Abstract
Maintaining normothermia for patients undergoing
surgery is important for positive surgical outcomes as well as patient safety, satisfaction,
and quality of life. Maintaining normothermia before, during, after surgery
shortens hospital stay durations up to 40% and decreases the risk of
surgical-site infections up to 64%. Abnormalities in the thermal insulation
mechanism during surgery and anesthesia lead to increased heat loss, hampering
the maintenance of normal body temperature. Passive/active external insulation,
heating systems, and internal heating methods are used to prevent heat loss and
to maintain normal body temperature of patients. Active heating methods include
the use of one or more the following principles: heat transmission, radiation, and
convection. Passive
heating methods are those intended for conserving patients’ body temperature.
These methods, which include the use surgical dressings, swimming caps, socks, sheets,
metallizing plastic sheeting, blankets, piques will protect patients from
factors in the external environment. The heat gained in passive heating is
directly proportional to the amount of body surface covered. Previous studies
have focused on the use of blankets. Some studies have used cotton blankets to
study patients’ body temperature changes. A floor-heated cotton blanket
prevents 33% of heat loss and the use of a two-fold cotton blanket reduces the
additional 18% heat loss and has been reported to provide more benefits.
However, passive heating methods with cotton blankets can only prevent body
temperature loss and cannot increase the body temperature; hence, it is
recommended that they be used in conjunction with active heating methods. This
study reviews the literature regarding the prevention of postoperative
hypothermia.
References
- Müftüoğlu, H.E., Preoperatif Aminoasit İnfüzyonunun Spinal Anestezide Perioperatif Termoregulasyona Etkisi. 2009: İstanbul.
- Fred, C., et al., Intraoperatively Acquired Pressure Ulcers and Perioperative Normothermia: A Look at Relationships. AORN Journal, 2012. 96(3): p. 251-260.
- Braunstein, G., Chapter 9: The Hypothalamus, in The Pituitary. 2011, Elsevier: London. p. 303-43.
- Barret, K., et al., Chapter 10: Pain and Temperature in Review of Meical Physciology. 2011, Mc Graw Hill: Newyork. p. 167-301.
- Cooper, S., The Effect of Preoperative Warming Patients' Postoperative Temperatures. AORN, 2006. 83(5): p. 1090-113.
- Hall, J.E., Chapter 73: Body Temperature Regulation and Fever, in Guyton Medical Physciology, B. Çağlayan Yeğen, İ. Alican, and Z. Solakoğlu, Editors. 2013, Nobel Tıp Kitapevi: Ankara. p. 867-81.
- Sherwood, L., Chapter 17: Energy Balance and Temperature Regulation in Human Physciology. 2007, Gengage Learning: Canada. p. 635-56.
- Camus, Y., et al., Prevention of hypothermia by cutaneous warming with new electric blankets during abdominal surgery. Br J Anaesth, 1997. 79(6): p. 796-807.
- Karaaslan, D. and S. Öztürk, Anestezi Sonrası Titreme ve Termoregulasyon. Türkiye Klinikleri Journal of Anesthesiology and Reanimation, 2009. 7(2): p. 98-104.
- Eren, Ş., et al., Hipotermi Değerlendirmesi, Tanı ve Tedavisi. Akademik Acil Tıp Dergisi, 2009. 8(1): p. 9-12.
- Hynson, J. and D.I. Sessler, Intraoperative Warming Therapies: A Comparision of Three Devices. J Clin Anesth, 1992. 4: p. 194-9.
- Marmaralı, A., et al. Thermal Comfort of Some New Yarns Generation Knitted Fabrics. in AUTEX World Textile Conference. 2009. İzmir.
- Pikus, E. and V. Hooper, Postoperative Rewarming: Are There Alternatives to Warm Hospital Blankets? Journal of Peri Anesthesia Nursing, 2010. 25(1): p. 11-23.
- Sutton, L., et al., A Quasi-Experimental Study Examining the Safety Profile and Comfort Provided by Two Different Blanket Temperatures. Journal of PeriAnesthesia Nursing, 2012. 27(3): p. 181-189.
- Journeaux, M., Peri-operative hypothermia: implications for practice. Nursing Standard, 2013. 27(45): p. 33-8.
- Marino, M., et al., Nutrition and Human Health from a sex-gender perspective. Molecular Aspects of Medicine, 2011. 32: p. 1-70.
- Lundgren, P., et al., The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2011. 19(59): p. 1-7.
- Özdil, N., A. MARMARALI, and S.D. Kretzschmar, Effect of Yarn Properties on Thermal Comfort of Knitted Fabrics. International Journal of Thermal Sciences, 2007. 46: p. 1318-1322.
