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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]

The article focuses on the use of intravenous immunoglobulin (IVIg) in treating conditions like Kawasaki disease and multisystem inflammatory syndrome in children (MIS-C), highlighting its potential adverse effects including hypothermia, a rare occurrence. It presents cases of two children who developed hypothermia during IVIg infusion, prompting further discussion about this phenomenon, although the exact mechanism behind it remains unclear.

Accidental perioperative hypothermia is a common but preventable surgical complication. This study aimed to review the risk factors for hypothermia in major abdominal surgery patients. Databases (CINAIL via EBSCO, Embase, Ovid MEDLINE, and Cochrane Center Register of Controlled Trials) were searched from inception to September 27, 2022. Meta-analyses were performed to calculate the pooled effects of risk factors. The Newcastle-Ottawa Scale was used to assess the quality of studies, and heterogeneity was examined by I-square tests. A total of 12 studies were involved in this review. The meta-analysis showed that hypothermia had an association with ASA (OR 0.48, 95% CI 0.30–0.77), mode of warming (OR 10.48, 95% CI 2.23–49.28), mode of presentation (OR 45.50, 95% CI 11.55–179.35), and baseline temperature (OR 5.54, 95% CI 2.30–13.25). Healthcare professionals should pay more attention to patients with these risk factors mentioned and reduce the risk of hypothermia. Besides, more evidence supported by high-quality studies is needed to explore the powers of the risk factors of hypothermia. [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]

Aims: To construct and validate an intraoperative hypothermia risk prediction model for elderly patients undergoing total hip arthroplasty (THA). Methods: We collected data from 718 patients undergoing THA in a tertiary hospital from January 2021 to December 2022. Of these patients, 512 were assigned to the modeling group from January 2021 to April 2022, and 206 participants were assigned to the validation group from May 2022 to December 2022. A logistic regression analysis was performed to construct the model. The area under the curve (AUC) was used to test the model's predictive ability. Results: The incidence rate of intraoperative hypothermia was 51.67%. The risk factors entered into the risk prediction model were age, preoperative hemoglobin level, intraoperative blood loss, postoperative hemoglobin level, and postoperative systolic blood pressure. The model was constructed as follows: logit (P) = − 10.118 + 0.174 × age + 1.366 × 1 (preoperative hemoglobin level) + 0.555 × 1 (postoperative hemoglobin level) + 0.009 × 1 (intraoperative blood loss) + 0.066 × 1 (postoperative systolic blood pressure). Using the Hosmer–Lemeshow test, the P value was 0.676 (AUC, 0.867). The Youden index, sensitivity, and specificity were 0.602, 0.790, and 0.812, respectively. The incidence rates of intraoperative hypothermia in the modeling and validation groups were 53.15% and 48.06%, respectively. The correct practical application rate was 89.81%. This model had good application potential. Conclusions: This risk prediction model has good predictive value and can accurately predict the occurrence of intraoperative hypothermia in patients who undergo THA, which provides reliable guidance for clinical work and has good clinical application value. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to understand the research hotspots, research trends and research frontiers for hypothermia in surgical patients and provide a reference for developing effective measures to reduce the incidence of hypothermia in these patients. Design: Using CiteSpace software, a visual analysis of 1288 included articles related to hypothermia in surgical patients was performed. Methods: CiteSpace software is a Java application that supports knowledge research, data visualization and analysis of literature databases. The following data were retrieved: title, abstract, year, keywords, author, academic institution, journal and citations. The included literature was analysed using CiteSpace visualization software, knowledge mapping, collaborative network analysis, cluster analysis and highlighting keywords for visualization. Results: A total of 1288 articles related to hypothermia in surgical patients were included, with the largest number of articles published in the United States (448), followed by in Germany (104) and China (102). The top three institutions, journals and authors were from the United States. The most common keywords were perioperative 'hypothermia', 'risk factors' and 'anesthesia'. [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]

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]

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa 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.)

