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Study of risk factors for intraoperative hypothermia during pediatric burn surgery
Yaoqin Hu1, Yangfan Tian2, Manqing Zhang1
1Department of Anesthesiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
Intraoperative hypothermia is common in pediatric burn surgery. Larger total burn surface area (TBSA) significantly increases the risk of hypothermia in children undergoing these procedures.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Burn Care
Background:
- Intraoperative hypothermia (core temperature <36.0°C) poses risks, particularly in pediatric patients.
- Burn surgery presents unique challenges for maintaining normothermia.
Purpose of the Study:
- To determine the incidence of intraoperative hypothermia in pediatric patients undergoing burn surgery.
- To identify risk factors associated with intraoperative hypothermia in this population.
Main Methods:
- A study enrolled 197 pediatric patients with burn injuries.
- Data on total burn surface area (TBSA) and intraoperative warming were collected.
- Statistical analysis was performed to identify risk factors for hypothermia.
Main Results:
- The incidence of intraoperative hypothermia was 17.8%.
- Larger TBSA and less intraoperative active warming were associated with hypothermia.
- Severe and extremely severe burns significantly increased hypothermia risk (ORs > 3.8 and 6.9, respectively).
- TBSA was the sole independent predictor of intraoperative hypothermia (OR=1.068, p=0.001) with good predictive ability (AUC=0.758).
Conclusions:
- Total burn surface area (TBSA) is a critical risk factor for intraoperative hypothermia in pediatric burn patients.
- TBSA can aid in predicting hypothermia risk during burn surgery.
Background:
Intraoperative hypothermia (core temperature <36.0°C) is common during the perioperative period and can result in adverse consequences, especially in children. We aimed to determine the incidence of intraoperative hypothermia and its risk factors in pediatric patients during burn surgery.
Methods:
In the present study we enrolled 197 pediatric patients with burn injury undergoing surgical debridement and skin grafting. Factors, such as total burn surface area (TBSA), were collected and analyzed to identify the potential risk factors for intraoperative hypothermia.
Results:
The incidence of intraoperative hypothermia among all patients was 17.8%. Compared with patients with normothermia, children with hypothermia were associated with larger TBSA (25% vs 15%, p<0.001) and with less intraoperative active warming (34.28% vs 54.93%, p<0.05). In addition, compared with patients with moderate-degree burn, patients with severe and extremely severe burn were associated with much higher risk of intraoperative hypothermia [severe: odds ratio (OR)=3.805, 95% confidence interval (CI)=1.396-10.368, p=0.009; extremely severe: OR=6.933, 95% CI=2.604-18.462, p<0.001]. TBSA was the only independent risk factor that emerged as being strongly associated with intraoperative hypothermia (OR=1.068, p=0.001) and could be used to predict the occurrence of hypothermia when combined with other factors. TBSA for predicting intraoperative hypothermia by receiver operating characteristic (ROC) curve analysis showed a good predictive ability with an area under the ROC curve of 0.758.
Conclusion:
TBSA is an important risk factor for intraoperative hypothermia in pediatric patients with burn.
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