Abstract
Background: Maintaining normothermia during porcine surgery is critical in ensuring subject welfare and recovery, reducing the risk of immune system compromise and surgical-site infection that can result from hypothermia. In humans, various methods of patient heating have been demonstrated to be useful, but less evaluation has been performed in techniques to prevent hypothermia perioperatively in pigs. Methods: We compared body temperature regulation during surgery before and after modification of the ambient temperature of the operating laboratories. Three different methods of heating were then compared; a standard circulating water mattress, a resistive fabric blanket, and a forced hot air system. The primary measure was percentage of temperature readings outside a specification range of 36.7–40.0 °C. Results: Tighter control of the ambient temperature while using a circulating water mattress reduced the occurrence of out-of-specification body temperature readings from 20.8% to 5.0%, with most of these the result of hypothermia. Use of a resistive fabric blanket further reduced out-of-specification readings to 1.5%, with a slight increase in the occurrence of hyperthermia. Use of a forced air system reduced out-of-specification readings to less 0.1%. Conclusions: Maintenance of normothermia perioperatively in pig can be improved by tightly controlling ambient temperatures. Use of a resistive blanket or a forced air system can lead to better control than a circulating water mattress, with the forced air system providing a faster response to temperature variations and less chance of hyperthermia.
Highlights
Perioperative hypothermia is a recurrent challenge which is critically important to patient welfare, recovery, and reliable data collection
Use of a resistive blanket or a forced air system can lead to better control than a circulating water mattress, with the forced air system providing a faster response to temperature variations and less chance of hyperthermia
Hypothermia occurs in most surgical patients who do not receive supplemental heat, primarily as a result of the cooler operating room temperatures required for surgeon and staff comfort along with the thermoregulatory impairment experienced by patients under anesthesia [1,2,3,4]
Summary
Perioperative hypothermia is a recurrent challenge which is critically important to patient welfare, recovery, and reliable data collection. Three hours into surgery, the linear decline in core temperature reaches a plateau in response to the development of a thermal equilibrium or a sufficiently hypothermic state which reactivates peripheral vasoconstriction [5,6,7] Under such conditions, tissue oxygenation is significantly reduced along with leukocyte migration, neutrophil phagocytosis, as well as antibody and cytokine production [8,9]. This study investigated the incidence of hypothermia in anesthetized porcine surgical patients under a standard warming protocol and evaluated the efficacy of various warming methods, including ambient temperature adjustment as well as the use of circulating hot water mattresses, conductive heating blankets, and forced-air warming systems
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