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Perioperative Hypothermia

Cheisson Gaëlle, Jacqueminet Sophie, Cosson Emmanuel, Ichai Carole, Leguerrier Anne-Marie, Nicolescu-Catargi Bogdan, Ouattara Alexandre, Tauveron Igor, Valensi Paul, Benhamou Dan
Perioperative hyperglycaemia (>1.80g/L or 10 mmol/L) increases morbidity (particularly due to infection) and mortality. Hypoglycaemia can be managed in the perioperative period by decreasing blood sugar levels with insulin between 0.90 and 1.80g/l but it may occur more frequently when the goal is strict normoglycaemia. We propose continuous administration of insulin therapy via an electronic syringe (IVES) in type-1 diabetes (T1D) and type-2 diabetes (T2D) patients if required or in cases of stress hyperglycaemia...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
Lee-Hwa Tai, Abhirami A Ananth, Rashmi Seth, Almohanad Alkayyal, Jiqing Zhang, Christiano Tanese de Souza, Phillip Staibano, Michael A Kennedy, Rebecca C Auer
BACKGROUND: Cancer surgery can promote tumour metastases and worsen prognosis, however, the effect of perioperative complications on metastatic disease remains unclear. In this study we sought to evaluate the effect of common perioperative complications including perioperative blood loss, hypothermia, and sepsis on tumour metastases in a murine model. METHODS: Prior to surgery, pulmonary metastases were established by intravenous challenge of CT26LacZ colon cancer cells in BALB/c mice...
March 12, 2018: BMC Cancer
A D Rogers, M Saggaf, N Ziolkowski
BACKGROUND: Patients with extensive burn injuries are susceptible to a host of accompanying adverse effects should they develop perioperative hypothermia, which occurs in up to ¼ of all major burn cases. This quality improvement project aimed to reduce the incidence of perioperative hypothermia to below 10% of cases in patients with major burn (Total Body Surface Area [TBSA] >15%), within a one year period. METHODS: A baseline diagnostic phase was undertaken to provide a greater understanding of the incidence, natural history and risk factors of perioperative hypothermia...
March 7, 2018: Burns: Journal of the International Society for Burn Injuries
Ramsis F Ghaly, Armen Haroutunian, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Altered mental status describes impaired mental functioning ranging from confusion to coma and indicates an illness, either metabolic or structural in nature. Metabolic causes include hypothyroidism, hyperuremia, hypo/hyperglycemia, hypo/hypernatremia, and encephalopathy. The structural causes include tumors, brain hemorrhage, infection, and stroke. To our knowledge, this is the first case in which a patient presented with altered mental status from both metabolic (myxedema coma) and structural diseases (frontal meningioma) with vasogenic edema and midline shift...
2018: Surgical Neurology International
Hui Yeon Lee, Gaeun Kim, Yeonghee Shin
AIMS AND OBJECTIVES: The aim of this study was to investigate whether warming the feet with socks would prevent hypothermia among patients undergoing spinal surgery. BACKGROUNDS: Perioperative hypothermia is a common health problem among spinal surgery patients. RESEARCH DESIGN: This study used a quasi-experimental design. METHODS: Seventy-two patients were assigned to two groups. The control group (n=36) received usual care without the warmed socks...
February 3, 2018: Journal of Clinical Nursing
Sahin Iscan, Bortecin Eygi, Yuksel Besir, Ismail Yurekli, Habib Cakir, Levent Yilik, Orhan Gokalp, Ali Gurbuz
Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response...
January 31, 2018: Current Pharmaceutical Design
Judy Munday, Sonya Osborne, Patsy Yates
PURPOSE: Rates of inadvertent perioperative hypothermia among women undergoing spinal anesthesia for cesarean delivery are reported to be high. Intrathecal morphine has been noted to have a potentially potent effect on thermoregulation. This retrospective case-control study sought to investigate the incidence of perioperative hypothermia in women undergoing cesarean delivery with and without intrathecal morphine and to describe any clinical factors associated with the condition, the identification of which would provide direction for nursing priorities in the care of the condition...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Jed Duff, Kim Walker, Karen-Leigh Edward
BACKGROUND: Perioperative hypothermia significantly increases a patient's risk of adverse complications, such as surgical site infection; morbid cardiac events, and surgical bleeding. Although guideline recommendations are relatively simple and inexpensive, they are often not adhered to in clinical practice. Knowledge tools are tangible resources that assist clinicians to provide evidence-based care. PURPOSE: This article reports the collaborative development of a knowledge tool-a perioperative thermal care bundle...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Raphael Okoué, Daniela Calabrese, Pascal Nzé, Simon Msika, Hawa Keita
BACKGROUND: Hypothermia is associated with an increased postoperative morbidity and mortality. Forced-air warming systems are the most effective methods for its prevention. When using a mattress, a reduction in the area of diffusion of warm air by crushing due to excess weight cannot be ruled out. METHODS: We designed a prospective study to compare the efficacy of a forced-air warming mattress (Bair Hugger® 585) to prevent hypothermia (core temperature (CT°) < 36 °C) in morbidly obese (group MO, body mass index (BMI) ≥ 40 kg/m2 ) and non-obese patients (group NO, BMI < 30 kg/m2 )...
