Unexpectedly high incidence of hypothermia before induction of anesthesia in elective surgical patients

医学 体温过低 围手术期 麻醉 入射(几何) 置信区间 前瞻性队列研究 逻辑回归 体质指数 颤抖 外科 内科学 光学 物理
作者
A. J. Wetz,Thorsten Perl,Ivo F. Brandes,Markus Harden,Martin Bauer,Anselm Bräuer
出处
期刊:Journal of Clinical Anesthesia [Elsevier BV]
卷期号:34: 282-289 被引量:33
标识
DOI:10.1016/j.jclinane.2016.03.065
摘要

Perioperative hypothermia is a frequently observed phenomenon of general anesthesia and is associated with adverse patient outcome. Recently, a significant influence of core temperature before induction of anesthesia has been reported. However, there are still little existing data on core temperature before induction of anesthesia and no data regarding potential risk factors for developing preoperative hypothermia. The purpose of this investigation was to estimate the incidence of hypothermia before anesthesia and to determine if certain factors predict its incidence. Data from 7 prospective studies investigating core temperature previously initiated at our department were analyzed. Patients undergoing a variety of elective surgical procedures were included. Core temperature was measured before induction of anesthesia with an oral (314 patients), infrared tympanic (143 patients), or tympanic contact thermometer (36 patients). Available potential predictors included American Society of Anesthesiologists status, sex, age, weight, height, body mass index, adipose ratio, and lean body weight. Association with preoperative hypothermia was assessed separately for each predictor using logistic regression. Independent predictors were identified using multivariable logistic regression. A total of 493 patients were included in the study. Hypothermia was found in 105 patients (21.3%; 95% confidence interval, 17.8%-25.2%). The median core temperature was 36.3°C (25th-75th percentiles, 36.0°C-36.7°C). Two independent factors for preoperative hypothermia were identified: male sex and age (> 52 years). As a consequence of the high incidence of hypothermia before anesthesia, measuring core temperature should be mandatory 60 to 120 minutes before induction to identify and provide adequate treatment to hypothermic patients.
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