Risk Of Hypothermia Research Articles

Implementasi Hot Pack Untuk Peningkatan Suhu Tubuh Pada Pasien Hipotermi Pasca Operasi

Introduction: As a kind of therapy, surgery involves cutting into the patient in order to reach the targeted location of the body. The risk of hypothermia is a potential consequence of anesthesia. A dangerous drop in core temperature, below 36 degrees Celsius, causes hypothermia. One way to alleviate cold symptoms is using a warm compress. An alternative to using hot packs to raise core temperature is a warm compress. Hot packs have many advantages over buli-buli, the most notable of which is that they can be reused and never run out of steam. Objective: This community service activity is to implement hot packs on hypothermic patients. Method: As part of their community service, volunteers take patients' temperatures using electronic thermometers. Including thirty individuals who were found to have hypothermia. Result: Impact of Volunteer Work Hypothermia after administration of a hot pack, with a pre-package average temperature of 35.20 degrees Celsius Average core temperature before administration of the hot pack: 36.50 °C Body temperature values ranged from 34.10C before implementation to 36.70C thereafter, with a low value of 35.10C and a high value of 35.90C before and after, respectively. Conclusion: This proves that there is an increase in body temperature in hypothermic patients after implementing Hot packs.

Modern CRRT systems are associated with lower risk of hypothermia.

One risk of continuous renal replacement therapy (CRRT) is inadvertent hypothermia (IH), which is defined as a non-therapeutic core temperature decrease below normal. In continuous renal replacement therapy, heat loss will always occur from blood pumped through the dialysis circuit to cooler environment, predisposing for hypothermia. Blood flow and effluent flows are the most important parameters causing heat loss. We investigated and compared the novel TherMax warmer to previous generation technologies during CRRT in a multicenter setting. This was a prospective observational multicenter study with historic single-center controls. The study group consisted of 100 patients in eight Swedish ICUs with clinical indication for CRRT, using the PrisMax platform and TherMax warmer. Both patient and set warmer temperatures were recorded hourly for the first 24h. The presence of treatment hours in hypothermia (< 36.0 Celsius) and the difference between set warmer temperature and measured patient temperature in the multi-center study cohort were compared to a matched single-center historic control cohort treated with the old Prismaflex platform and adjacent Barkey warmer. In the TherMax group 77/100 (77.0%) of patients, and for controls 26/86 (30.2%) of patients were free of hypothermia (Chi square, p < 0.001). The mean number of hours spent in hypothermia was (mean ± SD) 0.66 ± 1.60 and 6.92 ± 7.79h in the TherMax and control groups, respectively (Chi square p < 0.001).In the study group the patient temperature was higher than the set temperature on the warmer with a difference of Δ0.47 ± 0.80°C (minor difference), whereas in the control group the set temperature on the warmer was higher than the patient temperature with a difference of Δ4.55 ± 1.00°C (over-correction).The novel TherMax warmer technology protected against hypothermia and was significantly more accurate than the Barkey warmer.

Early prediction of intraoperative hypothermia in patients undergoing gynecological laparoscopic surgery: A retrospective cohort study.

Intraoperative hypothermia is one of the most common adverse events related to surgery, and clinical practice has been severely underestimated. In view of this, this study aims to build a practical intraoperative hypothermia prediction model for clinical decision-making assistance. We retrospectively collected clinical data of patients who underwent gynecological laparoscopic surgery from June 2018 to May 2023, and constructed a multimodal algorithm prediction model based on this data. For the construction of the prediction model, all data are randomly divided into a training queue (70%) and a testing queue (30%), and then 3 types of machine learning algorithms are used, namely: random forest, artificial neural network, and generalized linear regression. The effectiveness evaluation of all predictive models relies on the comprehensive evaluation of the net benefit method using the area under the receiver operating characteristic curve, calibration curve, and decision curve analysis. Finally, 1517 screened patients were filtered and 1429 participants were included for the construction of the predictive model. Among these, anesthesia time, pneumoperitoneum time, pneumoperitoneum flow rate, surgical time, intraoperative infusion, and room temperature were independent risk factors for intraoperative hypothermia and were listed as predictive variables. The random forest model algorithm combines 7 candidate variables to achieve optimal predictive performance in 2 queues, with an area under the curve of 0.893 and 0.887 and a 95% confidence interval of 0.835 to 0.951 and 0.829 to 0.945, respectively. The prediction efficiency of other prediction models is 0.783 and 0.821, with a 95% confidence interval of 0.725 to 0.841 and 0.763 to 0.879, respectively. The intraoperative hypothermia prediction model based on machine learning has satisfactory predictive performance, especially in random forests. This interpretable prediction model helps doctors evaluate the risk of intraoperative hypothermia, optimize clinical decision-making, and improve patient prognosis.