- Namba, R., H. Skinner, and R. Gupta, Chapter 7: Adult Reconstructive Surgery, in Current Diagnosis & Treatment in Orthopedics. 2006, Mc Graw Hill: Newyork.
- Eus, J.W. and S. Van, Chapter 22: Age Related Changes in Thermoception and Thermoregulation, in Handbook of the Biology of Aging. 2011. p. 463-74.
- Harwood, H. and J.R. James, The Adipocyte as an Endocrin Organ in The Regulation of Metabolic Homeostasis. Neuropharmacology, 2012. 63: p. 57-75.
- Batsis, J., et al., Body mass index and the impact on hospital resource use in patients undergoing total knee arthroplasty. J Arthroplasty, 2010. 25(8): p. 1250-7.
- Poveda, V., C. Galvao, and C. Santos, Factors Associated to the Development of Hypothermia in the Intraoperative Period. The Revista Latino-Americana de Enfermagem, 2009. 17(2): p. 228-233.
- Weirich, T.L., Hypothermia/Warming Protocols: Why Are They Not Widely Used in the OR? AORN Journal, 2008. 87: p. 333-44.
- Lynch, S., J. Dıxon, and D. Leary, Reducing The Risk of Unplanned Perioperative Hypothermia. AORN Journal, 2010. 92: p. 553-62.
- Baker, B. and R. Lawson, Maternal And Newborn Outcomes Related To Unplanned Hypothermia in Scheduled Low-Risk Cesarean Delivery Births. Newborn & Infant Nursıng Revıews, 2012. 12(2): p. 75-7.
- Radcliff, K., et al., Preoperative Risk Stratification Reduces the Incidence of Perioperative Complications After Total Knee Arthroplasty. The Journal of Arthroplasty, 2012. 27(8): p. 77-89.
- Winkler, M., et al., Aggressive warming reduces blood loss during hip arthroplasty. Anesth Analg., 2000. 91(4): p. 978-84.
- Hart, S., et al., Unintended Perioperative Hypothermia. The Ochsner Journal, 2011. 11: p. 259-270.
- Hooven, K., Preprocedure Warming Maintains Normothermia Throughout the Perioperative Period: A Quality Improvement Project. Journal of PeriAnesthesia Nursing, 2011. 26(1): p. 9-14.
- Jardeleza, A., et al., The effectiveness and cost of passive warming in adult ambulatory surgery patients. AORN Journal, 2011. 94(4): p. 363-369.
- Deren, M.E., et al., Prewarming Operating Rooms for Prevention of Intraoperative Hypothermia During Total Knee and Hip Arthroplasties. The Journal of Arthroplasty, 2011. 26(8): p. 1380-1386.
- Demirer, E., et al., Current Management of Hypothermia: from Theory to Application. Respiratory Case Reports, 2012. 1(2): p. 48-57.
- Vallire, D., et al., ASPAN’s Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia. Journal of Peri Anesthesia Nursing, 2010. 25(6): p. 346-365.
- Horn, E., et al., Active Warming During Cesarean Delivery. Anesth Analg., 2002. 94: p. 409-414.
- Cristina, M.G., et al., A Systematic Review of the Effectiveness of Cutaneous Warming Systems to Prevent Hypothermia. Journal of Clinical Nursing, 2009: p. 627-36.
- Saniç, A., Hangi Dezenfektan? Nasıl? Ankem Derg, 2006. 20: p. 89-93.
- Tünger, A., C. Çavuşoğlu, and M. Korkmaz, Asya Mikrobiyoloji. 2005, İzmir, Türkiye: Asya Tıp Kitapevi.
- Bilgin, M., Battaniye Sektör Araştırması. 2005: İstanbul. p. 1-17.
- Marmaralı, A., et al., Giysilerde Isıl Konforu Etkileyen Parametreler. Tekstil ve Konfeksiyon, 2006. 4(2006): p. 241-246.
