Preventing hypothermia in outpatient plastic surgery by self-warming or forced-air-warming blanket: A randomised controlled trial
BACKGROUND In our outpatient post anaesthesia unit patients reported that they were feeling cold with or without shivering. Anaesthetic agents cause reduced thermoregulation, initially by redistribution of blood flow from core to periphery, later by negative balance between thermogenesis and heat loss. Even mild peri-operative hypothermia increases the risk of surgical wound infections, bleeding, impaired cardiac function, shivering, and decreases comfort. OBJECTIVE(S) We aimed to evaluate which of our current active warming measures, self-warming blanket or forced-air-warming blanket, were most effective in preventing inadvertent intraoperative heat loss. Secondarily, we assessed whether they prevented inadvertent peri-operative hypothermia when defined as core body temperature below 36 °C. DESIGN Randomised controlled trial, parallel group design. SETTING Aleris Solsiden hospital for outpatient surgery, Trondheim, Norway, from March to June 2016. PATIENTS A total of 112 consecutive patients planned for outpatient plastic surgery. Reasons for noninclusion: failing to meet the criteria for outpatient surgery according to the standard of the national society of anaesthesiology. INTERVENTION(S) Patients were randomised to active warming by a self-warming blanket or a forced-air-warming blanket. All patients received routine measures to prevent hypothermia with a high temperature in the operation theatres, prewarmed fluids, cotton blankets and surgical dra...
CONCLUSIONS: Critical incidents lead to longer length of stay in the PACU. Regular inspection and immediate response for critical incidents in the PACU is essential for the maintenance of the quality of the immediate postoperative care. PMID: 32778494 [PubMed - as supplied by publisher]
CONCLUSION: Reducing perioperative blood loss requires a multimodal and multidisciplinary approach. Although high-quality evidence exists in certain areas, the overall evidence base for reducing intraoperative blood loss remains limited. PMID: 31903592 [PubMed - in process]
Inadvertent perioperative hypothermia (IPH), where core body temperature is less than 36 °C or 96.8°F, occurs in 26-90% of patients undergoing elective surgery. This preventable anesthesia- and surgery-related complication affects patients’ outcome and is associated with increased risk for surgical site infections (SSIs), bleeding, blood transfusions, and decreased patient thermal c omfort.
A 72-year-old male cardiac transplant patient presented after sustaining facial and extremity trauma caused by a pit bull dog attack. The case was further complicated by duration of the surgery, bleeding, infection risk, intraoperative hypothermia, immunosuppression, and the risk of sepsis. His anesthetic management required careful coordination with his transplant team. We also sought the expertise of the in-house pharmacist to obtain the appropriate administration strategies for the patient ’s immunosuppressants.
A 72-year-old male cardiac transplant patient presented after sustaining facial and extremity trauma caused by a pit bull dog attack. The case was further complicated by the duration of the surgery, bleeding, infection risk, intraoperative hypothermia, immunosuppression, and the risk of sepsis. His anesthetic management required careful coordination with his transplant team. We also sought the expertise of the in-house pharmacist to obtain the appropriate administration strategies for the patient's immunosuppressant agents.
Marco Vacante1, Antonio Biondi1, Francesco Basile1, Roberto Ciuni1, Salvatore Luca1, Salomone Di Saverio2, Carola Buscemi3, Enzo Saretto Dante Vicari3 and Antonio Maria Borzì3* 1Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy 2Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom 3Department of Clinical and Experimental Medicine, Specialization School in Geriatrics, University of Catania, Catania, Italy There is a high prevalence of hypothyroidism in the elderly population, mainly among women. The mo...
This article is protected by copyright. All rights reserved. PMID: 30714261 [PubMed - as supplied by publisher]
This article is protected by copyright. All rights reserved. PMID: 30609198 [PubMed - as supplied by publisher]
This study investigated the effect of intraoperative body temperature fluctuations on the prognosis of liver recipients.METHODSThe body temperatures of liver recipients recorded from the induction of anesthesia (T0) until the end of surgery (T14) were retrieved. The patients were divided into two groups: the hypothermia group ( 5 min) and the normothermia group (≥35 °C or
For those looking for a better way to preserve the brain and vital organs in the future, an article released recently about work by scientists at Massachusetts General Hospital may give us a peek at a future tool in our resuscitation toolbox. It’s a process that might prove valuable if used in conjunction with extracorporeal membrane oxygenation (ECMO), impedance threshold devices (ITDs) and head-up CPR to keep people in a suspended state of animation until their malady is found, corrected and allowed to begin healing. Massachusetts General is the original and largest teaching hospital at Harvard Medical School. Thei...