Suprathel® and water-filtered infrared-A radiation (wIRA) as a new treatment strategy for toxic epidermal necrolysis (TEN): A prospective study

Toxic epidermal necrolysis (TEN) is a life-threatening condition with a mortality rate of approximately 25% to 30%. Early and adequate wound coverage is necessary due to largescale skin defects. Suprathel® is a modern wound dressing that shows promising results when treating superficial wounds such as scald, burns and abrasions. Previous reports on wound care in TEN patients using Suprathel® have described radical debridement of the entire affected body surface prior to the application of Suprathel®. However, the heavy wound secretion frequently results in the loss of a significant portions of Suprathel® over time. Prolonged operation time increases the risk of hypothermia. In addition, the large open wound areas result in an increased risk for hypovolemic shock, wound infection, and subsequent sepsis. This study presents a new strategy that involves serial hydrotherapeutic wound debridement and the stepwise application of Suprathel® to the affected areas. Water-filtered infrared A light (wIRA) was used to keep the Suprathel®-covered areas dry. Retrospective data from patients who received polyhexanide gel treatment (control group 1) and those who only received Suprathel® (control group 2) were collected for matched-pair analysis. The length of stay in the intensive care unit (ICU) and the need for catecholamines were compared among the three groups. By using serial debridement and combining wIRA treatment with Suprathel® dressings, we were able to significantly reduce the need for catecholamines, lower the risk of hypothermia and infection, and shorten ICU stay compared to the two control groups. We propose incorporating this methodology into the standard of care to promote wound closure and healing when treating TEN patients.

Perioperative anaesthetic complications in healthy cats undergoing anaesthesia for neutering in first opinion practice.

The aim of the present study was to identify the incidence of common perioperative anaesthetic complications in cats undergoing anaesthesia for neutering in three UK first opinion practices. A retrospective anaesthetic record analysis was performed on cats anaesthetised for neutering at practices 1 and 2 between 9 December 2017 and 2 February 2021 and practice 3 between 9 March 2020 and 7 January 2021. A search of the practice management system identified all cats that had undergone neutering in the selected timeframe. Data from 1019 cats were included in the study. Information relating to patient characteristics and data from the anaesthesia session were extracted from electronic patient records and anaesthesia record charts and entered into an Excel spreadsheet. A definition of the complications was created after reviewing the literature and their incidence determined from the data set. Comparisons between different groups of cats in the study were made using a χ2 test for homogeneity or Fisher's exact tests to identify factors associated with increased incidence of complications. The anaesthetic-related mortality was 1/1019 (0.10%). The most common complications were hypotension (22.6%), bradycardia (16.7%) and hypothermia (13.8%). Less common complications were hypocapnia (12.7%), hypercapnia (8.7%), tachycardia (6.6%), apnoea (3.1%), hyperthermia (1.7%), hypertension (1.4%), endotracheal tube obstruction (1.1%), hypoxia (0.3%), undesirable recovery (0.6%) and cardiac arrhythmia (0.2%). Factors associated with increased risk of hypotension were acepromazine pre-anaesthetic medication, higher maximum isoflurane dose, longer anaesthetic duration and lower body weight. Factors associated with increased risk of bradycardia were medetomidine pre-anaesthetic medication, longer anaesthetic duration and higher body weight. Factors associated with increased risk of hypothermia were higher maximum isoflurane dose, increased anaesthetic duration and lower body weight. This study showed that anaesthetic complications were frequently observed, with complications documented in 53.4% of the cats in the study. The information in this study may help to guide prioritisation of monitoring in feline anaesthesia.

