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Time Trends and Predictors of Abnormal Postoperative Body Temperature in Infants Transported to the Intensive Care
Hedwig Schroeck1, Angela K Lyden2, Wendy L Benedict2
1Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
Insights
Active warming methods improved postoperative normothermia in sick infants, decreasing hypothermia significantly. However, hyperthermia rates remained stable, necessitating careful monitoring to prevent overcorrection.
Area of Science:
- Pediatric Anesthesiology
- Critical Care Medicine
- Neonatalogy
Background:
- Effectiveness of active warming methods on postoperative temperature in critically ill infants remains understudied.
- Abnormal postoperative temperatures (hypothermia and hyperthermia) pose risks to sick infants.
Purpose of the Study:
- To evaluate the effectiveness of active warming methods on postoperative temperature abnormalities in critically ill infants.
- To identify trends and associated factors for postoperative hypothermia and hyperthermia.
Main Methods:
- Retrospective analysis of 2,350 critically ill infants' temperature readings, patient characteristics, and procedural factors (June 2006-May 2014).
- Primary endpoints: incidence and trends of postoperative hypothermia and hyperthermia on intensive care unit arrival.
- Univariate and adjusted analyses to determine factors associated with abnormal temperatures.
Main Results:
- Postoperative normothermia increased from 2006 to 2014, with hypothermia decreasing from 24% to 2% (p < 0.0001).
- Hyperthermia rates remained stable (13% in 2006, 8% in 2014, p = 0.357).
- Factors associated with hypothermia: higher ASA status, lack of convective warming, earlier procedure date. Factors for hyperthermia: lower body weight, earlier procedure date.
Conclusions:
- Significant improvement in postoperative normothermia rates observed in critically ill infants between 2006 and 2014.
- Continued vigilance and careful monitoring are recommended to prevent iatrogenic hyperthermia due to overcorrection.
Abstract:
Background. Despite increasing adoption of active warming methods over the recent years, little is known about the effectiveness of these interventions on the occurrence of abnormal postoperative temperatures in sick infants. Methods. Preoperative and postoperative temperature readings, patient characteristics, and procedural factors of critically ill infants at a single institution were retrieved retrospectively from June 2006 until May 2014. The primary endpoints were the incidence and trend of postoperative hypothermia and hyperthermia on arrival at the intensive care units. Univariate and adjusted analyses were performed to identify factors independently associated with abnormal postoperative temperatures. Results. 2,350 cases were included. 82% were normothermic postoperatively, while hypothermia and hyperthermia each occurred in 9% of cases. During the study period, hypothermia decreased from 24% to 2% (p < 0.0001) while hyperthermia remained unchanged (13% in 2006, 8% in 2014, p = 0.357). Factors independently associated with hypothermia were higher ASA status (p = 0.02), lack of intraoperative convective warming (p < 0.001) and procedure date before 2010 (p < 0.001). Independent associations for postoperative hyperthermia included lower body weight (p = 0.01) and procedure date before 2010 (p < 0.001). Conclusions. We report an increase in postoperative normothermia rates in critically ill infants from 2006 until 2014. Careful monitoring to avoid overcorrection and hyperthermia is recommended.
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