Çocuk Hastanesinde Perioperatif Hipotermi Sıklığı ve Predispozan Faktörler

Kübra EVREN ŞAHİN, M. Sözbilen
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Abstract

Background/Aim: Perioperative hypothermia is more common in pediatric patients than in adult patients due to increased body surface area/weight ratio and limited subcutaneous fat deposits. Therefore, active and passive warming techniques are used more frequently in the surgeries applied to pediatric patients. This study presents the prevalence of perioperative hypothermia and the predisposing conditions for perioperative hypothermia in pediatric orthopedic surgeries in which active and passive warming techniques are applied. Methods: This cross-sectional, descriptive, and observational study included 102 children admitted to the pediatric orthopedic clinic of a children’s hospital. Temperature measurements were made with a calibrated infrared tympanic thermometer in all cases while they were waiting in the service room, when they entered the operation theater, when they left the operation theater, and when they left the postoperative care unit. Their demographic data, hemogram, and thyroid hormone parameters, preoperative fasting times related to the procedure, and temperature were recorded. Also, the humidity and temperature values of the operating theater, the operation type performed, the anesthesia method applied during the operation, the complications encountered, and the time spent in the operating theater were all recorded in their follow-up forms. Data analysis was done using SPSS V21.0 and was conducted at a 95% confidence interval. Results: Hypothermia was observed in 20,58% of 102 patients included in the study. Predisposing factors were determined for perioperative hypothermia as follows; the patient's American Society of Anesthesiologists risk score is above 1, concomitant diagnosis of cerebral palsy, low hemoglobin level in the preoperative period, fasting longer than 8 hours, the low body temperature of the patient in the service room, long time stayed in the operating room, and different humidity values of the operating theatre. Conclusion: Although active and passive warming techniques are applied during the operation, perioperative hypothermia was observed in 20,58% of pediatric patients who underwent the orthopedic operation. Consideration of predisposing factors together with active and passive warming techniques may reduce the incidence of perioperative hypothermia.
背景/目的:由于体表面积/体重比增加和皮下脂肪沉积有限,围手术期低温在儿科患者中比成人患者更常见。因此,在儿科患者的手术中,主动和被动加热技术的使用频率更高。本研究介绍了围手术期低体温的患病率以及应用主动和被动加热技术的儿童骨科手术围手术期低体温的易感条件。方法:这项横断面、描述性和观察性研究纳入了一家儿童医院儿科骨科门诊收治的102名儿童。在所有病例中,当他们在服务室等待时,当他们进入手术室时,当他们离开手术室时,以及当他们离开术后护理病房时,使用校准的红外鼓膜温度计进行温度测量。记录患者的人口统计学数据、血象、甲状腺激素参数、术前与手术相关的禁食时间和体温。并在随访表中记录手术室湿度、温度值、手术类型、手术中使用的麻醉方式、出现的并发症、在手术室停留的时间。数据分析采用SPSS V21.0,置信区间为95%。结果:纳入研究的102例患者中有20.58%出现了低温症。围手术期低温的易感因素如下:患者美国麻醉学会风险评分在1分以上,同时诊断为脑瘫,术前血红蛋白水平低,禁食时间超过8小时,在服务室患者体温低,在手术室停留时间长,手术室湿度值不同。结论:虽然在手术过程中应用了主动和被动加热技术,但20.58%的儿童骨科手术患者围手术期出现了低温。考虑易感因素并结合主动和被动加热技术可减少围手术期低体温的发生率。
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