Urology Department, Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain.
J Pediatr Urol. 2021 Oct;17(5):750-752. doi: 10.1016/j.jpurol.2021.01.048. Epub 2021 Feb 10.
Inadvertent perioperative hypothermia (a drop in core temperature to below 36 °C) occurs because of interference with normal temperature regulation by anaesthetic drugs, skin exposure for prolonged periods and the introduction of large volumes of intravenous and irrigation fluids. If the temperature of these fluids is below core body temperature, they can cause significant heat loss. Warming irrigation fluids might prevent some of this heat loss and subsequent hypothermia and that is the role of warming irrigation fluid systems.
The video describes prone ultra mini PCNL with suction-evacuation access sheath under warming irrigation fluid system in a 15 month-old boy with a 2 cm-600HU staghorn calculi and one stone of 7 mm-500HU in proximal ureter.
The surgery was performed without intraoperative complications and perioperative hypothermia was prevented. The patient started the surgery at 35.4 °C and the final temperature was 36.3 °C in 90 min of procedure, in addition to being free of stones.
The warming irrigation fluid system can be helpful in preventing inadvertent perioperative hypothermia in children, improving the safety of ultra mini PCNL with suction-evacuation access sheath and shows promising results with high stone-free rates and low complications.
由于麻醉药物干扰正常体温调节、皮肤长时间暴露以及大量静脉输液和灌洗液的引入,术中会发生意外的围手术期低体温(核心温度降至 36°C 以下)。如果这些液体的温度低于核心体温,它们可能会导致明显的热量损失。加热灌洗液可能会防止部分热量损失和随后的低体温,这就是加热灌流系统的作用。
视频描述了在加热灌流系统下,15 个月大的男孩采用俯卧位行超微经皮肾镜取石术(mini PCNL)并使用抽吸清除通道鞘,该男孩患有 2cm-600HU 的鹿角形结石和 1 颗 7mm-500HU 的近端输尿管结石。
手术过程中无术中并发症,预防了围手术期低体温。患者在手术开始时体温为 35.4°C,90 分钟的手术结束时体温为 36.3°C,并且结石完全清除。
加热灌流系统有助于预防儿童围手术期低体温,提高经皮肾镜取石术抽吸清除通道鞘的安全性,具有较高的无石率和较低的并发症发生率,结果令人满意。