温和术中保温之间短暂中断与术中低体温发生率有关

背景

对于手术时间超过30分钟的手术，建议预防不经意的低体温，因为低体温会增加心肌缺血、术中失血、输血和伤口并发症的风险。因此，术前保温和术中保温之间的短暂中断可能导致低体温发生。这项回顾性调查研究的目的是确定术中不经意低体温的发生率是否受保温中断的影响。

方法

从麻醉记录单中获得术中最低体核温度和保温中断时间。连续记录患者体核温度，如果记录的最低体核温度低于36°C，则将患者归类为体温过低。计算低体温发生率与保温中断时间及术中体温过低发生率的相关性。  

结果

本研究共纳入5,084例患者。术中低体温发生率为15.3%。麻醉记录单记录19例(0.4%)患者的体温低于35.0°C。充气加温法中断时间增加与术中低体温发生率增加显著相关(P<0.0001)。充气加温法中断时间大于20min者低体温发生率明显高于充气加温法中断时间小于等于20min者(21.2%vs9.6%；P<0.0001)。  

结论

术中低体温发生率随着术前保温和术中保温之间充气加温法中断时间的延长而显著增加。短暂的保温中断可以保留术前保温的效果，并与术中低体温发生率相关。  

原始文献来源

Grote R, Wetz A, Bräuer A, Menzel M. Short interruptions between pre-warming and intraoperative warming are associated with low intraoperative hypothermia rates. Acta Anaesthesiol Scand. 2020;64:489–493.

Short interruptions between pre-warming and intraoperative   warming are associated with low intraoperative hypothermia  

rates 

Abstract

Background:Prevention of inadvertent hypothermia is recommended for procedures >30 minutes because hypothermia increases the risk of myocardial ischemia, intraoperative blood loss, transfusion and wound complications. Therefore, short warming interruptions between pre-warming and intraoperative warming might result in lower hypothermia rates. The aim of this retrospective investigation was to determine whether the incidence of inadvertent intraoperative hypothermia was affected by the warming interruption.

Methods:The lowest intraoperative body core temperature value and the warming interruption time were taken from anaesthesia records. Body core temperature was recorded continuously, and a patient was classified to be hypothermic if the lowest recorded temperature value was <36°C. Hypothermia rates and the correlation between warming interruption times and intraoperative hypothermia rates were calculated.

Results:Five thousand eighty-four patients were analysed. The intraoperative hypothermia rate was 15.3%. Nineteen patients (0.4%) had a recorded temperature of <35.0°C. An increase in forced-air warming interruption time was significantly associated with an increase in intraoperative hypothermia rates (P <0.0001). Patients with interruptions in forced-air warming >20 minutes showed significantly higher hypothermia rates than those with interruptions of ≤20 minutes (P <0.0001).

Conclusion:Intraoperative hypothermia rates increased significantly with longer forced-air warming interruptions between pre-warming and intraoperative warming. Short warming interruptions can preserve the effect of pre-warming and are associated with low intraoperative hypothermia rates.