Jeyadoss J, Thiruvenkatarajan V, Watts R W, Sullivan T, van Wijk R M A W
The Queen Elizabeth Hospital, Woodville, South Australia.
Anaesth Intensive Care. 2013 Nov;41(6):759-64. doi: 10.1177/0310057X1304100611.
Intraoperative hypothermia in open elective abdominal aortic aneurysm repair may be associated with increased hospital morbidity. This retrospective, single centre study investigated whether there was an association between intraoperative hypothermia in open elective abdominal aortic aneurysm repair and postoperative in-hospital morbidity. The data of 119 patients who underwent open infrarenal abdominal aortic aneurysm repair between January 2006 and January 2011 were collected. The electronic databases from the hospital, intensive care unit, transfusion medicine and operating theatres were linked by the patient's unique identifiers including date of birth and unit record number. Intraoperative nasopharyngeal temperature measurements were collected manually from paper-based anaesthetic records. The study group included 102 out of the 119 patients. Sixty-six patients (64.6%) had intraoperative hypothermia as defined by temperature <36°C. Intraoperative temperature was not predictive of hospital length-of-stay or any of the other perioperative complications such as acute renal failure, acute respiratory complications, acute myocardial infarction, transfusion requirements or postoperative infection. In the normothermic group, the number of hours in the intensive care unit was 35% lower (ratio of means=0.65; 95% confidence interval 0.51 to 0.84; P=0.0008), even after adjusting for possible confounders such as age, duration of anaesthesia, size of aneurysm, comorbidities and transfusion. Intraoperative hypothermia is a persisting problem and more aggressive warming strategies may need to be identified and employed to achieve normothermia.
开放性择期腹主动脉瘤修复术中的体温过低可能与医院发病率增加有关。这项回顾性单中心研究调查了开放性择期腹主动脉瘤修复术中体温过低与术后住院发病率之间是否存在关联。收集了2006年1月至2011年1月期间接受开放性肾下腹主动脉瘤修复术的119例患者的数据。医院、重症监护病房、输血医学和手术室的电子数据库通过患者的唯一标识符(包括出生日期和单位记录编号)进行链接。术中鼻咽温度测量值从纸质麻醉记录中手动收集。研究组包括119例患者中的102例。66例患者(64.6%)术中体温过低,定义为体温<36°C。术中体温不能预测住院时间或任何其他围手术期并发症,如急性肾衰竭、急性呼吸并发症、急性心肌梗死、输血需求或术后感染。在体温正常组中,即使在调整了年龄、麻醉持续时间、动脉瘤大小、合并症和输血等可能的混杂因素后,重症监护病房的小时数仍低35%(均值比=0.65;95%置信区间0.51至0.84;P=0.0008)。术中体温过低是一个持续存在的问题,可能需要确定并采用更积极的升温策略以实现体温正常。