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Hypothermia can be the first and only sign of sepsis in young infants, yet there is a paucity of standard recommendations for pediatric primary-care office management of those infants identified. The SMART aim of this study was to standardize the identification and care of infants age 0 to 49 days at risk of hypothermia in pediatric primary care by decreasing the percent of infants with temperatures ≤36.5°C from 24% to 10% within 2 years. Over the course of this project, variation in documented temperatures ≤36.5°C decreased from 24% to 7% of encounters. Temperatures ≤36.5°C were documented for 951 infants or 13.4% (1078 of 8020 encounters). Of the 951 infants with temperatures ≤36.5°C, 96.1% were rewarmed in the office. Thirty-one patients ultimately required hospitalization. Application of quality improvement in a primary-care office decreased low temperatures by standardizing care, empowering staff, and triaging at-risk infants to the most appropriate level of care. [ABSTRACT FROM AUTHOR]

Aim: Hypothermia (HT) is a common and serious problem during anesthesia. As the ratio of skin surface area to body volume is higher in neonates than in adults, heat loss and ultimately HT are more common in the intraoperative period. This study aimed to determine the incidence and independent risk factors of HT in the neonatal period. Materials and Methods: This retrospective observational cohort study included 63 patients who underwent neonatal surgery within a one-year period. HT was defined as body temperature <36 °C and the patients were divided into two groups: Group I (body temperature <36 °C) and Group II (≥36 °C). Demographic data, ASA score, operative diagnosis, duration of surgery and anesthesia, amount of fluid, inotrope and vasopressor therapy, amount of bleeding, amount of blood transfusion, preoperative and postoperative temperatures, and the heating methods of the patients were recorded. Results: The median age of the patients was 5 days (0-28 days) and their mean weight was 2,792±782 grams. The esophageal method was used for temperature monitoring in 88.9% (56 patients) and the rectal method in 10.1% (7 patients). HT developed in 54% of the patients. Caps and socks were used to prevent HT in 96.8% of the patients, forced-air warming blankets in 95.2%, warming gel mattresses in 27%, and fluid and blood warming devices in 17.5%. In the logistic regression model, the operating room temperature was identified as the only independent risk factor associated with neonatal HT. Conclusion: Despite the use of active and passive warming methods, the incidence of HT in the neonatal period was found to be high. Cold operating rooms were found to be the only independent factor associated with neonatal HT. [ABSTRACT FROM AUTHOR]

The MARCH (Massive hemorrhage, Airway, Respirations, Circulation, and Hypothermia/Head injuries) algorithm taught to military medics includes interventions to prevent hypothermia. As possible sequelae from major trauma, hypothermia is associated with coagulopathy and lower survival. This paper sought to define hypothermia within our combat trauma population using an outcomes-based method, and determine clinical variables associated with hypothermia. This is a secondary analysis of a previously described dataset from the Department of Defense Trauma Registry focused on casualties who received prehospital care. A receiver operating curve was constructed and Youden's index was used to define hypothermia within the predetermined population based on mortality risk. A multivariable regression model was used to identify associations. There were 23,243 encounters that met the inclusion criteria for this study with patients having received prehospital care and documentation of at least one emergency department temperature. An optimal threshold of 36.2° C was found to predict mortality; 3,159 casualties had temperatures below this threshold (14%). Survival to discharge was lower among casualties with hypothermia (91% versus 98%). Hypothermic casualties were less likely to undergo blanket application (38% versus 40%). However, they had higher proportions with Hypothermia Prevention and Management Kit application (11% versus 7%) and radiant warming (2% versus 1%). On multivariable regression modeling, none of the hypothermia interventions were associated with a decreased likelihood of hypothermia. Non-hypothermia interventions associated with hypothermia included prehospital intubation (OR 1.57, 95% CI 1.45–1.69) and blood product administration. Hypothermia, including a single recorded low temperature in the patient care record, was associated with worse outcomes in this combat trauma population. Prehospital intubation was most strongly associated with developing hypothermia. Prehospital warming interventions were not associated with a reduction in hypothermia risk. Our dataset suggests that current methods for prehospital warming are inadequate. [ABSTRACT FROM AUTHOR]

