Therapeutic hypothermia and temperature management最新文献

{"title":"Cardiovascular Hemodynamics of Hypoxic Neonates During Therapeutic Hypothermia and the Warming Phase: A Literature Review.","authors":"Natalia Brunets, Veronika Brunets, Renata Bokiniec","doi":"10.1089/ther.2025.0035","DOIUrl":"10.1089/ther.2025.0035","url":null,"abstract":"<p><p>This study aimed to evaluate the effects of therapeutic hypothermia (TH) and the warming phase on cardiovascular hemodynamics among neonates suffering from perinatal asphyxia. The reviewed literature on hemodynamic changes among neonates undergoing TH was obtained from the following databases: PubMed, Embase, POPLINE, Cochrane Reference Libraries, Google Scholar, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. Search strategies included keywords, combinations, medical subject headings, and snowball searches of related articles. The following search terms were used: brain injury, hypoxic-ischemic encephalopathy, left ventricular (LV) dysfunction, right ventricular (RV) dysfunction, and TH. We selected publications evaluating RV and LV heart function and cerebral, renal, and visceral circulation function for analysis. There were 12 prospective studies, with a total of 361 patients in the study groups and 149 patients in the control groups. There were seven retrospective studies, with a total of 1637 patients. One study was a randomized controlled trial, one was a systematic review, and one was a Cochrane review. The limitations of the review are that most of the studies are observational, making it difficult to precisely assess the causes of the observed changes, whether they are related to asphyxia, hypothermia, or other pathology. The results of the observational studies were not consistent with those of the randomized trials for ethical reasons. The hemodynamic characteristics of the cardiovascular system during TH and the rewarming phase are significantly complex. Therefore, an in-depth understanding of the pathophysiological attributes associated with these aspects is essential to provide individualized therapeutic approaches for optimizing cerebral perfusion pressure and reducing secondary injuries.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"161-173"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild Hypothermia Therapy Reduces the Incidence of Early Cerebral Herniation and Decompressive Craniectomy after Mechanical Thrombectomy for Acute Ischemic Stroke with Large Infarction.","authors":"Guanping Tan, Jing Wang, Jia Duan, Lun Li, Feibao Pan, Chunlei He, Wenli Xing","doi":"10.1089/ther.2024.0049","DOIUrl":"10.1089/ther.2024.0049","url":null,"abstract":"<p><p>The application value of mechanical thrombectomy (MT) in acute large-vessel occlusion cerebral infarction has been confirmed, but considering the poor prognosis of large-core infarction (LCI), the current guidelines and practices are based on anterior circulation small-core infarction. Reducing the perioperative complications of thrombectomy in LCIs is the key to saving more patients previously considered unsuitable for thrombectomy. Patients with acute anterior circulation cerebral infarction who were admitted to Suining Central Hospital of Sichuan Province from January 2022 to December 2023 and whose Alberta Stroke Program Early Computed Tomography Score value was 3-5 (the score range was 0-10, and the lower the score was, the larger the infarct area) or whose infarct core volume was ≥70 mL and who received MT were enrolled consecutively. The patients were grouped based on whether they were treated with mild hypothermia (mild hypothermia treatment group vs. conventional treatment group). Patients who were evaluated preoperatively for large-core cerebral infarction and underwent mild hypothermia treatment were performed immediately after MT. The clinical data of the patients were collected. The primary outcome events were the incidence of cerebral hernia within one week after the operation and the rate of requiring decompressive craniectomy (%). The secondary outcome was the modified Rankin scale (mRS) score at 90 days (the score range was 0-6, and the higher the score was, the greater the degree of functional disability). A total of 64 patients were included. Twenty-nine patients were assigned to the mild hypothermia treatment group, and 35 patients were assigned to the conventional treatment group. There was no significant difference in the baseline data between the two groups. The proportions of cerebral hernia and the need for decompressive craniectomy within one week after the operation were significantly lower in the mild hypothermia treatment group than in the conventional treatment group (31% vs. 57.1%, odds ratio [OR] 0.338, 95% confidence interval [CI] 0.120-0.948; <i>p</i> = 