Abstract
Cerrahi
hastalarında, normoterminin sürdürülmesi; hasta güvenliği, hasta memnuniyeti, olumlu
cerrahi sonuçların elde edilmesi ve kaliteli bakımın sürdürülmesi için
önemlidir. Ameliyat sırası ve sonrası dönemde normoterminin sürdürülmesi; taburculuk
süresini %40’a kadar kısaltmakta ve cerrahi alan enfeksiyonu riskini %64’e
kadar azaltmaktadır. Ameliyat sırasında ısı
yalıtım mekanizmasının bozulması ve anestezi ısı kaybını arttırarak normoterminin sürdürülmesini engellemektedir. Hastanın ısı kaybını önlemek ve normotermiyi sürdürmek için pasif izolasyon, aktif eksternal
ısıtma sistemleri ve internal ısıtma yöntemleri kullanılmaktadır. Aktif
ısıtma yöntemleri ile
hastaya dışarıdan iletim, ışınım, taşınım yollarından biri veya birden
fazlasıyla ısı verilmektedir. Pasif ısıtma yöntemleri; hastanın vücut ısısının korunmasına
yönelik yöntemlerdir. Pasif ısıtma; cerrahi örtüler, boneler, çoraplar, çarşaflar,
pikeler, battaniyeler, metalize plastik örtüler gibi hastayı dış ortam
sıcaklığından koruyacak malzemeler kullanılarak sağlanmaktadır. Pasif ısıtmada örtülen vücut
alanı ile korunan ve/veya kazanılan ısı miktarı doğru orantılı olduğundan; çalışmalar
battaniyeler üzerinde yoğunlaşmıştır. Hastaların vücut ısısını korumada kullanılan
battaniyelerin üretiminde değişik hammaddelerin kullanılabilmesine rağmen daha önce yapılan çalışmalarda
pamuklu battaniye kullanıldığı dikkat çekmektedir. Bir kat ısıtılmış pamuklu
battaniyenin ısı kaybını %33, İki kat
pamuklu battaniyenin ısı kaybını ek %18 azalttığı, daha fazla katın fayda
sağlamadığı bildirilmiştir. Pasif
ısıtma yöntemlerinden pamuklu battaniyelerin vücut ısısını koruyabildikleri
fakat arttıramadıkları belirtilmekte, bu nedenle aktif ısıtma yöntemleri ile
birlikte kullanılmaları önerilmektedir. Bu çalışmada postoperatif hipoterminin
kontrolü ile ilgili literatür özetlenmiştir
References
- Müftüoğlu, H.E., Preoperatif Aminoasit İnfüzyonunun Spinal Anestezide Perioperatif Termoregulasyona Etkisi. 2009: İstanbul.
- Fred, C., et al., Intraoperatively Acquired Pressure Ulcers and Perioperative Normothermia: A Look at Relationships. AORN Journal, 2012. 96(3): p. 251-260.
- Braunstein, G., Chapter 9: The Hypothalamus, in The Pituitary. 2011, Elsevier: London. p. 303-43.
- Barret, K., et al., Chapter 10: Pain and Temperature in Review of Meical Physciology. 2011, Mc Graw Hill: Newyork. p. 167-301.
- Cooper, S., The Effect of Preoperative Warming Patients' Postoperative Temperatures. AORN, 2006. 83(5): p. 1090-113.
- Hall, J.E., Chapter 73: Body Temperature Regulation and Fever, in Guyton Medical Physciology, B. Çağlayan Yeğen, İ. Alican, and Z. Solakoğlu, Editors. 2013, Nobel Tıp Kitapevi: Ankara. p. 867-81.
- Sherwood, L., Chapter 17: Energy Balance and Temperature Regulation in Human Physciology. 2007, Gengage Learning: Canada. p. 635-56.
- Camus, Y., et al., Prevention of hypothermia by cutaneous warming with new electric blankets during abdominal surgery. Br J Anaesth, 1997. 79(6): p. 796-807.
- Karaaslan, D. and S. Öztürk, Anestezi Sonrası Titreme ve Termoregulasyon. Türkiye Klinikleri Journal of Anesthesiology and Reanimation, 2009. 7(2): p. 98-104.
- Eren, Ş., et al., Hipotermi Değerlendirmesi, Tanı ve Tedavisi. Akademik Acil Tıp Dergisi, 2009. 8(1): p. 9-12.
- Hynson, J. and D.I. Sessler, Intraoperative Warming Therapies: A Comparision of Three Devices. J Clin Anesth, 1992. 4: p. 194-9.
- Marmaralı, A., et al. Thermal Comfort of Some New Yarns Generation Knitted Fabrics. in AUTEX World Textile Conference. 2009. İzmir.
- Pikus, E. and V. Hooper, Postoperative Rewarming: Are There Alternatives to Warm Hospital Blankets? Journal of Peri Anesthesia Nursing, 2010. 25(1): p. 11-23.
- Sutton, L., et al., A Quasi-Experimental Study Examining the Safety Profile and Comfort Provided by Two Different Blanket Temperatures. Journal of PeriAnesthesia Nursing, 2012. 27(3): p. 181-189.
- Journeaux, M., Peri-operative hypothermia: implications for practice. Nursing Standard, 2013. 27(45): p. 33-8.
- Marino, M., et al., Nutrition and Human Health from a sex-gender perspective. Molecular Aspects of Medicine, 2011. 32: p. 1-70.
- Lundgren, P., et al., The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2011. 19(59): p. 1-7.
- Özdil, N., A. MARMARALI, and S.D. Kretzschmar, Effect of Yarn Properties on Thermal Comfort of Knitted Fabrics. International Journal of Thermal Sciences, 2007. 46: p. 1318-1322.
