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Published on: November 21, 2017
Perioperative Outcomes Associated with Intraoperative Hypothermia in Pediatric Patients with Preserved Functional
Worachet Saezhang1, Maliwan Oofuvong1, Nalinee Kovitwanawong1
1Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Insights
Intraoperative hypothermia in pediatric patients undergoing anesthesia is linked to increased risks of longer hospital stays and intensive care unit (ICU) admission. Vigorous perioperative temperature management is crucial to mitigate these adverse outcomes.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Limited research exists on perioperative adverse events from intraoperative hypothermia in pediatric patients with preserved functional capacity.
- Intraoperative hypothermia is a common concern during pediatric anesthesia.
- Understanding its impact on outcomes is vital for improving patient care.
Purpose of the Study:
- To assess the association between intraoperative hypothermia and adverse perioperative outcomes in pediatric patients undergoing anesthesia.
- To identify specific adverse events linked to hypothermia in this population.
- To inform clinical practice regarding temperature management.
Main Methods:
- Retrospective cohort study of pediatric patients (<12 years) undergoing anesthesia in 2020.
- Intraoperative hypothermia defined as core temperature <36 °C.
- Exclusion of patients with American Society of Anesthesiologists (ASA) physical status 4-5 to focus on preserved functional capacity.
- Multivariate regression analysis to adjust for confounders.
Main Results:
- 18.9% of 892 pediatric patients experienced intraoperative hypothermia.
- Hypothermia significantly associated with increased postoperative ventilator requirements, ICU admission, and prolonged ICU stays and hospitalization.
- Multivariate analysis showed hypothermia linked to a 1.0-day longer ICU stay and a 20% higher hospitalization risk.
Conclusions:
- Intraoperative hypothermia is associated with significant adverse perioperative outcomes in pediatric patients with preserved functional capacity.
- Current hospital policies may require modification to emphasize rigorous perioperative temperature management.
- Effective temperature control can mitigate adverse events and improve patient outcomes.
Abstract:
Background/Objectives: Few studies have investigated the perioperative adverse events following intraoperative hypothermia in pediatric patients with preserved functional capacity. We aimed to assess associations between intraoperative hypothermia and adverse outcomes in pediatric patients undergoing anesthesia. Methods: This retrospective cohort study included children under 12 years of age who underwent anesthesia in 2020 at Songklanagarind Hospital, Thailand. Intraoperative hypothermia was defined as the occurrence of one or more episodes of a core temperature drop to <36 °C during anesthesia. Perioperative data were extracted from the hospital information system and analyzed to identify adverse outcomes. Children with an American Society of Anesthesiologists (ASA) physical status of 4-5 were excluded to ensure that only those with preserved functional capacity before surgery were included. Multivariate regression modeling was used to evaluate associations between hypothermia and adverse outcomes after adjusting for potential confounders. Odds ratios, count ratios or beta coefficients with 95% confidence intervals (CIs) were determined. Results: Among the 892 patients included, 169 (18.9%) experienced intraoperative hypothermia. Intraoperative hypothermia was significantly associated with postoperative ventilator requirements (p < 0.001), postoperative intensive care unit (ICU) admission (p < 0.001), longer ventilator requirements (p < 0.001), and prolonged ICU stays (p < 0.001) and hospitalization periods (p < 0.001). Multivariate analysis demonstrated that intraoperative hypothermia was associated with a 1.0-day longer ICU stay and a 20% higher risk of hospitalization. Conclusions: Intraoperative hypothermia was associated with adverse outcomes in children with preserved functional capacity undergoing anesthesia, suggesting hospital policies should be modified to ensure vigorous perioperative temperature management to mitigate these outcomes.
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