Background: The surgical nurse should identify patients at high risk of hypothermia. Considering the complications that hypothermia may cause; preventive measures should be taken before, during, and after surgery to prevent the development of inadvertent hypothermia. Objective: To determine the knowledge and applications of nurses to prevent the development of hypothermia related to the perioperative period. Method: This descriptive study consisted of 153 surgical nurses working in the surgical wards of a university hospital. Data collection form in the research; it consisted of questions that determined the demographic characteristics of nurses, their knowledge and applications to prevent hypothermia development during the perioperative period. Descriptive statistics, chi-square, independent samples t-test, repeated measures analysis of variance (ANOVA), Pearson correlation coefficient were used in data analysis. Results: In the study, nurses reported that seven of the 20 high-risk patient groups with a high risk of hypothermia were at risk. The nurses stated that they knew and applied the methods of covering the patient, putting on socks and warming the bed among passive heating methods and the method of using a blanket with hot air blowing among active heating methods. In the study, a positive correlation was found between the preoperative, intraoperative, postoperative period and general knowledge score and the preoperative, intraoperative, postoperative and general practice score of the nurses (p<0.001). Conclusion: The research showed that nurses do not know the majority of patients with high risk of hypothermia, and passive methods are known and applied more than active methods in the prevention of hypothermia. At the same time, the research revealed that with the increase in nurses' knowledge about the prevention of hypothermia, their practices also increased. As a result of this research, it is recommended that organize to training programs for the prevention of hypothermia in the perioperative process. [ABSTRACT FROM AUTHOR]

Background & Problems: Post-operation hypothermia tends to induce complications. Sixty percent of robotic-assisted mitral valve surgery patients experienced hypothermia while admitted to our intensive care unit (ICU), resulting in prolonged ICU stays and 57% (eight) of those patients with hypothermia also experiencing cardiac arrhythmia. The causes of hypothermia in our ICU included low temperature in the operating room, delayed initiation of blanket coverage after surgery, and lack of postoperative thermal blankets, insufficient cardiopulmonary bypass rewarming time, cold ICU beds, lack of in-service training for hypothermia, and lack of procedure auditing. Purpose: This intervention was designed to reduce the incidence of hypothermia in ICU patients undergoing robotic-assisted mitral valve surgery upon ICU admission from 60% to 36% and the one-hour hypothermia rate from 43.3% to 26%. Resolutions: We implemented several measures including increasing the room temperature, pre-heating the ICU bed, achieving team consensus regarding prolonging the rewarming time after cardiopulmonary bypass, establishing a blanket warming area for postoperative patient use, and holding in-service training to enhance the awareness of the nurses were implemented. Result: The incidence of hypothermia in ICU patients receiving robotic-assisted mitral valve surgery upon ICU admission decreased from 60% to 19.4%, while the one-hour hypothermia rate decreased from 43.3% to 19.4%. Conclusions: Using systemic interprofessional collaboration, combined thermal care can be achieved to significantly reduce the incidence of postoperative hypothermia in patients undergoing robotic-assisted mitral valve surgeries resulting in higher patient care quality and shorter ICU stays. We recommend applying this combined method to improve the quality of perioperative care for long-duration and major surgical procedures that involve large postoperative wounds and for patients who may require wider exposure during their operation. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Early diagnosis, control and management of hypothermia are decisive in the outcome of burns. Various factors play a role in creating or aggravating accidental hypothermia in these patients. This study was conducted with the aim of determining accidental hypothermia prevalence and related factors among burned patients referred to Shahid Motahhari Hospital in Tehran, Iran in 2021. MATERIAL AND METHODS: In this prospective observational study, 151 burn patients who were transferred to the emergency department by EMS were selected through available sampling from February 2021 to August 2021. Data was collected and recorded in three areas (pre-hospital, emergency ward, and burn center) through observation and interview of patients and their relations and review of records from admission to discharge. The ambient temperature and core body temperature (CBT) of the patients was measured by a calibrated tympanic thermometer at the time of arrival. Individual, clinical, environmental, and care variables were investigated as factors related to hypothermia. The research data were analyzed using descriptive and inferential statistics such as Pearson correlation, chi-score, and multiple linear regression by SPSS software version 22. A significance level of less than 0.05 was considered. RESULTS: Forty-seven percent of patients had a CBT of less than 36 degrees Celsius at arrival. Through multiple linear regression, 15 independent variables were entered with the backward model. Only the kind of airway management (ß = -0.296, p < 0.001), and volume of fluids received (ß = 0.144, p = 0.082) were as predicting factors for accidental hypothermia in burn patients. CONCLUSIONS: About half of the patients were hypothermic at the time of admission. Optimizing care in pre-hospital and burn departments and empowering the healthcare team in the assessment of burn patients, and early detection, prevention, and proper management of accidental hypothermia are highly expected. [ABSTRACT FROM AUTHOR]

