Torossian A
University Hospital Marburg, Department of Anaesthesia and Intensive Care Medicine, Germany.
Eur J Anaesthesiol. 2007 Aug;24(8):668-75. doi: 10.1017/S0265021507000191. Epub 2007 Apr 11.
Inadvertent perioperative hypothermia causes serious morbidity in surgical patients. However, recent reports suggest that patients might still be hypothermic after elective surgery. We thus surveyed intraoperative temperature monitoring and management practices in Europe.
Postal survey of 801 representative hospitals from 17 European countries on the same day. The questions addressed the number of surgical procedures and type of anaesthesia performed, mode and site of temperature monitoring and method of patient warming. Mean and standard error of the mean or count and percentage were calculated. The t-test or contingency table analysis with the Fisher's exact test were used.
Eight thousand and eighty-three surgical procedures were assessed from 316 responding hospitals (39.4%). Overall, patient temperature monitored in 19.4% and 38.5% of the patients were actively warmed. Under general anaesthesia, body temperature was monitored in 25% and during regional anaesthesia in 6%, P = 0.0005. Nasopharyngeal temperature was most often taken under general anaesthesia, while tympanic temperature was preferred during regional anaesthesia. Under general anaesthesia, 43% of patients were actively warmed as compared to 28% with regional anaesthesia, P = 0.0005. Forced-air warming was the method of choice for both general and regional anaesthesia.
Intraoperative temperature monitoring is still uncommon and hence active patient warming is not a standard of care in Europe. Awareness of perioperative hypothermia is critical to its prevention, and thus temperature monitoring is a pre-requisite. The objective is to maintain normothermia in patients throughout surgery. A European practice guideline for perioperative patient temperature management is warranted.
围手术期意外低温会导致手术患者出现严重的并发症。然而，近期报告显示，择期手术后患者仍可能处于低温状态。因此，我们对欧洲术中体温监测与管理实践进行了调查。
于同一天对来自17个欧洲国家的801家代表性医院进行邮寄调查。问题涉及所实施的外科手术数量和麻醉类型、体温监测方式和部位以及患者保暖方法。计算均值和均值标准误差或计数及百分比。采用t检验或列联表分析及Fisher精确检验。
从316家回复的医院（39.4%）评估了8083例外科手术。总体而言，19.4%的患者进行了体温监测，38.5%的患者接受了主动保暖。在全身麻醉下，25%的患者进行了体温监测，而在区域麻醉下为6%，P = 0.0005。全身麻醉下最常采用鼻咽温度监测，而区域麻醉时则首选鼓膜温度监测。全身麻醉下，43%的患者接受了主动保暖，而区域麻醉时为28%，P = 0.0005。强制空气保暖是全身麻醉和区域麻醉的首选方法。
术中体温监测仍不常见，因此在欧洲主动为患者保暖并非护理标准。认识围手术期低温对其预防至关重要，因此体温监测是一项先决条件。目标是在整个手术过程中维持患者体温正常。有必要制定欧洲围手术期患者体温管理实践指南。