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]

Objective: Perioperative hypothermia occurs in the pediatric age group in the perioperative period at a high rate. In this study, it is aimed to reveal the incidence of perioperative hypothermia and the risk factors that play a role in its development in pediatric circumcision cases that have a brief operation duration. Materials and Methods: This prospective observational cohort study included 100 children who underwent circumcision under general anesthesia. All patients were heated with a passive heater and hypothermia was interpreted as a drop in body temperature below <36°C. The patients were divided into 2 groups: group 1 (patients with body temperature <36°C) and group 2 (≥36°C). Demographic data, the American Society of Anesthesiologists' Classification of Physical Health Score, premedication method, operation time, fluid amount, preoperative and postoperative temperature of patients as tympanic were recorded. Results: The average age of the patients was 70 ± 40 months (median: 84) and 93% were ASA I. In 71% of patients, a decrease in body temperature and hypothermia developed in 39% compared to baseline. The duration of operation was longer in the group with hypothermia (30 min [15-70] vs. 25 min [15-60], P < .001). Only the duration of operation was determined as the independent risk factor associated with hypothermia (odds ratio: 1.103 [1.017-1.197], P = .018). Conclusion: In this study, it was found that high rates of hypothermia developed even in minor operations such as pediatric circumcision. The risk of hypothermia increases with the prolongation of surgery. [ABSTRACT FROM AUTHOR]

A case study of a 62‑year man presented with weakness of the right hand6 months earlier as electromyography had shown extensive denervation and reinnervation all the segments. Topics include Oculomotor abnormalities (OMA) are smooth pursuit and saccadic abnormalities followed by supranuclear ophthalmoplegia and total external ophthalmoplegia; and severe muscle loss precluded endothermic muscular heat generation necessary to maintain normothermia in a cold environment.

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]

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI 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. Total joint arthroplasty (TJA) usually leads to substantial blood loss, which may cause allogenic blood transfusion. Hypothermia occurring during operation has been reported to increase blood loss and transfusion rates in nonorthopedic cohorts. However, the relationship between intraoperative hypothermia and blood loss remains controversial in patients undergoing orthopedic surgeries. The aims of this study were to investigate the incidence of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty (TKA and THA, respectively). Methods. This retrospective study enrolled 616 consecutive patients, who underwent primary unilateral TKA or THA at our institution during the period from April 2012 to July 2014. The occurrence of a temperature below 36°C during the operation was documented to identify the incidence of hypothermia. Univariate analysis was performed to find the risk factors for hypothermia. Multiple regression analysis and multivariate logistic regression analysis were employed to explore the association of intraoperative temperature and hypothermia with intraoperative blood loss and perioperative blood transfusion. Results. The incidence of intraoperative hypothermia was 13.5%, 14.0%, and 13.1% in TJA, TKA, and THA, respectively. Intraoperative temperature (P = 0.045 , P = 0.006) and hypothermia (P = 0.042 , P < 0.001) were associated with intraoperative blood loss and perioperative transfusion in TKA. Intraoperative temperature (P = 0.002) was negatively related to the amount of blood loss, and hypothermia (P = 0.031) was the independent risk factor for transfusion in THA. Conclusion. Intraoperative hypothermia is associated with increased blood loss and transfusion rates in TJA. Efforts should be made to maintain normothermia during operation in these patients. [ABSTRACT FROM AUTHOR]

Background: Inadvertent intraoperative hypothermia increases the risk of adverse events, but its related risk factors have not been defined in video-assisted thoracoscopic surgery (VATS). This study aimed at analyzing the prevalence and factors related to inadvertent intraoperative hypothermia in adults undergoing elective VATS under general anesthesia. Methods: This was a retrospective study using data from the Peking University People's Hospital from January through December, 2018. Data were collected on age, sex, height, weight, American Society of Anesthesiologists physical status, the duration of preparation and surgery, timing of surgery, surgery types, anesthesia types, intraoperative core temperature and the length of stay (LOS) in the hospital from the electronic database in our center. Patients were covered with a cotton blanket preoperatively and the surgical draping during the operation. A circulation-water warming mattress set to 38 °C were placed under the body of the patients. Inadvertent intraoperative hypothermia was identified as a core temperature monitored in nasopharynx < 36 °C. Multivariate logistic regression analysis was used to identify independent risk factors of hypothermia. Results: We found that 72.7% (95% CI 70.5 to 75.0%) of 1467 adult patients who underwent VATS suffered hypothermia during surgery. The factors associated with inadvertent intraoperative hypothermia included age (OR = 1.23, 95% CI 1.11 to 1.36, p < 0.001), BMI (OR = 1.83, 95% CI 1.43 to 2.35, p < 0.001), the duration of preparation (OR = 1.01, 95% CI 1.00 to 1.02, p = 0.014), the duration of surgery (OR = 2.10, 95% CI 1.63 to 2.70, p < 0.001), timing of surgery (OR = 1.64, 95% CI 1.28 to 2.12, p < 0.001), ambient temperature in the operating room (OR = 0.67, 95% CI 0.53 to 0.85, p = 0.001) and general anesthesia combined with paravertebral block after induction of anesthesia (OR = 2.30, 95% CI 1.31 to 4.03, p = 0.004). The average LOS in the hospital in the hypothermia group and the normothemic group was 9 days and 8 days, respectively (p < 0.001). Conclusions: We highlight the high prevalence of inadvertent intraoperative hypothermia during elective VATS and identify key risk factors including age, duration of surgery more than 2 h, surgery in the morning and general anesthesia combined with paravertebral block (PVB) after intubation. We also find that hypothermia did prolong the LOS in the hospital. [ABSTRACT FROM AUTHOR]