Background: Inadvertent perioperative hypothermia is an unintentional drop in core body temperature to less than 36 °C perioperatively and is associated with many negative outcomes such as infection, a prolonged stay in a recovery room, and decreased patient comfort. Objective: To determine the incidence of postoperative hypothermia and to identify the associated factors with postoperative hypothermia in patients undergoing head, neck, breast, general, urology, and vascular surgery. The incidences of pre- and intraoperative hypothermia were examined as the intermediate outcomes. Materials and methods: A retrospective chart review was conducted in adult patients undergoing surgery at a university hospital in a developing country for two months (October to November 2019). Temperatures below 36 °C were defined as hypothermia. Univariate and multivariate analyses were used to identify factors associated with postoperative hypothermia. Results: A total of 742 patients were analyzed, the incidence of postoperative hypothermia was 11.9% (95% CI 9.7%-14.3%), and preoperative hypothermia was 0.4% (95% CI 0.08%-1.2%). Of the 117 patients with intraoperative core temperature monitoring, the incidence of intraoperative hypothermia was 73.5% (95% CI 58.8–90.8%), and hypothermia occurred most commonly after anesthesia induction. Associated factors of postoperative hypothermia were ASA physical status III-IV (OR = 1.78, 95%CI 1.08–2.93, p = 0.023) and preoperative hypothermia (OR = 17.99, 95%CI = 1.57-206.89, p = 0.020). Patients with postoperative hypothermia had a significantly longer stay in the PACU (100 min vs. 90 min, p = 0.047) and a lower temperature when discharged from PACU (36.2 °C vs. 36.5 °C, p < 0.001) than those without hypothermia. Conclusion: This study confirms that perioperative hypothermia remains a common problem, especially in the intraoperative and postoperative periods. High ASA physical status and preoperative hypothermia were associated factors of postoperative hypothermia. In order to minimize the incidence of perioperative hypothermia and enhance patient outcomes, appropriate temperature management should be emphasized in patients at high risk. Registration: Clinical Trials.gov (NCT04307095) (13/03/2020). [ABSTRACT FROM AUTHOR]

INTRODUCTION: Hypothermia is highly prevalent among trauma patients. If hypothermia is diagnosed and managed early, complications from hypothermia can be reduced. This study aimed to determine the prevalence of accidental hypothermia and related factors in prehospital trauma patients. MATERIAL AND METHODS: This is a single-center prospective observational study. From 2 to 16 November 2018, 132 trauma patients were selected by convenience sampling. To collect data, the patient's core body temperature (CBT) and the temperature of the ambulance cabin were measured as the patient left the ambulance. A combination of observation and emergency medical technician records was used to identify factors influencing hypothermia onset or exacerbation. SPSS 16 was used to analyze the data using descriptive statistics and multiple logistic regression. A significance level of 5% was considered. RESULTS: It was calculated that 44.1% of prehospital trauma patients had accidental hypothermia. The predicting variables for accidental hypothermia in trauma patients were found to be level of consciousness (OR = 2.19, p < 0.049), pulse rate (OR = 1.04, p < 0.02), and ambient cabin temperature (OR = 1.32, p < 0.015). CONCLUSIONS: At the time of hospital admission, a significant number of trauma patients were hypothermic. This study emphasizes the need for identifying unintentional hypothermia in trauma patients early on during the pre-hospital stage. [ABSTRACT FROM AUTHOR]