January 11, 2018: Obesity Surgery
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
Judy Munday
The prevention of perioperative hypothermia is a responsibility of all members of the perioperative team. Nurses are well placed to have a central role in implementing strategies to reduce perioperative heat loss, which is associated with a host of adverse outcomes (National Collaborating Centre for Nursing and Supportive Care 2008).
May 2017: Australian Nursing & Midwifery Journal
Victoria M Steelman, Sena Chae, Jed Duff, Michael J Anderson, Adnan Zaidi
PURPOSE: To determine whether warming of irrigation fluids (32°C-40°C) compared with using room-temperature irrigation fluids (20°C-22°C) decreases the risk of perioperative hypothermia (<36°C) for patients undergoing shoulder, hip, or knee arthroscopy. METHODS: One reviewer, with the assistance of a medical librarian, searched the following databases: PubMed, Embase, Cochrane Central, SPORTDiscus, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature)...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jordan B Simpson, Vijai S Thomas, Sabir K Ismaily, Pavel I Muradov, Philip C Noble, Stephen J Incavo
BACKGROUND: Total joint patients are particularly vulnerable to perioperative hypothermia (PH) (combined effects of anesthesia, radiation, and convective heat loss from exposed skin surfaces and cool temperatures in the operating room). There are limited studies on PH in these patients. METHODS: In a retrospective review of 204 patients undergoing primary hip and 179 undergoing primary knee replacement surgeries, time and temperature parameters were collected from the electronic health records from preoperative and postoperative recovery room nursing assessments, intraoperative anesthesia records, and floor nursing notes...
November 8, 2017: Journal of Arthroplasty
A Alam, Rafael Olarte, Jeannie Callum, Arsham Fatahi, B Nascimento, Claude Laflamme, Robert Cohen, Avery B Nathens, Homer Tien
BACKGROUND: Hypothermia (<36°C) exacerbates trauma-induced coagulopathy and worsens morbidity and mortality among severely injured trauma patients; there is a paucity of published data describing how well trauma centres adhere to standards regarding measurement of temperature, and best practices for preventing and treating hypothermia. METHODS: We completed a retrospective quality audit of all severely injured trauma patients (Injury Severity Score (ISS≥20)) who had urgent surgery at Sunnybrook Health Sciences Centre (SHSC) between 2010 and 2014...
January 2018: Injury
Mary J Ogg
Bed bugs Key words: bed bugs, pest management, infestation, transmission. Warming irrigation fluids Key words: irrigation fluid, warming fluid, hypothermia, warming cabinet. Fasting before surgery Key words: fasting, NPO, liquids, solids. Advanced cardiac life support requirements for perioperative nurses Key words: advanced cardiac life support, ACLS certification, pediatric advanced life support, PALS certification, basic life support.
December 2017: AORN Journal
R Grote, A J Wetz, A Bräuer, M Menzel
BACKGROUND: Inadvertent perioperative hypothermia, which is defined as a core body temperature of less than 36.0 °C, can have serious consequences in surgery patients. These include cardiac complications, increased blood loss, wound infections and postoperative shivering; therefore, the scientific evidence that inadvertent perioperative hypothermia should be avoided is undisputed and several national guidelines have been published summarizing the scientific evidence and recommending specific procedures...
November 20, 2017: Der Anaesthesist
Rudolf Mörgeli, Tobias Wollersheim, Claudia Spies, Felix Balzer, Susanne Koch, Sascha Treskatsch
Frail patients are more prone to develop complications during and after surgery. As the syndrome becomes more common, recognition and special management of frail patients in the perioperative setting is becoming crucial to improve short- and long-term outcomes. Based on current literature and guidelines, we present a compilation of strategies that could be employed to reduce postoperative complication rates in frail patients. Due to their impaired response to stressors, potential perioperative hazards to frail patients are identified and discussed...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
Jed Duff, Kim Walker, Karen-Leigh Edward, Nicholas Ralph, Jo-Ann Giandinoto, Kimberley Alexander, Jeff Gow, John Stephenson
AIMS AND OBJECTIVES: To improve the prevention, detection and treatment of perioperative inadvertent hypothermia in adult surgical patients by implementing a Thermal Care Bundle. BACKGROUND: Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections and morbid cardiac events. The Thermal Care Bundle consists of three elements: (i) assess risk; (ii) record temperature; and (iii) actively warm...
November 17, 2017: Journal of Clinical Nursing
K Ousey, K-L Edward, S Lui, J Stephenson, K Walker, J Duff, D Leaper
OBJECTIVE: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. METHOD: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs...
November 2, 2017: Journal of Wound Care
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