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Risk factors for perioperative hypothermia

2022.06.19 / Sunday

Risk factors for perioperative hypothermia

What are the risk factors for perioperative hypothermia?

In this article, we summarize four factors, which are explained below.

First, the age factor.

The changes in body temperature in the elderly and children during the perioperative period are relatively obvious, because the body surface area/weight ratio of the elderly and children has a relatively large change in body temperature, and patients with other special diseases are more prone to hypothermia.

In addition, it should be noted that preoperative preparation may lead to hypothermia, and thermal insulation measures should be implemented before surgery.

Second, environmental factors.

The greater the difference between the operating room temperature and the patient's body surface temperature, the more prone the patient is to hypothermia.

This is because, when the humidity in the operating room decreases, the amount of evaporation also increases, further increasing the loss of body heat.

And it should be noted that the rapid convection of the air in the laminar flow operating room will also increase the heat dissipation of the body.

Third, the effect of anesthesia.

General anesthesia is the main factor that causes perioperative hypothermia. After anesthesia starts, the patient's metabolic rate will decrease by more than 20% to 30%. At the same time, the human body will automatically reduce the threshold of vasoconstriction and chills, and increase the temperature from the center to the periphery. Poor; regional anesthesia will cause vasodilation, lower the threshold of vasoconstriction and chills, the transmission of sensory signals below the block level will be hindered, and the vasoconstriction and chills responses of the block segment will also be inhibited; intraoperative blood transfusion and fluid infusion It is also a risk factor for perioperative hypothermia. 

In adults, core temperature decreases by 0.25°C for every 1,000 mL of intravenous infusion of fluids below ambient temperature, or for every 200 mL of 4°C blood infused.

Fourth, surgical factors.

The longer the operation time, the more the patient loses heat;

The greater the exposure of the body surface and body cavity, the more water evaporates;

A large amount of fluid flushing during surgery (whether flushing the thoracic cavity or flushing the abdominal cavity) will remove heat;

Intraoperative blood loss, fluid loss, and poor microcirculation perfusion will increase the impact on body temperature.

Based on the above factors, at the beginning of perioperative surgery, it is recommended to start 24-hour body temperature monitoring, use a disposable medical temperature probe to monitor the patient's body temperature changes in real time, and take timely warming measures to ensure perioperative safety.