Background: Perioperative hypothermia and shivering are common and can cause adverse outcomes. The aim of this study was to investigate the incidence of postoperative hypothermia and shivering and their risk factors in patients undergoing malignant tumor surgery. Methods: This retrospective study collected data from patients with American Society of Anesthesiologists physical status (ASA) I or II who underwent scheduled surgery from November 2020 to March 2021 at Fudan University Shanghai Cancer Center. Each patient's core body temperature was measured at three time points: time point 1 (arrival at the postanesthesia care unit (PACU)), time point 2 (after 30-min care in the PACU), and time point 3 (at discharge from the PACU). At time point 1, if the patient's body temperature was below 36 ℃, we provided an active forced-air warmer. At time point 2, if it was still below 36 ℃, the forced-air warmer was still applied until the patient was discharged from the PACU. If it reached 36 ℃, the forced-air warmer would be switched off. Univariate and multivariate logistic regression combined with stepwise methods and linear regression were used to explore risk factors for postoperative hypothermia and shivering. Results: The numbers (percentage) of 202 patients who developed postoperative hypothermia at the different time points were 52 (25.7%), 37 (18.3%) and 28 (13.9%). Eight patients (4.0%) experienced shivering. Multivariate logistic regression showed that high weight (OR = 0.923, 95% CI: 0.884 to 0.964, P = 0.0003) and low estimated blood loss (OR = 0.252, 95% CI: 0.115 to 0.550, P = 0.0005) were protective factors against hypothermia, while long surgical duration (OR = 3.339, 95% CI: 1.675 to 6.655, P = 0.0006) was an independent risk factor for hypothermia at time point 1. There was no risk factor associated with the occurrence of shivering (P > 0.05). There was a significant difference between the hypothermia and normothermia groups in the median length of stay in the PACU (59.0 vs. 49.0 min, P = 0.0123). Conclusions: Postoperative hypothermia occurred frequently. Weight, estimated blood loss and surgical duration were significantly associated with hypothermia on arrival at the PACU. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hypothermia is a common clinical issue during the perioperative period. The patients with perioperative inadvertent hypothermia are associated with higher risk of postoperative complications and higher hospitalisation costs. Aims: The aim of this study is to explore the prevalence of and predictors for hypothermia in patients entering postanaesthesia care unit. Design: Retrospective cohort study. Methods: A rigorous retrospective cohort study was conducted according to the STROBE reporting checklist. A total of 7216 patients were enrolled in this study. The perioperative variables potentially related to hypothermia were collected. Univariate analysis and multivariate logistic regression analysis were performed to investigate the contributing factors. Results: The overall prevalence of inadvertent hypothermia in postanaesthesia care unit was 21.3% (n = 1505). The multivariate logistic regression analysis showed that age >65 (OR = 1.561, 95% CI 1.371–1.778, p <.001), non‐supine position [lateral decubitus position (OR = 1.341, 95% CI 1.133–1.586, p =.001), lithotomy position (OR = 1.639, 95% CI 1.295–2.075, p <.001)], non‐superficial surgery (OR = 2.195, 95% CI 1.566–3.077, p <.001), non‐open surgery [laparoscopic surgery (OR = 1.205, 95% CI 1.020–1.423, p =.029), endoscopic surgery (OR = 1.430, 95%CI 1.084–1.887, p =.011)], the volume of intravenous infusion fluid >1000 ml (OR = 1.814, 95% CI 1.500–2.194, p <.001), blood transfusion (OR = 1.552, 95% CI 1.159–2.078, p =.003), operation performed in the summer or fall (OR = 1.874, 95%CI 1.656–2.122, p <.001) and use of dexmedetomidine (OR = 1.147, 95%CI 1.015–1.296, p =.028) were associated with increased risk of hypothermia. In contrast, our finding showed that body mass index ≥25 kg/m2 (OR = 0.556, 95%CI 0.491–0.630, p <.001), higher baseline body temperature (OR = 0.641, 95%CI 0.541–0.761, p <.001) and duration of fasting ≥18 h (OR = 0.487, 95%CI 0.345–0.689, p <.001) were associated with decreased risk of hypothermia. Compared with non‐hypothermic patients, patients with hypothermia were associated with prolonged length of hospital days (5 vs. 4 days, p <.001). Conclusion: For patients admitted to postanaesthesia care unit after elective procedures, old age, non‐supine position, non‐open surgery, non‐superficial surgery, large volume of intravenous infusion fluid, dexmedetomidine, blood transfusion and Summer or Fall operative season were associated with increased risk of hypothermia, whereas high body mass index, high baseline body temperature and long fasting duration were associated with decreased risk of hypothermia. Relevance to clinical practice: The outcomes of this study will raise the concerns of perioperative care team on hypothermia in surgical patients. Measures should be taken to improve perioperative hypothermia and clinical outcome. [ABSTRACT FROM AUTHOR]