Content validation of the NANDA‐I nursing diagnosis risk for perioperative hypothermia (00254)

AbstractPurposeThe objectives of this study were to refine and validate the NANDA‐I nursing diagnosis risk for perioperative hypothermia (RPH) (00254).MethodsA quantitative, descriptive study was carried out according to the adapted diagnostic content validation model by Fehring. Data from a previously conducted literature study were triangulated with expert validation data to examine the nursing diagnosis RPH as well as potentially suggested new factors resulted from the literature review. In addition, the Wisdom of Crowds model was also considered. A nonprobability sampling technique, including purposive and snowball sampling methods, was used to recruit a panel of nurse experts. An anonymous and standardized questionnaire was developed in three languages for data collection. For validation, descriptive statistics, weighted ratios, and a one‐sample T‐test were used.ResultsNinety‐two nurse experts from seven countries and three continents participated in this study. Fifty‐eight nurse experts (63%) were female, and 33 (36%) were male, with a mean age of 42.26 years and 19.22 years of working experience. The diagnosis label, definition, 4 out of 5 risk factors (RF), 6 out of 14 at‐risk populations (ARPs), and 5 out of 9 associated conditions (ACs) were classified as major. One RF, eight ARP, and four ACs were considered minor. In addition, the experts validated 1 RF, 5 ARP, and 12 ACs from a previous literature study at least minor.ConclusionsThe nursing diagnosis RPH (00254) could be confirmed by specialized experts. No RF, ARP, or AC of the current nursing diagnosis needed to be rejected, and the added diagnostic indicators increased the robustness of the diagnosis.Implications for nursing practiceA precise concept of the nursing diagnosis RPH improves nurses' clinical reasoning and strengthens an individualized, evidence‐based care plan.

Cold exposure accelerates lysine catabolism to promote cold acclimation via remodeling hepatic histone crotonylation

BackgroundCold environments pose serious threats on human health, with increased risk for myocardial infarction, stroke, frostbite, and hypothermia. Acquired cold acclimation is required to minimize cold-induced injures and to improve metabolic health. However, the underlying mechanisms remain to be fully elucidated. ObjectiveWe aimed to identify critical amino acids involved in cold acclimation and unmask the regulatory mechanisms. MethodsA total of twenty male participants were recruited and followed up after 3 months’ natural cold exposure. Cold-induced vasodilation (CIVD) tests and clinical biochemical analysis were performed at baseline and after 3-months cold exposure, whilst blood samples were collected, and plasma amino acids were analyzed by targeted metabolomics. To further confirm the effect of lysine on cold tolerance and explain the latent mechanism, mice were challenged with chronic cold exposure for 7 days with lysine supplement, then core and local surface temperature as well as thermogenesis activity were detected. ResultsContinuous cold exposure shortened the CIVD onset time and increased the average finger temperature. Levels of the plasma lysine and glycine were decreased in both humans and mice. Venn analysis from three datasets revealed that lysine was the only significantly changed plasma amino acid, which strongly correlated with the altered CIVD. Moreover, mice sustained a relatively higher core temperature and surface temperature in the back, tail and paws upon lysine supplementation. Furthermore, lysine supplementation increased the level of histone H3K18cr and promoted the gene and protein expression of Cpt1a, Cpt2 and Cyp27a1 in liver. ConclusionOur work identified lysine as a critical amino acid for the remodeling of hepatic histone crotonylation that facilitates cold acclimation.

Perioperative Complications in Percutaneous Nephrolithotomy: Predictive Risk Factors and Hemodynamic Alterations.

