Perioperative hypothermia in patients undergoing major colorectal surgery

Abstract

Perioperative hypothermia occurs frequently and can have serious health-related and financial consequences. Despite multiple warming methods available, perioperative hypothermia remains prevalent. To be effective, preventative measures must be timely and target patients most at risk. The aim of this retrospective review was to document the incidence and patterns of hypothermia in patients undergoing major colorectal surgery. Hospital records were used to obtain demographic and clinical information on 255 patients undergoing major colorectal surgery over one year. Temperatures were recorded from five perioperative time-points and correlated with potential contributing factors. Most patients (74%) experienced mild hypothermia, which was most common intraoperatively. Elective patients experienced the greatest drop in temperature between admission and commencement of surgery while emergency patients experienced a similar drop intraoperatively. The most significant determinant of intraoperative hypothermia was core temperature at the start of surgery (P < 0.01). Factors increasing hypothermia at the start of surgery were an elective presentation, an arrival temperature below 36.5°C (P < 0.01) and an age greater than 70 years (P < 0.05). Mild hypothermia in patients undergoing major colorectal surgery is common, despite preventative measures. Core temperatures prior to commencement of the operation should be optimized with both active and passive warming measures, particularly for older patients and those arriving with lower core temperatures. Elective patients should also have their temperatures monitored as closely, if not more closely, than emergency patients. Preventing early declining trends in core temperature may positively influence later perioperative temperatures and improve outcomes.