Background & Aims: Accidental hypothermia is a common complication in trauma patients. Hospitalization of these patients in the Operating Room (OR) can greatly affect the prevalence of inadvertent hypothermia. Due to the negative patient's outcomes, the aim of this study was to investigate its prevalence and related risk factors among trauma patients in the OR. Methods: This prospective observational study was conducted on trauma patients who underwent surgery in the OR department of the Educational and Treatment Center of Mousavi in Zanjan. In this study, 59 eligible patients were selected using convenience sampling method in December 2017. Individual, clinical, environmental and care variables related to hypothermia were collected by a researcher and recorded in a researcher-made data sheet. Results: The majority of patients (66.1%) were men. The mean and standard deviation of their age was 46.8 (17.7) years. The most common mechanism of trauma was blunt trauma (66.1%) and the main cause of trauma was motor vehicle crash (45.8%). The prevalence of accidental hypothermia in the OR was 67.8%. Eighteen independent variables were entered into the logistic regression model as factors related to accidental hypothermia, and in the final step of the model, low systolic blood pressure (OR=1.141, P=0.022), low blood oxygen saturation (OR=2.229, P=0.009), and inadequate clothing and coverage of patients (OR=8.354, P=0.039) were identified as risk factors. High OR ambient temperature (OR=0.126, P=0.035) and short duration of surgery (OR=0.086, P=0.016) also acted as protective factors. Conclusion: In the current study, a significant part of surgical patients was hypothermic during operation and factors such as surgery time, systolic blood pressure, blood oxygen saturation, ambient temperature of the OR, and the condition of the patients' clothing were found to be effective in its development. This study has aimed to emphasize the need for early identification of hypothermia and effective management of related factors in order to prevent unwanted consequences. [ABSTRACT FROM AUTHOR]

Purpose: The research is conducted in order to determine the incidence of involuntary hypothermia developed at the patients after abdominal surgery in the postoperative period and the factors affecting the development of the undesired hypothermia. Methodology: In this research that is conducted in descriptive and sectional style, 189 patients who had abdominal surgery in the general surgery and urology clinics of a university hospital in between 2nd of May -- 2nd of October 2019, who are in preoperative period with body temperature 36°C and above. These data are collected via patient identification forms and hypothermia evaluation form and individuals with body temperature below 36°C are considered as in hypothermia. In the evaluation of the data average, percentage distribution and chi-square test are used. Findings: The ratios of incidence in the postoperative period are determined as 62.4% in 0th postop hour, 42.9% at 1st postop hour, 33.9% at 2nd postop hour, 22.2% at postop 3rd hour and 13.2% at 4th postop hour. The lowest body temperature is measured as (35.69±0.66) at 0th postop hour. In patients with operation time our two hours and in risk classification II and above of the American Society of Anesthesiologists, the ratios of incidence of hypothermia are determined to be significantly higher (p<0.05). Results: In this study, it is determined that the hypothermia incidence in the postoperative period of the patients who had abdominal surgery is high, in the patients with long operation time and who are over risk classification II and above of the American Anesthesiologists Association, the hypothermia is seen more frequently. [ABSTRACT FROM AUTHOR]

Introduction: The sensation to cold, shake occurrence and shivering are events that are commonly developed following general anesthesia administration postoperatively. Hypothermia has been considered as the most frequent outcome of surgery underwent by anesthesia. Inadvertent hypothermia has been taken into account as common side effect in the postoperative period immediately and it is related to wide impairments and anomalies of different body organs. Concentration on predictive factors of hypothermia would be important to reduce the incidence rate and correct preventable unnecessary risks for patients in the health settings following surgical operations. The aim of study is to assess the magnitude and associated factors of postoperative hypothermia recovery room in patients underwent general anesthesia. Methods: A hospital-based prospective cross-sectional study was conducted on200patients with different age groups of both genders who underwent a scheduled non-cardiac surgery and general anesthesia consecutively during the period between the October 1stand the November1st2016. Results: The study revealed that the overall core hypothermia in the study sample was31%. The study showed that the post-operative temperatures decreased statistically significantly in all study patients and separately in adults, children, males, or females P<0.001. The study also revealed that the operation duration(p=0.045) and pre-operative temperature P<0.001were predictors of post-operative hypothermia in study sample. Conclusions: The incidence of hypothermia among study sample was not so high. A significant reduction in core body temperature of patients between pre and post-operation times was found. Those patients with longer operation duration, lower room temperature, and lower pre-operative temperature were at more risk of post-operative hypothermia. [ABSTRACT FROM AUTHOR]