Background Percutaneous nephrolithotomy (PCNL) is one of the most frequently used methods of treating large and/or complex kidney stones. Despite the growing interest in this area, there are relatively few papers that report studies of the changes in hemodynamics in the perioperative period and the potential factors that might influence the patient's condition. This aspect, however, has not been well described in the current literature, although fluctuations in blood pressure, temperature, and electrolyte balance during surgery may also lead to development of complications. Objectives In this study, variations in vital signs during surgery and between surgeries of 134 patients who underwent PCNLwere analyzed in relation to other predisposing factors such as hypothermia and the need for blood transfusion. Methods Biochemical data such as systolic blood pressure (SBP) and diastolic blood pressure (DBP), temperature, hemoglobin (Hb), hematocrit (Hct), and serum sodium and potassium were assessed at admission, during PCNL, and at 24 hours after surgery in 134 patients. In this study logistic regression was used to assess the influence of factors such as age, BMI (body mass index), surgery duration, volume of irrigation fluid, number of tracts, estimated blood loss, hypothermia, and requirement of red blood cell transfusions. Results The mean arterial pressure declined during surgery as compared to the preoperative value, reaching a value of 97.34 during the operation. The monitored mean temperature of the patient during the perioperative period was therefore reduced, with a small increase towards the end of the surgery. In the plasma concentrations, there was a decrease compared to pre- and postoperative values, and there was also a decline in 48-hour Hb, Hct, and sodium values. The analysis identified the volume of irrigation fluid as a predictor of mild hypothermia risk. A longer surgery time along with more tracts and worse condition of the patient meant that the patient needed more blood transfusion. It was also noted that none of them influenced the amount of Hb that was lost. Conclusion Variability in the recorded ABCs (airway, breathing, and circulation) before and after PCNL procedures was normative. Despite hypothermia being associated with the volume of irrigation fluids used in surgeries, most of the transfusions were administered in patient-complicated operations and critical states. This suggested that there was potential in defining the modifiable factors that worsen clinically reported outcomes to assist in enhancing protocol.

Wet Military Uniforms Pose Low Risk of Hypothermia while Static in Mild Cold Air.

Wet clothing is less insulative than dry clothing and increases heat loss in cold air. Tactical necessity can render removal of wet clothing impossible and/or require Warfighters to remain static to avoid detection, limiting heat production and posing a threat of hypothermia (core temperature <35°C). This study aimed to characterize body temperatures and evaluate hypothermia risk while statically exposed to 5°C air wearing three wet military uniforms. Further, low-speed loaded walking was evaluated as a strategy to raise end-static temperatures. Twelve adults (11M, 1F) randomly completed three wet-cold trials wearing either the Improved Hot Weather Combat Uniform (IHWCU), Army Combat Uniform (ACU), or ACU with silk-weight base layer (ACU+). Each trial involved 180 minutes of cold air (5.3±0.3°C, 0.8 m·s-1) exposure after a clothed 2-minute head-out immersion (34.0 ± 0.2°C). Volunteers were static for 60 minutes followed by 120 minutes of loaded walking. Rectal temperature (Tre) area under the curve did not differ among the three wet uniforms when static (p=0.431) with Tre increasing, rather than decreasing, across the 60 minutes (IHWCU: +0.26±0.19°C, ACU: +0.37±0.21°C, ACU+: +0.36±0.20°C). Hypothermia risk with 60-minute static wet-cold exposure therefore appears minimal, regardless of the military uniform worn. End-static finger temperatures (IHWCU: 9.48±2.30°C, ACU: 9.99±1.82°C, ACU+: 9.27±1.66°C, p >0.999) were reduced by ~20-23°C posing a considerable dexterity concern. Heat production of ~210 W·m2 appeared sufficient to begin to reverse negative cumulative heat storage and initiate slight elevation of rectal and peripheral temperatures, although finger temperatures increased < 2°C after 120 minutes. ClinicalTrials.gov ID:NCT05409937.

Hypothermia and the Global War on Terror: 18 Years of Minimal Progress.

