Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 659-668 , December 2008

Thermal management during anaesthesia and thermoregulation standards for the prevention of inadvertent perioperative hypothermia

  • Alexander Torossian, MD (Associate Professor of Anaesthesia)

      Affiliations

    • Corresponding Author InformationTel.: +49-6421-2865980; Fax: +49-6421-2865555.

References 

  1. Torossian A. TEMMP (Thermoregulation in Europe Monitoring and Managing Patient Temperature) study group. survey on intraoperative temperature management in Europe. European Journal of Anaesthesiology. 2007;24:668–675
  2. Wunderlich C. Das Verhalten der Eigenwärme in Krankheiten. Leipzig: Verlag Otto Wigard; 1868;
  3. Sund-Levander M, Forsberg C, Wahren LK. Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review. Scandinavian Journal of Caring Sciences. 2002;16:122–128
  4. Hooper VD, Andrews JO. Accuracy of noninvasive core temperature measurement in acutely ill adults: the state of the science. Biological Research for Nursing. 2006;8:24–34
  5. Erickson R. Oral temperature difference in relation to thermometer and technique. Nursing Research. 1980;29:157–164
  6. Cork RC, Vaughan RW, Humphrey LS. Precision and accuracy of intraoperative temperature monitoring. Anesthesia and Analgesia. 1983;62:211–214
  7. Bissonnette B, Sessler DI, LaFlamme P. Intraoperative temperature monitoring sites in infants and children and the effect of inspired gas warming on esophageal temperature. Anesthesia and Analgesia. 1989;69:192–196
  8. Kelly G. Body temperature variability (Part 1): a review of the history of body temperature and its variability due to site selection, biological rhythms, fitness, and aging. Alternative Medicine Review. 2006;11:278–293
  9. ASPAN . Clinical guideline for the prevention of unplanned perioperative hypothermia. Journal of Perianesthesia Nursing. 2001;16:305–314
  10. American Society of Anesthesiologists (ASA) . Standards, guidelines and statements. Park Ridge, IL, USA: ASA; 2005;
  11. Satinoff E. Neural organization and evolution of thermal regulation in mammals – several hierarchically arranged integrating systems may have evolved to achieve precise thermoregulation. Science. 1978;201:16–22
  12. Just B, Delva E, Camus Y, et al. Oxygen uptake during recovery following naloxone. Anesthesiology. 1992;76:60–64
  13. Vassilieff N, Rosencher N, Sessler DI, et al. The shivering threshold during spinal anesthesia is reduced in the elderly. Anesthesiology. 1995;83:1162–1166
  14. Bredahl C, Hindsholm KB, Frandsen PC. Changes in body heat during hip fracture surgery: a comparison of spinal analgesia and general anesthesia. Acta Anaesthesiologica Scandinavica. 1991;35:548–552
  15. Matsukawa T, Sessler DI, Sessler AM, et al. Heat flow and distribution during induction of general anesthesia. Anesthesiology. 1995;82:662–673
  16. Sessler DI, Moayeri A, Stoen R, et al. Thermoregulatory vasoconstriction decreases cutaneous heat loss. Anesthesiology. 1990;73:656–660
  17. Kurz A, Plattner O, Sessler DI, et al. The threshold for thermoregulatory vasoconstriction during nitrous oxide/isoflurane anesthesia is lower in elderly than in young patients. Anesthesiology. 1993;79:465–469
  18. Caldwell FT, Wallace BH, Cone JB. The effect of wound management on the interaction of burn size, heat production, and rectal temperature. The Journal of Burn Care & Rehabilitation. 1994;15:121–129
  19. Hildebrand F, Giannoudis PV, van Griensven M, et al. Pathophysiologic changes and effects of hypothermia on outcome in elective surgery and trauma patients. American Journal of Surgery. 2004;187:363–371
  20. Scott EM, Buckland R. A systematic review of intraoperative warming to prevent postoperative complications. AORN Journal. 2006;83:1090–11041107–13
  21. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of wound infection and temperature group. The New England Journal of Medicine. 1996;334:1209–1215
  22. Frank SM, Beattie C, Christopherson R, et al. Unintentional hypothermia is associated with postoperative myocardial ischemia. The perioperative ischemia randomized anesthesia trial study group. Anesthesiology. 1993;78:468–476
  23. Schmied H, Kurz A, Sessler DI, et al. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289–292