0.037). The proportion of patients who underwent decompressive craniectomy in the mild hypothermia treatment group was significantly lower (13.8% vs. 42.8%, OR 0.213, 95% CI 0.061-0.745, <i>p</i> = 0.011). There was no significant difference in the mRS score between the two groups at 90 days (4.31 ± 1.75 vs. 4.48 ± 1.57, <i>p</i> = 0.456) or in the proportion of patients with a good prognosis (mRS 0-3) between the two groups (OR 0.569, 95% CI 0.18-1.793, <i>p</i> = 0.333). Mild hypothermia treatment can reduce the incidence of early cerebral hernia and the need for decompressive craniectomy in patients with acute large-core cerebral infarction after MT; this treatment can be used as an important adjuvant treatment after thrombectomy for LCI, but may not change the long-term prognosis.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"184-191"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fever Prevention and Neurological Recovery in In-Hospital Cardiac Arrest Survivors at a Limited-Resource Setting.","authors":"Abdullah Bakhsh, Wijdan Bakhashwain, Mohammed Alhazmi, Salem Bahwireth, Saleh Binmahfooz, Reem Alghamdi, Ahmad Bakhribah, Hadeel Alsufyani","doi":"10.1089/ther.2024.0051","DOIUrl":"10.1089/ther.2024.0051","url":null,"abstract":"<p><p>Temperature management plays a critical role in the neurological recovery of cardiac arrest survivors. While advanced device-based temperature control systems are prevalent in high-resource settings, their implementation in low-resource environments remains a challenge. This study aimed to examine the impact of fever prevention on neurological outcomes in cardiac arrest survivors managed without device-based temperature control. We conducted a retrospective study of adult in-hospital cardiac arrest survivors at an academic institution from 2013 to 2020. Patients were included if they were ≥18 years old, survived for at least 72 hours post-return of spontaneous circulation (ROSC), and experienced cardiac arrest in inpatient wards, intensive care units, or the emergency department. Fever was defined as a rectal temperature ≥37.5°C, and neurological outcomes were assessed using the Cerebral Performance Category (CPC) scale at 1 month post-ROSC. A good neurological outcome was defined as CPC 1 or 2. Statistical analyses included chi-square tests and logistic regression to identify predictors of outcomes. Of the 427 patients included, 58.8% experienced fever, and 12.8% achieved a good neurological outcome. Patients with fever were significantly less likely to have favorable outcomes (<i>p</i> < 0.01). Logistic regression revealed that each 1°C increase in body temperature beyond 37.5°C was associated with a 31% reduction in the likelihood of a good outcome (<i>p</i> < 0.01). Other predictors of poor outcomes included prolonged low-flow states and higher pre-arrest frailty scores. Fever is strongly associated with poor neurological outcomes in cardiac arrest survivors, particularly in low-resource settings without device-based temperature management. Effective fever prevention strategies, such as intravenous antipyretics and physical cooling methods, should be prioritized to improve outcomes.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"213-219"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Multivariable Factors Associated With Inadvertent Intraoperative Hypothermia During Robot-Assisted Radical Cystectomy Surgery: A Multicenter Retrospective Study.","authors":"Jingjing Wang, Fengxia Chen, Qiaoju Yang","doi":"10.1177/21537658251390727","DOIUrl":"10.1177/21537658251390727","url":null,"abstract":"<p><p>To analyze the prevalence and factors related to inadvertent intraoperative hypothermia (IOH) in adults undergoing elective robot-assisted radical cystectomy surgery (RARC) under general anesthesia. A retrospective study observed data from June 2022 to August 2023 in two large teaching hospital. Collecting core temperature and potential influencing factors through electronic medical records. Univariate and multivariate logistic regression analyses were used to identify independent risk factors of IOH. 690 patients were included finally, with 266 (38.6) patients suffered IOH. The factors related to IOH embraced anesthesia induction time (odds ratio [OR]: 0.523; 95% confidence interval [CI]: 0.372-0.735; <i>p <</i> 0.05); age (OR: 0.984; CI: 0.970-0.970; <i>p <</i> 0.05); smoking (OR: 3.489; CI: 1.999-6.089; <i>p <</i> 0.05); intraoperative fluid volume (OR: 0.999; CI: 0.999-0.999; <i>p <</i> 0.05); surgery duration (OR: 0.996; CI: 0.994-0.998; <i>p <</i> 0.05); and baseline core temperature (OR: 1.859; CI: 1.165-2.965; <i>p <</i> 0.05). We emphasize the relatively high prevalence of IOH during elective RARC under general anesthesia and identify related factors, including lower baseline core temperature, age, longer surgery duration, surgery in the morning, larger intraoperative fluid volume, and smoking.