Inadvertent hypothermia: a prevalent perioperative issue that remains to be improved

Inadvertent hypothermia, defined as a body temperature lower than 36 °C, remains to be a critical issue during the perioperative period. Despite of the development of the active warming devices, the incidence of perioperative hypothermia has been reported to varying between 10%–80%. The top five risk factors of perioperative hypothermia include advanced age, low body mass index, duration of anesthesia or surgery, preoperative hypothermia and large amount of fluid or blood product. A prediction scoring system may be helpful in identifying the population with high risk of perioperative hypothermia. Perioperative hypothermia is associated with shivering, postoperative infection, increased amount of intraoperative blood loss and infusion of fluid or blood products, and delayed recovery after anesthesia. The most accepted warming intervention is forced-air warmers, which has been reported to be associated with elevated intraoperative temperature and reduced intraoperative bleeding and postoperative infection. The present review will focus on the mechanism, incidence, risk factor, adverse outcome, monitoring and warming strategies of perioperative hypothermia.

Graphical Abstract