  24. Leslie K, Sessler DI, Bjorksten AR, Moayeri A. Mild hypothermia alters propofol pharmacokinetics and increases the duration of action of atracurium. Anesthesia and Analgesia. 1995;80:1007–1014
  25. Heier T, Caldwell JE. Impact of hypothermia on the response to neuromuscular blocking drugs. Anesthesiology. 2006;104:1070–1080
  26. Lenhardt R, Marker E, Goll V, et al. Mild intraoperative hypothermia prolongs postanesthetic recovery. Anesthesiology. 1997;87:1318–1323
  27. Melling AC, Ali B, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet. 2001;358:876–880
  28. Horn EP, Schroeder F, Gottschalk A, et al. Active warming during cesarean delivery. Anesthesia and Analgesia. 2002;94:409–414
  29. Sessler DI, Schroeder M, Merrifield B, et al. Optimal duration and temperature of prewarming. Anesthesiology. 1995;82:674–681
  30. Cheney FW, Posner KL, Caplan RA, Gild WM. Burns from warming devices in anesthesia. A closed claims analysis. Anesthesiology. 1994;80:806–810
  31. Sessler DI, Schroeder M. Heat loss in humans covered with cotton hospital blankets. Anesthesia and Analgesia. 1993;77:73–77
  32. Hynson JM, Sessler DI. Intraoperative warming therapies: a comparison of three devices. Journal of Clinical Anesthesia. 1992;4:194–199
  33. Borms SF, Engelen SL, Himpe DG, et al. Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation. Journal of Clinical Anesthesia. 1994;6:303–307
  34. Lamb FJ, Rogers R. Forced-air warming maintains normothermia during orthotopic liver transplantation. Anaesthesia. 1995;50:745
  35. Komatsu H, Chujo K, Ogli K. Forced-air warming system for perioperative use in neonates. Paediatric Anaesthesia. 1996;6:427–428
  36. Rajek A, Lenhardt R, Sessler DI, et al. Efficacy of two methods for reducing postbypass afterdrop. Anesthesiology. 2000;92:447–456
  37. Huang JK, Shah EF, Vinodkumar N, et al. The Bair Hugger patient warming system in prolonged vascular surgery: an infection risk?. Critical Care. 2003;7:R13–R16
  38. Nesher N, Uretzky G, Insler S, et al. Thermowrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage. The Journal of Thoracic and Cardiovascular Surgery. 2005;129:1371–1378
  39. Nesher N, Wolf T, Uretzky G, et al. A novel thermoregulatory system maintains perioperative normothermia in children undergoing elective surgery. Paediatric Anaesthesia. 2001;11:555–560
  40. Taguchi A, Ratnaraj J, Kabon B, et al. Effects of a circulating-water garment and forced-air warming on body heat content and core temperature. Anesthesiology. 2004;100:1058–1064
  41. Janicki PK, Higgins MS, Janssen J, et al. Comparison of two different temperature maintenance strategies during open abdominal surgery: upper body forced-air warming versus whole body water garment. Anesthesiology. 2001;95:868–874
  42. Negishi C, Hasegawa K, Mukai S, et al. Resistive-heating and forced-air warming are comparably effective. Anesthesia and Analgesia. 2003;96:1683–1687
  43. Bräuer A, Weyland W, Kazmaier S, et al. Efficacy of postoperative rewarming after cardiac surgery. Annals of Thoracic and Cardiovascular Surgery. 2004;10:171–177
  44. Smith CE, Desai R, Glorioso V, et al. Preventing hypothermia: convective and intravenous fluid warming versus convective warming alone. Journal of Clinical Anesthesia. 1998;10:380–385
  45. Moore SS, Green CR, Wang FL, et al. The role of irrigation in the development of hypothermia during laparoscopic surgery. American Journal of Obstetrics and Gynecology. 1997;176:598–602
  46. El-Gamal N, El-Kassabany N, Frank SM, et al. Age-related thermoregulatory differences in a warm operating room environment (approximately 26 degrees C). Anesthesia and Analgesia. 2000;90:694–698
  47. Bissonnette B, Sessler DI. Passive or active inspired gas humidification increases thermal steady-state temperatures in anesthetized infants. Anesthesia and Analgesia. 1989;69:783–787
  48. Tander B, Baris S, Karakaya D, et al. Risk factors influencing inadvertent hypothermia in infants and neonates during anesthesia. Paediatric Anaesthesia. 2005;15:574–579

PII: S1521-6896(08)00062-1

doi: 10.1016/j.bpa.2008.07.006

Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 659-668 , December 2008

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