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"201-206"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Thermal Blanket on Patients' Vital Signs, Shivering Level, Chill Status, and Thermal Comfort Perception in the Preoperative and Postoperative Periods.","authors":"İpek Köse Tosunöz, Evşen Nazik, Gülay İpek Çoban","doi":"10.1177/21537658251371364","DOIUrl":"10.1177/21537658251371364","url":null,"abstract":"<p><p>This study aimed to determine the effects of the thermal blanket on patients' vital signs, shivering level, chill status, and thermal comfort perception in preoperative and postoperative periods. The study was designed as a randomized controlled trial and included 44 female patients who had undergone elective gynecological surgery in a hospital in the south of Turkey. The experimental group (<i>n</i> = 22) was warmed using the passive warming method via a thermal blanket, and the control group (<i>n</i> = 22) was administered routine care via a cotton pique. The data collection tools included the \"Patient Information Form,\" the \"Patient Follow-Up Form,\" the \"Shivering Level Diagnosis Form,\" and the \"Thermal Comfort Perception Scale.\" Patients were warmed passively before (at least 10 minutes) and after surgery (at least 60 minutes) with a thermal blanket or cotton pique according to their groups. Patients' vital signs and oxygen saturation were recorded during the preoperative and postoperative periods at 15-minute intervals. The patients' shivering levels were recorded at 15-minute intervals, and chill status and thermal comfort perceptions were recorded at 30-minute intervals during the postoperative period. The data obtained in the research were analyzed using the SPSS 24.0 program. There were no statistically significant differences between the vital signs and oxygen saturation of the intervention and control groups during the first 60 minutes after surgery. The shivering level and coldness of the control group were higher in the postoperative period, but the difference between the groups was not statistically significant. There were no statistical differences between the groups in the time to reach 36.0°C (<i>p</i> > 0.05). Thermal comfort perception scores during the first 90 minutes were significantly higher in the intervention group (<i>p</i> < 0.05). The thermal blanket is not superior to the cotton pique used in standard care in maintaining body temperature, but it is effective in increasing thermal comfort perception.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"21537658251371364"},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepping Out of the Cold: The Use of Surface Cooling Devices for Targeted Normothermia Temperature Management in Out of Hospital Cardiac Arrest Survivors-Common Pitfalls and Proposed Solutions.","authors":"Emma Ford, Josh Fox, James Williams","doi":"10.1177/21537658251378205","DOIUrl":"10.1177/21537658251378205","url":null,"abstract":"<p><p>The critical care unit at the University Hospital of Wales is a 38-bedded tertiary center. In 2023, the unit admitted 1251 unscheduled patients, of which 131 were out-of-hospital cardiac arrest (OOHCA) patients. The unit also participated in the Targeted Temperature Management 2 study and adopted the findings shortly after its publication in 2021. This gave us a unique exposure into the pitfalls associated with changing surface cooling protocols. The aim of this quality and safety initiative was to explore the causes of failure to comply with normothermic temperature targets in the OOHCA population, following a protocol change away from targeted therapeutic hypothermia. This article uses surface cooling data from OOHCA survivors. We discuss our findings from analysis of surface cooling data from 36 patients-13 pre-protocol change (targeted hypothermia) and 23 post-protocol change (targeted normothermia). Concerningly, following the change to targeted normothermia, rather than therapeutic hypothermia, the fever burden increased from an average of 2 to12 hours per patient. To address this problem, we reviewed the data and identified several causes of this failure. These failures included the failure to start the therapy at the selected trigger point, the interruption of therapy, inadequate pad sizing, and the failure to select the correct protocol. Surface cooling pitfalls are not commonly discussed in the literature, and therefore there remains a risk that units may overlook them, either when transitioning between protocols or when continuing with an ongoing surface cooling device. With evidence suggesting that pyrexia contributes to poorer outcomes, it is of vital importance that staff are aware of any potential pitfalls of surface cooling devices to mitigate unnecessary fever burden.