Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-19T01:23:26.899Z Has data issue: false hasContentIssue false
  • English
  • Français

Closing the audit loop – prevention of perioperative hypothermia: audit and reaudit of perioperative hypothermia

Published online by Cambridge University Press:  11 July 2005

G. A. Gallagher ,
T. McLintock  and
M. G. Booth
G. A. Gallagher
Affiliation:
Glasgow Royal Infirmary, Department of Anaesthesia, Glasgow, UK
T. McLintock
Affiliation:
Glasgow Royal Infirmary, Department of Anaesthesia, Glasgow, UK
M. G. Booth
Affiliation:
Glasgow Royal Infirmary, Department of Anaesthesia, Glasgow, UK
Get access

Extract

Summary

Background and objective: Perioperative hypothermia is generally regarded as undesirable, but its incidence rate in the elective procedures in our hospital and the effect of the preventative measures taken against it were unknown. An initial audit indicated that postoperative hypothermia occurred. Therefore, changes in practice were implemented to address the problem. A further audit was then undertaken to assess the impact of these measures.

Methods: The first audit recorded data from 177 patients undergoing major elective surgical procedures. Variables recorded were: ASA classification, duration of operation, use and description of preventative measures for hypothermia, blood loss, intravenous fluids, and core and peripheral temperatures on arrival and discharge from the recovery room. The subsequent audit included 158 patients undergoing major general, orthopaedic or vascular surgical procedures. Patients had core temperatures measured preoperatively, immediately upon arrival in the recovery room, and just before discharge back to the ward. Core temperatures in both audits were measured using an infrared temperature probe.

Results: The mean body temperature on arrival in the recovery room of patients in the initial audit was 35.5°C (range 32.2–37.2, SD ± 0.74), and in the subsequent audit 36.6°C (33.6–38.2, ±0.72). These differences reached significance (P < 0.0001). This was despite an average duration of surgery of 133.5 (25–330) min in the initial study compared with 154.7 (90–480) min subsequently.

Conclusions: We found that with simple but consistently implemented changes in practice, postoperative hypothermia in elective patients could largely be eradicated.

Keywords

ANAESTHESIA, GENERALBODY TEMPERATURE CHANGES, hypothermiaPOSTOPERATIVE COMPLICATIONSSURGICAL PROCEDURES, operative
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 9 , September 2003 , pp. 750 - 752
Copyright
© 2003 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. J Am Med Assoc 1997; 277: 1127–1134.Google Scholar
Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalisation. N Engl J Med 1996; 334: 1209–1215.Google Scholar
Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet 1996; 347: 289–292.Google Scholar
Morris RH, Kumar A. The effect of warming mattresses on the maintenance of body temperature of the anesthetized, paralyzed adult patient. Anesthesiology 1972; 36: 408–411.Google Scholar