AORN Journal
Volume 88, Issue 3 , Pages 358-368 , September 2008

Prevention of Unplanned Perioperative Hypothermia

  • Cynthia A. Paulikas, RN, BSN, MS, CNOR

      Affiliations

    • Cynthia A. Paulikas, RN, BSN, MS, CNOR, is an RN first assistant at Osceola Regional Medical Center, Kissimmee, FL. Ms Paulikas has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

References 

  1. SCIP Project Information  . Thermal management flow chart . http://www.medqic.org/dcs/ContentServer?cid=1122904933959&pagename=Medqic%2FMQTools%2FToolTemplate&c=MQTools Accessed June 14, 2008.
  2. Farley A , McLafferty E . Nursing management of the patient with hypothermia . Nurs Stand . 2008;22(17):43–46
  3. Taguchi A , Ratnaraj J , Kabon B , et al.   Effects of a circulating-water garment and forced-air warming on body heat content and core temperature . Anesthesiology . 2004;100(5):1058–1064
  4. Vanni SM , Braz JR , Módolo NS , Amorim RB , Rodrigues GR . Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery . J Clin Anesth . 2003;15(2):119–125
  5. Jeong SM , Hahm KD , Jeong YB , Yang HS , Choi IC . Warming of intravenous fluids prevents hypothermia during off-pump coronary artery bypass graft surgery . J Cardiothorac Vasc Anesth . 2008;22(1):67–70
  6. Recommended practices for the prevention of unplanned perioperative hypothermia . In: Perioperative Standards and Recommended Practices . Denver, CO: AORN, Inc; 2008;p. 407–420
  7. Kim JY , Shinn H , Oh YJ , Hong YW , Kwak HJ , Kwak YL . The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off-pump coronary artery bypass surgery . Eur J Cardithorac Surg . 2006;29(3):343–347
  8. Good KK , Verble JA , Secrest J , Norwood BR . Postoperative hypothermia—the chilling consequences . AORN J . 2006;83(5):1054–1066
  9. Fry DE , Fry RV . Surgical site infection: the host factor . AORN J . 2007;86(5):801–810
  10. Nesher N , Zisman E , Wolf T , et al.   Strict thermoregulation attenuates myocardial injury during coronary artery bypass graft surgery as reflected by reduced levels of cardiac-specific troponin I . Anesth Analg . 2003;96(2):328–335
  11. De Witte J , Sessler DI . Perioperative shivering: physiology and pharmacology . Anesthesiology . 2002;96(2):467–484
  12. Rajagopalan S , Mascha E , Na J , Sessler DI . The effects of mild perioperative hypothermia on blood loss and transfusion requirement . Anesthesiology . 2008;108(1):71–77
  13. Hofer CK , Worn M , Tavakoli R , et al.   Influence of body core temperature on blood loss and transfusion requirements during off-pump coronary artery bypass grafting: a comparison of 3 warming systems . J Thorac Cardiovasc Surg . 2005;129(4):838–843
  14. Stadfelt D , Baker K . Intra-anesthetic problems . In:  Dunn PF ,  Alston TA ,  Baker KH ,  Davison JK ,  Kwo J ,  Rosow CE editor. Clinical Anesthesia Procedures of the Massachusetts General Hospital . 7th ed.. Philadelphia, PA: Lippincott Williams & Wilkins; 2007;p. 305–326
  15. Fukuoka N , Aibiki M , Tsukamoto T , Seki K , Morita S . Biphasic concentration change during continuous midazolam administration in brain-injured patients undergoing therapeutic moderate hypothermia . Resuscitation . 2004;60(2):225–230
  16. Fritz HG , Holzmayr M , Walter B , Moeritz KU , Lupp A , Bauer R . The effect of mild hypothermia on plasma fentanyl concentration and biotransformation in juvenile pigs . Anesth Analg . 2005;100(4):996–1002
  17. Tortorici MA , Kochanek P , Poloyac SM . Effects of hypothermia on drug disposition, metabolism, and response: a focus of hypothermia-mediated alterations on the cytochrome P450 enzyme system . Crit Care Med . 2007;35(9):2196–2204
  18. Heier T , Caldwell JE . Impact of hypothermia on the response to neuromuscular blocking agents . Anesthesiology . 2006;104(5):1070–1080
  19. Wagner D , Byrne M , Kolcaba K . Effects of comfort warming on preoperative patients . AORN J . 2006;84(3):427–448
  20. Zangrillo A , Pappalardo F , Talò G , et al.   Temperature management during off-pump coronary artery bypass graft surgery: a randomized clinical trial on the efficacy of a circulating water system versus a forced-air system . J Cardiothorac Vasc Anesth . 2006;20(6):788–792
  21. Sessler DI . Temperature monitoring . In:  Miller RD editors. Miller's Anesthesia . 6th ed.. Philadelphia, PA: Elsevier; 2005;p. 1571–1597

  indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 365–366 and then completing the answer sheet and learner evaluation on pages 367–368.You also may access this article online at http://www.aornjournal.org.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.

PII: S0001-2092(08)00351-7

doi: 10.1016/j.aorn.2008.05.020

AORN Journal
Volume 88, Issue 3 , Pages 358-368 , September 2008

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