Target Temperature Management for the Elimination of Postoperative Hypothermia
Perioperative (unintended) hypothermia develops spontaneously as a result of injury, surgery and anesthesia as a result of violations of compliance of heat production and heat loss suppression of compensatory thermoregulatory response. Objective. To study the effects of unintended hypothermia in the postoperative period, the development of its associated postoperative complications in patients with multiple injuries and to evaluate the effectiveness of its elimination using convection heating systems. Materials and methods. The study involved 40 patients with multiple injuries after surgery, who were actively rewarmed with convection heating system «WarmAir» (CSZ, USA) (n = 20) and passively rewarmed (n = 20). We studied the duration and rate of rewarming, the need for red blood cell transfusions in the postoperative period and duration of stay in an intensive care unit. Results. The duration of warming at convection warming group was 2.81 ± 0.84 hours as compared to 5.57 ± 0.91 h in the group with passive warming; warming rate of 0.91 ± 0.29 and 0.28 ± 0.07 °C/h, respectively. The need for blood transfusion of erythrocytes in patients with convective warming was significantly less (763.0 ± 1.31 ml) compared to the group with passive warming (978.0 ± 1.29 mL). There was no significant difference between the groups in the duration of patients staying in an intensive care unit. Conclusions. Using convective warming system in ICU allows quickly and effectively normalize the temperature homeostasis in critically ill patients with multiple trauma.
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Mayer S., Sessler D. Therapeutic hypothermia. — New York: Marcel Dekker, 2005. — 629 p.
Buggy D.J., Crossley A.W. Thermoregulation, mild perioperative hypothermia and postanaesthetic shivering // Br. J. Anaesth. — 2000. — Vol. 84 (5). — P. 615-628.
Сесслер Д. Температурный контроль во время операции // Актуальные проблемы анестезиологии и реаниматологии. Освежающий курс лекций. — Архангельск: Тромсе, 1997. — С. 76-82.
Zhao J., Luo A-L., Xu L., Huang Y.-G. Forced-air warming and fluid warming minimize core hypothermia during abdominal surgery // Chin. Med. Sci. J. — 2005. — Vol. 20 (4). — Р. 261-264.
Kurz A., Kurz M., Poeschl G. [et al.] Forced-air warming maintains intraoperative normothermia better than circulating-water mattresses // Anesth. Analg. — 1993. — Vol. 77 (1). — P. 89-95.
Abelha F.J., Castro M.A., Neves A.M., Landeiro N.M., Santos C.C. Hypothermia in a surgical intensive care unit // BMC Anesthesiology. — 2005. — Vol. 5. — 7 (doi:10.1186/1471-2253-5-7).
Pasquer M., Zurron N., Weith B. et al. Deep accidental hypothermia with core temperature below 24 degrees presenting with vital signs // High Alt. Biol. — 2014. — V. 815. — P. 58-63.
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