- Namba, R., H. Skinner, and R. Gupta, Chapter 7: Adult Reconstructive Surgery, in Current Diagnosis & Treatment in Orthopedics. 2006, Mc Graw Hill: Newyork.
- Eus, J.W. and S. Van, Chapter 22: Age Related Changes in Thermoception and Thermoregulation, in Handbook of the Biology of Aging. 2011. p. 463-74.
- Harwood, H. and J.R. James, The Adipocyte as an Endocrin Organ in The Regulation of Metabolic Homeostasis. Neuropharmacology, 2012. 63: p. 57-75.
- Batsis, J., et al., Body mass index and the impact on hospital resource use in patients undergoing total knee arthroplasty. J Arthroplasty, 2010. 25(8): p. 1250-7.
- Poveda, V., C. Galvao, and C. Santos, Factors Associated to the Development of Hypothermia in the Intraoperative Period. The Revista Latino-Americana de Enfermagem, 2009. 17(2): p. 228-233.
- Weirich, T.L., Hypothermia/Warming Protocols: Why Are They Not Widely Used in the OR? AORN Journal, 2008. 87: p. 333-44.
- Lynch, S., J. Dıxon, and D. Leary, Reducing The Risk of Unplanned Perioperative Hypothermia. AORN Journal, 2010. 92: p. 553-62.
- Baker, B. and R. Lawson, Maternal And Newborn Outcomes Related To Unplanned Hypothermia in Scheduled Low-Risk Cesarean Delivery Births. Newborn & Infant Nursıng Revıews, 2012. 12(2): p. 75-7.
- Radcliff, K., et al., Preoperative Risk Stratification Reduces the Incidence of Perioperative Complications After Total Knee Arthroplasty. The Journal of Arthroplasty, 2012. 27(8): p. 77-89.
- Winkler, M., et al., Aggressive warming reduces blood loss during hip arthroplasty. Anesth Analg., 2000. 91(4): p. 978-84.
- Hart, S., et al., Unintended Perioperative Hypothermia. The Ochsner Journal, 2011. 11: p. 259-270.
- Hooven, K., Preprocedure Warming Maintains Normothermia Throughout the Perioperative Period: A Quality Improvement Project. Journal of PeriAnesthesia Nursing, 2011. 26(1): p. 9-14.
- Jardeleza, A., et al., The effectiveness and cost of passive warming in adult ambulatory surgery patients. AORN Journal, 2011. 94(4): p. 363-369.
- Deren, M.E., et al., Prewarming Operating Rooms for Prevention of Intraoperative Hypothermia During Total Knee and Hip Arthroplasties. The Journal of Arthroplasty, 2011. 26(8): p. 1380-1386.
- Demirer, E., et al., Current Management of Hypothermia: from Theory to Application. Respiratory Case Reports, 2012. 1(2): p. 48-57.
- Vallire, D., et al., ASPAN’s Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia. Journal of Peri Anesthesia Nursing, 2010. 25(6): p. 346-365.
- Horn, E., et al., Active Warming During Cesarean Delivery. Anesth Analg., 2002. 94: p. 409-414.
- Cristina, M.G., et al., A Systematic Review of the Effectiveness of Cutaneous Warming Systems to Prevent Hypothermia. Journal of Clinical Nursing, 2009: p. 627-36.
- Saniç, A., Hangi Dezenfektan? Nasıl? Ankem Derg, 2006. 20: p. 89-93.
- Tünger, A., C. Çavuşoğlu, and M. Korkmaz, Asya Mikrobiyoloji. 2005, İzmir, Türkiye: Asya Tıp Kitapevi.
- Bilgin, M., Battaniye Sektör Araştırması. 2005: İstanbul. p. 1-17.
- Marmaralı, A., et al., Giysilerde Isıl Konforu Etkileyen Parametreler. Tekstil ve Konfeksiyon, 2006. 4(2006): p. 241-246.
Details
| Subjects | Nursing |
|---|---|
| Journal Section | reviews |
| Authors | |
| Publication Date | April 30, 2017 |
| Submission Date | January 6, 2017 |
| Acceptance Date | April 28, 2017 |
| Published in Issue | Year 2017 Volume: 2 Issue: 1 |
Cited By
İstenmeyen perioperatif hipotermi bakım algoritması
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi
https://doi.org/10.33631/duzcesbed.801281
Health Academy Kastamonu is included in the class of 1-b journals (journals scanned in international indexes other than SCI, SSCI, SCI-expanded, ESCI) according to UAK associate professorship criteria. HEALTH ACADEMY KASTAMONU Journal cover is registered by the Turkish Patent Institute.