The association between hypothermia, coagulopathy, and acidosis in trauma is well described. Hypothermia mitigation starts in the prehospital setting; however, it is often a secondary focus after other life-saving interventions. The deployed environment further compounds the problem due to prolonged evacuation times in rotary wing aircraft, resource limitations, and competing priorities. This analysis evaluates hypothermia in combat casualties and the relationship to resuscitation strategy with blood products. Using the data from the Department of Defense Joint Trauma Registry from 2003 to 2021, a retrospective analysis was conducted on adult trauma patients. Inclusion criteria was arrival at the first military treatment facility (MTF) hypothermic (<95ºF). Study variables included: mortality, year, demographics, battle vs non-battle injury, mechanism, theater of operation, vitals, and labs. Subgroup analysis was performed on severely injured (15 < ISS < 75) hypothermic trauma patients resuscitated with whole blood (WB) vs only component therapy. Of the 69,364 patients included, 908 (1.3%) arrived hypothermic; the vast majority of whom (N = 847, 93.3%) arrived mildly hypothermic (90-94.9°F). Overall mortality rate was 14.8%. Rates of hypothermia varied by year from 0.7% in 2003 to 3.9% in 2014 (P <0.005). On subgroup analysis, mortality rates were similar between patients resuscitated with WB vs only component therapy; though base deficit values were higher in the WB cohort (-10 vs -6, P < 0.001). Despite nearly 20 years of combat operations, hypothermia continues to be a challenge in military trauma and is associated with a high mortality rate. Mortality was similar between hypothermic trauma patients resuscitated with WB vs component therapy, despite greater physiologic derangements on arrival in patients who received WB. As the military has the potential to conduct missions in environments where the risk of hypothermia is high, further research into hypothermia mitigation techniques and resuscitation strategies in the deployed setting is warranted.

Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital, Thailand.

Hypothermia is a relatively common complication in patients receiving continuous renal replacement therapy (CRRT). However, few studies have reported the factors associated with hypothermia. A retrospective cohort study was performed in five intensive care units (ICUs) to evaluate the incidence of hypothermia and the predictive factors for developing hypothermia during CRRT, with hypothermia defined as a time-weighted average temperature <36 °C. From January 2020 to December 2021, 300 patients were enrolled. Hypothermia developed in 23.7% of them within the first 24 hours after CRRT initiation. Compared to non-hypothermic patients, hypothermic patients were older and had lower body weight, more frequent acidemia, and higher ICU and 30-day mortality rates. In the multivariate analysis, age >70 years (odds ratio [OR], 2.59; 95% CI, 1.38-4.98; P=0.004), higher positive fluid balance on the day before CRRT (OR, 1.11; 95% CI, 1.02-1.22; P=0.02), and CRRT dose (OR, 1.003; 95% CI, 1.00-1.01; P=0.04) were significantly associated with hypothermia. Conversely, a higher body weight was independently associated with mitigated risk of hypothermia (OR, 0.89; 95% CI, 0.81-0.97; P=0.01). Moreover, a higher coefficient of variance of temperature was associated with greater ICU mortality (OR, 1.41; 95% CI, 1.13-1.78; P=0.003). Hypothermia during CRRT is a relatively common occurrence, and factors associated with hypothermia onset in the first 24 hours include older age, lower body weight, higher positive fluid balance on the day before CRRT, and higher CRRT dose. Greater temperature variability was associated with increased ICU mortality.

Comparison of Thermal Stability Between Immersion Bath and Sponge Bath Followed by Kangaroo Mother Care in Stable Preterm in Postnatal Ward.

Preterm neonates are at high risk of hypothermia, which can lead to adverse health outcomes. This study aimed to compare the effects of immersion bath followed by Kangaroo Mother Care (KMC) versus sponge bath followed by KMC on the thermal stability of preterm neonates. A prospective interventional study was conducted on 76 preterm neonates, with 38 neonates in each group (immersion bath and sponge bath). Axillary temperature was measured before the bath and at various time intervals after the bath (immediately, 15, 30, 45, and 60 minutes). The mean axillary temperature was significantly higher in the immersion bath group compared to the sponge bath group immediately after the bath (97.6°F vs. 96.3°F, p<0.001), at 15 minutes (97.6°F vs. 96.8°F, p<0.001), 30 minutes (97.9°F vs. 97.3°F, p=0.001), and 45 minutes (98.1°F vs. 97.7°F, p=0.002) post-bath. However, the difference was not statistically significant at 60 minutes post-bath (98.2°F vs. 98.0°F, p=0.091). Immersion bathing followed by KMC is more effective than sponge bathing followed by KMC in maintaining thermal stability in preterm neonates. Healthcare providers should consider adopting this approach as the preferred bathing method for preterm neonates to promote better health outcomes.

