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[围手术期体温过低的预防:S3指南的实施]

[Prevention of perioperative hypothermia : Implementation of the S3 guideline].

作者信息

Horn E-P, Klar E, Höcker J, Bräuer A, Bein B, Wulf H, Torossian A

机构信息

Anästhesiologie, Regio Kliniken, Fahltskamp 74, 25421, Pinneberg, Deutschland.

Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Universitätsmedizin Rostock, Chirurgische Klinik und Poliklinik, Rostock, Deutschland.

出版信息

Chirurg. 2017 May;88(5):422-428. doi: 10.1007/s00104-016-0357-0.

Abstract

To improve perioperative quality and patient safety, the German S3 guideline should be consistently implemented to avoid perioperative hypothermia. Perioperative normothermia is a quality indicator and should be achieved by anesthesiologists and surgeons. To detect hypothermia early during the perioperative process, measuring body temperature should be started 1-2 h preoperatively. Patients should be actively warmed for 20-30 min before starting anesthesia. Prewarming is most effective and should be included in the preoperative process. Patients should be informed about the risks of perioperative hypothermia and members of the perioperative team should be educated. A standard operating procedure (SOP) to avoid hypothermia should be introduced in every operative unit. The incidence of postoperative hypothermia should be evaluated in operative patients every 3-6 months. The goals should be to measure body temperature in >80% of patients undergoing surgery and for >70% to exhibit a core temperature >36 °C at the end of surgery.

摘要

为提高围手术期质量和患者安全,应始终贯彻德国S3指南以避免围手术期体温过低。围手术期正常体温是一项质量指标,应由麻醉医生和外科医生实现。为在围手术期过程中早期发现体温过低,应在术前1-2小时开始测量体温。患者应在开始麻醉前积极保暖20-30分钟。术前预热最为有效,应纳入术前流程。应告知患者围手术期体温过低的风险,并对围手术期团队成员进行培训。每个手术科室都应引入避免体温过低的标准操作程序(SOP)。应每3-6个月对手术患者术后体温过低的发生率进行评估。目标应是在超过80%的手术患者中测量体温,且超过70%的患者在手术结束时核心体温>36°C。

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