Background: Postanesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication. The main purpose of this meta-analysis was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering. Methods: We searched the following databases: Medline, Embase, and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome observed was the difference of the incidence rate of postanesthetic shivering between ketamine group and placebo group. The secondary outcomes were the sedation score and incidence of the side effects caused by ketamine and any other drugs utilized in the studies. Results: In this meta-analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P<0.01). Regarding side effects, there was no evident variability of the incidence of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo. Hallucinations were more frequently observed in patients who received higher doses of ketamine. No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions. Conclusions: Ketamine can prevent postanesthetic shivering without severe side effects. However, ketamine shows no advantage over other anti-shivering drugs. [ABSTRACT FROM AUTHOR]

Objective:The objective of this study was to study the epidemiology of neonatal hypothermia in preterm infants using World Health Organization (WHO) temperature criteria.Study Design:A population-based cohort of 8782 very low birth weight (VLBW) infants born in California neonatal intensive care units in 2006 and 2007. Associations between admission hypothermia and maternal and neonatal characteristics and outcomes were determined using logistic regression.Result:In all, 56.2% of infants were hypothermic. Low birth weight, cesarean delivery and a low Apgar score were associated with hypothermia. Spontaneous labor, prolonged rupture of membranes and antenatal steroid administration were associated with decreased risk of hypothermia. Moderate hypothermia was associated with higher risk of intraventricular hemorrhage (IVH). Moderate and severe hypothermic conditions were associated with risk of death.Conclusion:Hypothermia by WHO criteria is prevalent in VLBW infants and is associated with IVH and mortality. Use of WHO criteria could guide the need for quality improvement projects targeted toward the most vulnerable infants. [ABSTRACT FROM AUTHOR]

Background: Hypothermia and shivering are common complications after spinal anaesthesia, especially after uroscopic procedures in which large amounts of cold intraluminal irrigation fluids are used. Magnesium sulfate and dexmedetomidine are the most effective adjuvants with the least side effects. The aim of this study was to compare the effects of intrathecal dexmedetomidine versus intrathecal magnesium sulfate on the prevention of post-spinal anaesthesia shivering. Methods: This prospective randomized, double-blinded controlled study included 105 patients who were scheduled for uroscopic surgery at the Kasr El-Aini Hospital. The patients were randomly allocated into three groups. Group C (n = 35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 0.5 ml of normal saline, Group M (n = 35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 25 mg of magnesium sulfate in 0.5 ml saline, and Group D (n = 35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 5 μg of dexmedetomidine in 0.5 ml saline. The primary outcomes were the incidence and intensity of shivering. The secondary outcomes were the incidence of hypothermia, sedation, the use of meperidine to control shivering and complications. Results: Group C had significantly higher proportions of patients who developed shivering (21), developed grade IV shivering (20) and required meperidine (21) to treat shivering than group M (8,5,5) and group D (5,3,6), which were comparable to each other. The time between block administration and meperidine administration was similar among the three groups. Hypothermia did not occur in any of the patients. The three groups were comparable regarding the occurrence of nausea, vomiting, bradycardia and hypotension. All the patients in group C, 32 patients in group M and 33 patients in group D had a sedation score of 2. Three patients in group M and 2 patients in group D had a sedation score of 3. Conclusions: Intrathecal injections of both dexmedetomidine and magnesium sulfate were effective in reducing the incidence of post-spinal anaesthesia shivering. Therefore, we encourage the use of magnesium sulfate, as it is more physiologically available, more readily available in most operating theatres and much less expensive than dexmedetomidine. Trial registration: Clinical trial registration ID: Pan African Clinical Trial Registry (PACTR) Trial Number PACTR201801003001727; January 2018, "retrospectively registered". [ABSTRACT FROM AUTHOR]