Thermal insulation does not hamper assessment of injuries in trauma CT scans.

The use of thermal insulations reduces the risk of hypothermia, therefore decreases the risk of death in trauma victims. The aim of the study was to assess whether thermal insulations cause artifacts, which may hinder the diagnosis of injuries, and how the used thermo-systems alter the radiation dose in polytrauma computed tomography. Computed tomography scans were made using the road accident victim body wrapped consecutively with 7 different covers. 14 injury areas were listed and evaluated by 22 radiologists. The radiation dose was measured using a dosimeter placed on the victim in the abdominal area. No significant artifacts in any of the tested covers were observed. The presence of few minor artifacts did not hinder the assessment of injuries. Certain materials increased (up to 19,1%) and some decreased (up to -30,3%) the absorbed radiation dose. Thermal insulation systems tested in this study do not cause significant artifacts hindering assessment of injuries in CT scans. Concern for artifacts and increased radiation dose should not be a reason to remove patients' thermal insulation during performing trauma CT-scanning.

Design of an innovative flow isolation device (FID) as an air flow barrier to control the temperature of large storage areas in cold room applications

The virus transmission chain of Covid-19 has a resulted in a significant, global impact on social and working life. Covid-19 vaccines require protective refrigerated conditions during delivery and storage. Warehousing and transportation of these vaccines need to be properly controlled to maintain the product quality and efficacy. Logistics companies developed large-scale refrigerated warehouses as storage relay stations. The heat convection between two rooms of the large-scale, low-temperature warehouses with different temperatures for example (5 °C, -15 °C) should be prevented to improve efficiency. In this study, an innovative flow isolation device (FID) was designed in Taipei Tech to block the storage areas, preventing heat convection. This device can maintain a constant low-temperature in warehouses used for vaccine storage. The axial flow fan draws air from the protected zones (5 °C, -15 °C) into the device. A perforated plate stabilizes the flow rate and maintains a uniform flow direction, creating a flow barrier created between two rooms. This flow can significantly block the heat convection induced by two warehouses with different temperatures. The computational fluid dynamics (CFD) software Ansys Fluent is used to simulate the effect of the FID on the prevention of the heat convection between two rooms. Different case studies were simulated at different machine sizes and supply air flow speeds. The simulated flow patterns and velocity fields are used to evaluate the highest isolation efficiency. The findings show that the FID device can effectively maintain the low temperature of the warehouse. Moreover, the FID helps to avoid heat loss and maintain thermal comfort in working areas, reducing the risk of hypothermia.

Development and validation of an intraoperative hypothermia nomograph model for patients undergoing video-assisted thoracoscopic lobectomy: a retrospective study

This study aimed to develop and internally validate a nomogram model for assessing the risk of intraoperative hypothermia in patients undergoing video-assisted thoracoscopic (VATS) lobectomy. This study is a retrospective study. A total of 530 patients who undergoing VATS lobectomy from January 2022 to December 2023 in a tertiary hospital in Wuhan were selected. Patients were divided into hypothermia group (n = 346) and non-hypothermia group (n = 184) according to whether hypothermia occurred during the operation. Lasso regression was used to screen the independent variables. Logistic regression was used to analyze the risk factors of hypothermia during operation, and a nomogram model was established. Bootstrap method was used to internally verify the nomogram model. Receiver operating characteristic (ROC) curve was used to evaluate the discrimination of the model. Calibration curve and Hosmer Lemeshow test were used to evaluate the accuracy of the model. Decision curve analysis (DCA) was used to evaluate the clinical utility of the model. Intraoperative hypothermia occurred in 346 of 530 patients undergoing VATS lobectomy (65.28%). Logistic regression analysis showed that age, serum total bilirubin, inhaled desflurane, anesthesia duration, intraoperative infusion volume, intraoperative blood loss and body mass index were risk factors for intraoperative hypothermia in patients undergoing VATS lobectomy (P < 0.05). The area under ROC curve was 0.757, 95% CI (0.714–0.799). The optimal cutoff value was 0.635, the sensitivity was 0.717, and the specificity was 0.658. These results suggested that the model was well discriminated. Calibration curve has shown that the actual values are generally in agreement with the predicted values. Hosmer–Lemeshow test showed that χ2 = 5.588, P = 0.693, indicating that the model has a good accuracy. The DCA results confirmed that the model had high clinical utility. The nomogram model constructed in this study showed good discrimination, accuracy and clinical utility in predicting patients with intraoperative hypothermia, which can provide reference for medical staff to screen high-risk of intraoperative hypothermia in patients undergoing VATS lobectomy.

