Hyperthermia during repair of pectus excavatum

We have observed an elevation of body temperature during surgical repair of pectus excavatum. To document this phenomenon and attempt to prevent it, we undertook a combination retrospective-prospective study. The retrospective arm included an analysis of the anesthetic records of patients undergoing repair of pectus excavatum during the past 5 years and included 22 boys and 3 girls. Body temperature increased in all 25 patients, from a starting temperature of 36.1 degrees C +/- 0.5 degree C to 38.0 degrees C +/- 0.6 degree C. The maximum temperature exceeded 38 degrees C in 12 patients and 39 degrees C in 3 patients. An additional retrospective review of the anesthetic records of 15 children undergoing another type of thoracic procedure (thoracotomy) for noninfectious problems revealed only a modest, statistically nonsignificant rise in temperature from a starting point of 35.9 degrees C +/- 0.7 degree C to a maximum of 36.3 degrees C +/- 1.2 degrees C. The maximum temperature was greater than 38 degrees C in one of these 15 patients. The prospective arm of the study included a standardized anesthetic technique in 10 patients. Neither a heated humidifier nor a warming blanket were used, and the ambient temperature of the room was maintained at 70 degrees F. Core body temperature increased from a starting temperature of 36.1 degrees C +/- 0.6 degree C to 36.8 degrees C +/- 0.8 degree C. A significant elevation of body temperature occurs in children during repair of pectus excavatum that may be avoided by eliminating the use of exogenous methods to prevent hypothermia (e.g., heated humidifier, warming blanket).