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大手术患者群体中新发术中高热:一项回顾性观察研究。

New-onset intra-operative hyperthermia in a large surgical patient population: A retrospective observational study.

机构信息

From the Department of Anesthesiology, New York Medical College, Valhalla (AJCM), Department of Population Health Science and Policy (H-ML) and Department of Anesthesiology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA (DW).

出版信息

Eur J Anaesthesiol. 2021 May 1;38(5):487-493. doi: 10.1097/EJA.0000000000001322.

Abstract

BACKGROUND

Intra-operative hypothermia has been extensively investigated. However, the incidence of intra-operative hyperthermia has not been investigated in detail.

OBJECTIVE

The main objective of this study was to assess the incidence and risk factors of new-onset intra-operative hyperthermia in a large surgical patient population.

DESIGN

Retrospective database review.

SETTING

Tertiary-care teaching hospital.

PATIENTS

Patients undergoing surgery with general anaesthesia between 1 January 2002 and 31 December 2017 were included.

MAIN OUTCOME MEASURES

The primary outcome measurement was new-onset intra-operative hyperthermia (>37.5 °C). A logistic regression model was fitted to identify risk factors for intra-operative hyperthermia.

RESULTS

A total of 103 648 patients were included in the final analyses. The incidence of new-onset hyperthermia in the overall patient cohort was 6.45%, reaching 20 to 30% after prolonged (>8 h) surgery, and was up to 26.5% in paediatric patients. The use of forced air active patient warming, larger amounts of fluid administration, longer surgery, younger age and smaller body size were all independently associated with intra-operative hyperthermia. The adoption of the Surgical Care Improvement Project (SCIP) temperature measures was associated with an increased incidence of intra-operative hyperthermia.

CONCLUSION

Mild intra-operative hyperthermia is not uncommon particularly in longer procedures and small children.

摘要

背景

术中低体温已被广泛研究。然而,术中高热的发生率尚未得到详细研究。

目的

本研究的主要目的是评估大型手术患者人群中新发术中高热的发生率和危险因素。

设计

回顾性数据库研究。

地点

三级保健教学医院。

患者

纳入 2002 年 1 月 1 日至 2017 年 12 月 31 日期间接受全身麻醉手术的患者。

主要观察指标

主要观察指标为新发术中高热(>37.5°C)。拟合逻辑回归模型以确定术中高热的危险因素。

结果

最终分析共纳入 103648 例患者。总体患者队列中高热的发生率为 6.45%,长时间(>8 小时)手术后发生率达到 20%至 30%,儿科患者中发生率高达 26.5%。使用强制空气主动患者加热、输注更多液体、手术时间延长、年龄较小和体型较小均与术中高热独立相关。采用外科护理改进项目(SCIP)体温措施与术中高热发生率增加相关。

结论

术中轻度高热并不少见,尤其是在手术时间较长和儿童患者中。

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