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"21537658251378205"},"PeriodicalIF":1.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothermia and Influence of Rewarming Rates on Survival Among Patients Admitted to Intensive Care with Bloodstream Infection: A Multicenter Cohort Study.","authors":"Kyle C White, Lachlan Quick, Mahesh Ramanan, Alexis Tabah, Kiran Shekar, Siva Senthuran, Felicity Edwards, Antony G Attokaran, Aashish Kumar, Jason Meyer, James McCullough, Sebastiaan Blank, Christopher Smart, Peter Garrett, Kevin B Laupland","doi":"10.1089/ther.2024.0047","DOIUrl":"10.1089/ther.2024.0047","url":null,"abstract":"<p><p>Although critically ill patients with bloodstream infections (BSIs) who present with hypothermia are at the highest risk for death, it is not known how rewarming rates may influence the outcomes. The objective of this study was to identify the occurrence and determinants of hypothermia among patients admitted to intensive care units (ICUs) with BSI and assess how the rate of temperature correction may influence 90-day all-cause case-fatality. A cohort of 3951 ICU admissions associated with BSI was assembled. The lowest temperature measured within the first 24 hours of admission was identified, and among those who were hypothermic (<36°C), the rewarming rate [(time difference between lowest and subsequent first temperature ≥36°C) divided by hypothermia severity (difference between lowest measured and 36°C)] was determined. Within the first 24 hours of admission to the ICU, 329 (8.4%) and 897 (22.7%) subjects had the lowest temperature measurements ranging <34.9°C and 35-35.9°C, respectively. Patients with lower temperatures were more likely to be admitted to tertiary care ICUs, have more comorbid illnesses, have greater severity of illness, and have a higher need for organ-supportive therapies. The 90-day all-cause case-fatality rate was 22.9% overall and was 45.3%, 24.8%, and 19.6% for those with the lowest 24 hours temperatures of <35°C, 35-35.9°C, and ≥36°C, respectively (<i>p</i> < 0.001). Among 1133 hypothermic patients with documented temperatures corrected to the normal range while admitted to the ICU, the median rate of temperature increase was 0.24 (interquartile range, 0.13-0.45)^oC/hour. After controlling for the severity of illness and comorbidity, a faster rewarming rate was associated with significantly lower 90-day case-fatality. Hypothermia is a significant risk factor associated with death among critically ill patients with BSI that faster rates of rewarming may modify.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"141-146"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effect of Surgical Drapes on Intraoperative Hypothermia: A Randomized Clinical Trial.","authors":"Neslihan Ilkaz, Emine Iyigun","doi":"10.1089/ther.2024.0043","DOIUrl":"10.1089/ther.2024.0043","url":null,"abstract":"<p><p>Many patients experience unintended hypothermia in intraoperative processes. This randomized clinical trial aims to investigate the impact of surgical drapes on hypothermia during the intraoperative period. A randomized clinical trial was conducted from April 2019 to November 2020 in the Department of Anesthesiology and Reanimation/Operating Rooms at an education and research hospital. Out of 205 patients assessed for eligibility, 74 underwent elective abdominal surgery and were randomized into two groups: nonwoven surgical drapes and woven surgical drapes. The study had two stages: preoperative and intraoperative. Preoperative data were collected using information and evaluation forms, while intraoperative assessment involved forms for wetness and weight. Tympanic and esophageal temperatures were recorded every 15 minutes, and surgical drapes were weighed with a precision scale before and after surgery. There was no significant difference between the two groups in terms of body mass index, irrigation amount, surgery duration, gender, and preoperative shivering (<i>p</i> > 0.05). A statistically significant difference was found in preoperative body temperature (36°C), type of surgery, and intraoperative hypothermia (<i>p</i> < 0.05). Both types of surgical drapes were wet, but this difference was not statistically significant between the nonwoven group (mean ± SD [1368 ± 607]) and the woven group (mean ± SD [1335 ± 636], <i>p</i> = 0.824). This study demonstrated that neither woven nor nonwoven surgical drapes, nor the wetness of the surgical drapes, had a significant effect on intraoperative hypothermia. However, there is a need for randomized controlled trials involving uniform types of surgery related to the topic.