Introduction: Data on management of severe accidental hypothermia published from an established high-volume extracorporeal membrane oxygenation centre are scarce. Methods: A total of 28 patients with intravesical temperature lower than 28°C on admission were either treated with veno-arterial extracorporeal membrane oxygenation or rewarmed conservatively. Results: A total of 10 patients rewarmed on veno-arterial extracorporeal membrane oxygenation (age: 37 ± 12.6 years) and 18 conservatively (age: 55.2 ± 11.2 years) were collected over a course of 5 years. The dominant cause was alcohol intoxication with exposure to cold (39%), 12 patients were resuscitated prior to admission. The admission temperature in the extracorporeal membrane oxygenation group (23.8 ± 2.6°C) was lower than in the non–extracorporeal membrane oxygenation group (26.0 ± 1.5°C, p = 0.01). The peripheral percutaneous veno-arterial extracorporeal membrane oxygenation was always cannulated in malignant arrhythmias causing refractory cardiac arrest. The typical extracorporeal membrane oxygenation blood flow was 3-4 L/minute and sweep gas flow 2 L/minute, the median extracorporeal membrane oxygenation duration was 48.3 (28.1-86.7) hours. The median rates of rewarming did not differ (0.41 (0.35-0.7)°C/hour in extracorporeal membrane oxygenation and 0.77 (0.54-0.98)°C/hour in non–extracorporeal membrane oxygenation, p = 0.46) as well as the admission arterial lactate, pH and potassium. Their development was not different between the groups except for higher pH between the third and ninth hour of rewarming in the extracorporeal membrane oxygenation group. The hospital mortality was 10% in the extracorporeal membrane oxygenation group and 11.1% in the non–extracorporeal membrane oxygenation group with the median last Glasgow Coma Scale 15 and Cerebral Performance Score 1. Conclusion: Veno-arterial extracorporeal membrane oxygenation for severe hypothermia shows promising outcome data collected in an extracorporeal membrane oxygenation/extracorporeal cardiopulmonary resuscitation centre located in a European urban area. Except for presence of refractory cardiac arrest, the established hypothermia-related prognostic indicators did not differ between patients in need for extracorporeal membrane oxygenation and those rewarmed without extracorporeal membrane oxygenation. [ABSTRACT FROM AUTHOR]

Temperature monitoring is a critically important aspect of patient care; however, hypothermia may not always be detected at initial onset due to a lack of temperature monitoring and implemented guidelines. The following study aimed to identify potential risk factors and patterns in the development of hyperthermia postoperatively and whether differences exist between the use of axilla and tympanic thermometers. Immediate recognition and intervention of hypothermia is critical in the Post Anaesthetic Care Unit (PACU) as it can lead to serious post-operative complications, a longer PACU stay and increased hospital costs (Connor & Wren, 2000). [ABSTRACT FROM AUTHOR]

Background: Based on the previous investigation in our institution, the incidence of intraoperative hypothermia in neonates was high. Since September 1st, 2019, the recommendation had been launched to utilize ≤1 L/min fresh gas flow during the neonates' surgical procedure. We therefore intended to evaluate the association between low fresh gas flow anesthesia and the occurrence of hypothermia in neonates undergoing digestive surgeries. Methods: A retrospective chart review, before-after study was conducted for neonates who underwent digestive surgeries. The primary outcomes were the incidence of hypothermia. The secondary outcomes included hospital mortality, the value of lowest temperature, blood loss, mean body temperature during the surgery, the length of hypothermia during the surgery and postoperative hospital length-of- stay (PLOS). Results: 249 neonates fulfilled the eligibility criteria. The overall incidence of intraoperative hypothermia was 81.9%. The low fresh gas flow anesthesia significantly reduced the odds of hypothermia [routine group: 149 (87.6%) versus low flow group: 55 (69.6%); p < 0.01]. Moreover, the low fresh gas flow anesthesia could reduce the length of hypothermia [routine group: 104 mins (50, 156) versus low flow group: 30 mins (0,100); p < 0.01], as well as elevate the value of lowest temperature for neonates [routine group: 35.1 °C (34.5, 35.7) versus low flow group: 35.7 °C (35.3, 36); p < 0.01]. After adjustment for confounding, low fresh gas flow anesthesia and the length of surgical time were independently associated with intraoperative hypothermia. Conclusions: Low fresh gas flow anesthesia is an effective way to alleviate hypothermia in neonates undergoing open digestive surgery. [ABSTRACT FROM AUTHOR]