Thermal management and blood loss during hip arthroplasty

Perioperative hypotermia is a common, but preventable complication of anaesthesia and surgery. Mild perioperative hypothermia increases the incidence of morbid myocardial outcomes, reduces resistance to surgical wound infections, and prolongs both postanaesthetic recovery and hospitalization. Hypotermia causes a coagulopathy due to inhibition of platelet function. In this short review, we will discuss three studies done in the last 6 years, which explored the influence of perioperative hypotermia and blood loss. All evaluated blood loss during hip arthroplasty and had similar methodologies. Two studies demonstrate that blood loss is increased, especially during surgery, in hypotermic patients while a third study failed to identify any thermal influence on blood loss. The benefits of maintaining perioperative normothermia on blood loss thus remain unclear. We thus continue to recommend that surgical patients be kept normothermic.