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"134-140"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Model for Histological Chorioamnionitis Risk in Parturients with Intrapartum Fever.","authors":"Xiufang Shao, Bingqing Lv, Yingling Xiu, Lihua Wang, Jun Zhang, Mian Pan","doi":"10.1089/ther.2024.0045","DOIUrl":"10.1089/ther.2024.0045","url":null,"abstract":"<p><p>This study aimed to analyze the causative factors of histological chorioamnionitis (HCA) in parturients with intrapartum fever, assess the implications for maternal and neonatal outcomes, and develop a predictive model to enhance clinical decision-making. A retrospective analysis was performed on 408 parturients with intrapartum fever at Fujian Provincial Maternal and Child Health Hospital from January 2022 to June 2023. Based on post-delivery placental pathology, the data were categorized into HCA (249 cases) and non-HCA groups (159 cases). Variables were first screened using univariate analysis, followed by multivariate logistic regression to identify high-risk factors and develop a predictive model. The model's accuracy was validated using Bootstrap resampling and receiver operating characteristic (ROC) curve analysis. Significant differences were found between the HCA and non-HCA groups in terms of duration of premature rupture of membranes (≥24 hours), peak body temperature during labor (≥38°C), and levels of white blood cell count and C-reactive protein (CRP) at the onset of fever (<i>p</i> < 0.05). The predictive model showed strong accuracy, with an ROC area under the curve of 0.715. Intrapartum fever linked with HCA markedly exacerbates maternal and neonatal outcomes. Key risk factors for HCA include a peak labor temperature ≥38°C, CRP levels at fever onset, and grade III contamination of amniotic fluid. The developed model accurately predicts the HCA risk, enabling enhanced clinical interventions.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"153-159"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Warming Management Measures May Need to Be Further Enhanced During Scoliosis Correction and Internal Fixation Surgery: A Retrospective Cohort Study.","authors":"Hanmei Zhou, Lei Li, Qiang Li, Xiaorui Guo, Nuo Xu, Quanfu Zheng, Qiang Fu","doi":"10.1089/ther.2024.0041","DOIUrl":"10.1089/ther.2024.0041","url":null,"abstract":"<p><p>The incidence of intraoperative hypothermia (IPH) exceeds 70% during spinal surgery, which can lead to many adverse outcomes, including increased intraoperative blood loss/transfusion and delayed recovery. We aimed to evaluate the comprehensive efficiency of a kind of enhanced warming measure on patients undergoing spinal surgery. A retrospective analysis was conducted on the clinical data, surgical procedures, and outcomes of consecutive patients admitted to the department of orthopedics of a hospital from December 2019 to May 2023 and undergoing spinal surgery (scoliosis correction and internal fixation surgery). The impact of the perioperative warming measures on surgical temperature variation and postoperative recovery was analyzed. The surgical patients who received normal active warming measures (quilt, blood transfusion and infusion warming, flushing fluid warming) were the control group (Normal Warming Group [NWG], <i>n</i> = 199), and the enhanced active warming measures (NWG and forced air warming) were the experimental group (Enhanced Warming Group [EWG], <i>n</i> = 201). Incidence of IPH was the primary endpoint of this study. EWG exhibited a significantly reduced incidence of IPH and average frequency of hypothermia per patient compared with NWG (respectively, <i>p</i> < 0.01) and demonstrated notable reductions in intraoperative blood loss, urine output, anesthesia recovery time, and duration of arousal (respectively, <i>p</i> < 0.05, <i>p</i> < 0.01, and <i>p</i> < 0.001). Postoperatively, EWG showed a significantly reduced incidence of shivering (<i>p</i> < 0.001) and had lower costs for postoperative antibiotic use and albumin administration (respectively, <i>p</i> < 0.05 and <i>p</i> < 0.01). So we infer that the occurrence of hypothermia during spinal surgery may seem unavoidable, but EWG can effectively lower the occurrence of IPH and its adverse outcomes, and then somewhat alleviate the postoperative treatment burden. However, given that this study is a retrospective cohort study, it is not yet possible to definitively prove the above conclusions, so we will design relevant prospective clinical studies to prove that the optimization of temperature management may be crucial to ensure optimal overall recovery outcomes.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"124-133"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}