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Intraoperative pediatrics hypothermia and its factors during general anesthesia at comprehensive specialized
Melese Tadele Mekonnen1, Salh Yalew Mustofa2, Yophtahe Weldegerima Berhe2
1Department of Anesthesia, Boru Meda hospital, Wollo, Ethiopia.
Insights
Intraoperative pediatric hypothermia affects nearly half of surgical patients, with neonates and low operating room temperatures being significant risk factors. Close monitoring and environmental controls are crucial for preventing hypothermia in children during surgery.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Pediatric patients undergoing surgery and anesthesia are susceptible to hypothermia, defined as a core body temperature below 36°C.
- Maintaining normothermia is critical for physiological regulation during surgical procedures.
- This study investigated the incidence and contributing factors of intraoperative pediatric hypothermia in Northwest Ethiopia.
Purpose of the Study:
- To determine the incidence of intraoperative pediatric hypothermia.
- To identify factors associated with intraoperative pediatric hypothermia in pediatric surgical patients.
- To inform preventative strategies and improve patient outcomes during general anesthesia.
Main Methods:
- A multi-center prospective follow-up study involving 403 pediatric patients was conducted.
- Consecutive sampling was employed, with temperature monitoring using tympanic thermometers.
- Bivariable and multivariable logistic regression analyses were performed to identify associated factors.
Main Results:
- The incidence of intraoperative pediatric hypothermia was found to be 44.7%.
- Significant risk factors included being a neonate, receiving >500ml intravenous fluids, blood transfusion, and lower operating room temperatures (≤21°C or 22-24°C).
- Preoperative core temperature ≤35.9°C was also strongly associated with intraoperative hypothermia.
Conclusions:
- Intraoperative hypothermia is a significant concern in pediatric surgical patients, with a high incidence observed.
- Neonates, increased intravenous fluid administration, blood transfusions, low preoperative temperatures, and cold operating rooms are key associated factors.
- Recommendations include vigilant core body temperature monitoring, prioritizing neonates, optimizing operating room temperature, and judicious use of fluids and blood transfusions.
Background:
The human body can regulate its internal temperature under physiological conditions by balancing heat production and loss. Many pediatric patients may experience hypothermia during surgery and anesthesia. Hypothermia is defined as a core body temperature below 36 °C in pediatric patients undergoing surgery. Therefore, this study was aimed to determine the incidence of intraoperative pediatric hypothermia and its factors during general anesthesia at Comprehensive Specialized Hospitals, Northwest Ethiopia.
Methods:
A multi-center prospective follow-up study was conducted from May 2 to July 28, 2023, on 403 participants. A consecutive sampling method was used to select the study participants. Preoperative temperature and initial intraoperative temperature were measured using tympanic thermometer. Descriptive data was carried out and the results were presented as table, text and graph. Data was entered to Epi-data software (version 4.6) and analyzed with STATA software (version 17 SE). Bivariable and multivariable logistic regression analyses were used to identify associated factors. A p-value less than 0.05 with a 95% confidence interval were considered statistically significant.
Result:
The incidence of intraoperative pediatric hypothermia was 44.7% (CI=39.8-49.6). The neonates (AOR=3.7,95%CI=1.5-10.8), use of intravenous fluid>500ml (AOR=2.3,95%=1.48-4.43), having blood transfusion (AOR=2.7,95% CI=1.30-5.91), operation room temperature ≤21 degree Celsius (AOR=9.3, 95% CI= 5.78-20.58), operation room temperature in between 22-240c (AOR=2.6, 95%CI=1.28-5.35) and preoperative core temperature≤ 35.9 degree Celsius (AOR=4.8,95%CI=2.42-9.68) were associated with intraoperative pediatric hypothermia during general anesthesia.
Conclusion And Recommendation:
This study showed that the incidence of intraoperative hypothermia among pediatric surgical patients was considerably high. Neonate, using more than 500ml of intravenous fluid, having blood transfusion, preoperative core temprature≤35.9 °C and operation room temperature ≤21 °C were associated with intraoperative hypothermia during general anesthesia. Pediatric patients should be monitored their core body temperature during the intraoperative period to prevent and treat hypothermia. Emphasis should be given for neonates. Warming the operating room is recommended. We also recommend to use the optimal fluid and blood transfusion.
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