Koleini Evin, Cohen Jared S, Darwish Oussama M, Pourafkari Leili, Rein Laura, Nader Nader D
Department of Anaesthesiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Department of Urology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Turk J Anaesthesiol Reanim. 2020 Oct;48(5):391-398. doi: 10.5152/TJAR.2019.61214. Epub 2019 Dec 26.
To investigate the role of heated irrigation fluids in the risk of hypothermia and related complications in patients undergoing transurethral procedures.
The medical records of all patients who underwent transurethral procedures between 2000 and 2016 at the VA Hospital were reviewed. Irrigation fluids have been heated to 42°C since 2013, as per the institutional policy (Group II). Prior to this date, room temperature solutions were used (Group I). The perioperative body temperature, use of warming devices, procedure length, and anaesthesia type were extracted from records and compared for both groups. In addition, demographic and anthropometric data, preoperative comorbidities, laboratory data, admission information and postoperative complications were obtained from the quality improvement database.
There were 1,363 patients in Group I and 269 patients in Group II. Perioperative temperature was decreased by 0.10°C in Group I compared to a temperature gain of 0.32°C in Group II (p<0.001). Three hundred and forty-eight (21%) patients undergoing transurethral procedures developed hypothermia <36°C. There was no difference in the incidence of postoperative mortality or complications between the normothermic and hypothermic patients.
The replacement of room temperature solutions with warmed solutions for irrigation during transurethral procedures reduced the risk of temperature loss and hypothermia following these procedures. Available heating strategies effectively prevented the perioperative heat loss; however, such strategies did not affect the incidence of postoperative complications.
探讨温热冲洗液在经尿道手术患者体温过低风险及相关并发症中的作用。
回顾了2000年至2016年在退伍军人医院接受经尿道手术的所有患者的病历。自2013年起，根据机构政策，冲洗液已加热至42°C（第二组）。在此之前，使用室温溶液（第一组）。从记录中提取两组患者的围手术期体温、保暖设备使用情况、手术时长和麻醉类型并进行比较。此外，从质量改进数据库中获取人口统计学和人体测量数据、术前合并症、实验室数据、入院信息和术后并发症。
第一组有1363例患者，第二组有269例患者。第一组围手术期体温下降了0.10°C，而第二组体温升高了0.32°C（p<0.001）。1348例（21%）接受经尿道手术的患者体温低于36°C，发生体温过低。体温正常和体温过低的患者术后死亡率或并发症发生率没有差异。
经尿道手术期间用温热溶液替代室温溶液进行冲洗可降低这些手术后体温下降和体温过低的风险。现有的加热策略有效地预防了围手术期的热量损失；然而，这些策略并未影响术后并发症的发生率。
