A growing body of evidence is adding to our understanding of patient warming and the important contribution this has for patients undergoing surgery. It is widely recognised that best practice is not being implemented with any consistency. However, the availability of a new checklist could help ensure improved compliance.
Maintaining patient normothermia is a critical part of many surgical procedures. The evidence for patient warming has been building over the past 10 to 15 years and a plethora of clinical studies now show that even mild hypothermia can result in negative outcomes.
A study by Frank et al, for example, showed increased rates of morbid cardiac events in hypothermic patients (6.3% vs 1.4% in normothermic patients), as well as an increased rate of postoperative ventricular tachycardia (7.9% vs 2.4% in normothermic patients).1 Kurtz et al also conducted a study on patients undergoing colorectal surgery and found that the hypothermic group had three times as many culture positive surgical wound infections compared with the normothermic patients and a 19% rate of infection (compared to 6% in normothermic patients).2
Inadvertent hypothermia (when the patient’s core temperature drops below 36˚C) can also lead to prolonged and altered drug effect, thermal discomfort caused by shivering, and delayed emergence from anaesthesia. In some cases, it can even costs patients’ lives – a study by Bush et al highlighted the increased rate of mortality associated with hypothermia in patients undergoing elective surgery for aortic aneurysm repair (12.1% vs. 1.5% in the normothermic group).3
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