Effects of Optimal Temperature Control in Body Contouring Surgery: A Nonrandomized Controlled Clinical Trial.

Perioperative hypothermia in plastic surgery has underestimated risks, including increased risk of infection, cardiac events, blood loss, prolonged recovery time, and increased nausea, pain, and opioid usage. Inadequate preventive measures can result in up to 4 hours of normothermia restoration. The aim was to compare the impact of different strategies for normothermia during plastic surgery procedures and their relationship with clinical outcomes. A nonrandomized clinical trial was conducted in a single center in Bogota, Colombia. We enrolled adult patients undergoing body contouring surgery and divided them into 4 intervention groups with different measures to control body temperature. Univariate and bivariate analyses were performed, comparing several clinical symptoms to evaluate outcomes. A total of 197 patients were analyzed. Most of them were females (84.3%). Mean age was 38.6 years, and the median procedure duration was 260 minutes. Demographic and clinical characteristics did not exhibit significant differences between the groups. There were notable variations in temperature measurements at crucial moments during the surgical procedure among the groups, attributed to the implementation of distinct thermal protective strategies. Group comparisons showed a relationship between hypothermia and increased nausea, vomiting, shivering, pain, and additional analgesia requirements. Incorporation of active thermal protective measures, such as Blanketrol or HotDog, during body contouring procedures, markedly diminishes the risk of hypothermia and enhances overall clinical outcomes. Implementing these active measures to maintain the patient in a state of normothermia not only improves operating room efficiency but also leads to a reduction in recovery room duration.

Hybrid operating rooms and the risk of postoperative hypothermia in pregnant women with placenta previa: A retrospective cohort study.

Births at advanced maternal ages (≥ 35 years) are increasing. This has been associated with a higher incidence of placenta previa, which increases bleeding risk. Hybrid operating rooms, designed to accommodate interventions and cesarean sections, are becoming more prominent because of their dual capabilities and benefits. However, they have been associated with increased postoperative hypothermia in pediatric settings; moreover, this has not been studied in pregnant women with placenta previa. This retrospective cohort study included pregnant women diagnosed with placenta previa who underwent elective cesarean section under general anesthesia between May 2019 and 2023. The patients were categorized according to the operating room type. The primary outcome was to determine whether the hybrid operating room is a risk factor for immediate postoperative hypothermia, defined as a tympanic membrane temperature below 36.0°C. The secondary outcomes were the effects of immediate postoperative hypothermia on the durations of postanesthetic care unit and postoperative hospital stays and incidence of complications. Immediate postoperative hypothermia (tympanic membrane temperature < 36.0°C) was more prevalent in the hybrid than in the standard operating room group (20% vs. 36.6%, p = 0.033), with a relative risk of 2.86 (95% confidence interval 1.24-6.64, p < 0.001). Patients undergoing surgery in the hybrid operating room who experienced immediate postoperative hypothermia stayed longer in the postanesthetic care unit (26 min vs. 40 min, p < 0.001) and in the hospital after surgery (4 days; range 3-5 vs. 4 days; range 4-11, p = 0.021). However, the complication rates of both groups were not significantly different (11.3% vs 7.3%, p = 0.743). Hybrid operating rooms may increase the risk of postoperative hypothermia. Postoperative hypothermia is associated with prolonged postanesthetic care unit and hospital stays. Preventing hypothermia in patients in hybrid operating rooms is of utmost importance.

