Perioperative Hypothermia in the Pediatric Population: Prevalence, Risk Factors and Outcomes

Abstract

Background: Perioperative hypothermia has been associated with negative outcomes, and children may be at higher risk. This study describes the prevalence of pediatric perioperative hypothermia and evaluates its relationship to outcomes. Methods: This observational cohort study included the following electronically and prospectively recorded data from children fewer than 18 years of age undergoing general anesthesia: perioperative temperatures, warming interventions, patient characteristics, and surgical procedures, duration of anesthesia and perioperative outcomes. Intraoperative hypothermia was defi ned as temperature (T) < 36°C for at least fi ve minutes, and postoperative hypothermia as any T<36°C. Results: Of the 530 patients studied, 278 (52%) experienced intraoperative hypothermia. Invasive procedures and skin probe monitoring were associated with intraoperative hypothermia. In children with core T monitoring undergoing invasive procedures, older age, longer duration of anesthesia, greater blood loss and blood transfusion were associated with hypothermia. Warming interventions is used in most hypothermic children during operation, but in few in the post- anesthesia care unit (PACU). T was re-assessed in <6% of children who were hypothermic in the PACU. Conclusions: This study found a high prevalence of hypothermia and use of intraoperative warming techniques. Hypothermia was more common in older children and in those undergoing longer, invasive procedures and was associated with greater blood loss and blood transfusion.