The Wireless Health Monitoring for Neonatal Care

Abstract: The wireless health monitoring for neonatal care project addresses the critical need for advanced and non-intrusive health monitoring solutions for newborns in neonatal care settings. Approximately 10% of newborns require assistance at birth, and preterm infants often require specialized stabilization or resuscitation. Traditional monitoring methods, such as electrocardiography (ECG) and pulse oximetry (PO), face challenges in electrode application, delayed HR readings, and potential inaccuracies in assessing cardiac output. This project aims to develop a wireless health monitoring system that overcomes these limitations and offers real-time and accurate monitoring of vital parameters, with a focus on heart rate. The proposed system leverages wireless technology to enable continuous and non-intrusive monitoring, enhancing the efficiency of neonatal care in delivery rooms and neonatal intensive care units (NICUs). By incorporating state-of-the-art sensors and communication protocols, the system aims to provide timely and reliable data on neonatal vital signs. The wireless nature of the solution eliminates concerns related to electrode application difficulties, equipment availability, and the risk of hypothermia.

The effect of Qur’an recitation and kangaroo mother care on vital signs among low birth weight infants

Background: Infants with low birth weight require intensive care to prevent potential hypothermia, which increases the risk of pain and death. Kangaroo mother care, involving skin-to-skin contact, can reduce the risk of hypothermia and strengthen the bond with their mothers. Purpose: To observe the effect of the simultaneous application of Qur'an recitation and kangaroo mother care on the vital signs of low birth weight infants. Method: The study involved 17 stable low birth weight infants chosen through non-probability accidental sampling. The intervention consisted of playing recorded Qur'an recitation and administering kangaroo mother care for 45 minutes daily over a period of 3 days. The recitation was played at a volume of 40-50dB, maintaining at least 30 cm distance from the infants' ears. Results: The Shapiro-Wilk normality test showed that the data for oxygen saturation, heart rate, and temperature were normally distributed, with values exceeding α (0.05). According to the Wilcoxon test, the oxygen saturation data had a p-value of 0.001, with pre-test and post-test means of 94.29% and 98.53%, respectively. The heart rate data had a p-value of 0.011, with a pre-test mean of 139.8 beats per minute and a post-test mean of 132.4 beats per minute. The body temperature data had a p-value of 0.140, with pre-test and post-test means of 36.8°C and 36.7°C, respectively. Conclusion: Combining kangaroo care with playing recorded Qur'an recitation in the treatment and care of low birth weight infants significantly enhances physiological parameters, including oxygen saturation and heart rate.

Association of hypermagnesemia at birth and admission hypothermia in pre-term infants: A secondary analysis of a prospective cohort study.

Hypothermia on admission is associated with increased mortality in preterm infants. Drugs administered to pregnant women is implicated in its occurrence. Since magnesium sulfate has a myorelaxant effect, we aimed evaluating the association of hypermagnesemia at birth and admission hypothermia (axillary temperature <36.5°C) in preterm infants. We performed a secondary analysis of a prospective cohort study database including inborn infants <34 weeks, without congenital malformations. Hypermagnesemia was considered if the umbilical magnesium level > 2.5 mEq/L. Maternal and neonatal variables were used to adjust the model, submitted to the multivariate hierarchical modelling process. We evaluated 249 newborns with median birth weight and gestational age of 1375 (IQR 1020-1375) g and 31 (IQR 28-32) weeks, respectively. Hypermagnesemia occurred in 28.5% and admission hypothermia occurred in 28.9%. In the univariate analysis, the following variables were identified as being associated with admission hypothermia: hypermagnesemia (OR 3.71; CI 2.06-6.68), resuscitation (OR 2.39; CI 1.37-4.19), small to gestational age (OR 1.91; CI1.03-3.53), general anesthesia (OR 3.34; CI 1.37-8.13), birth weight (OR 0.998; CI 0.998-0.999) and gestational age (OR 0.806; CI 0.725-0.895). In the hierarchical regression model, hypermagnesemia remained independent associated with admission hypothermia (OR 3.20; CI 1.66-6.15), as well as birth weight (OR 0.999; CI 0.998-0.999) and tracheal intubation (3.83; CI 1.88-7.80). Hypermagnesemia was associated with an increased risk of admission hypothermia, as did tracheal intubation and lower birth weight.