Case study

Case study: The effect of anaesthetic room pre-warming on the incidence of inadvertent perioperative hypothermia: a quality improvement project

Authors: Rona J, University of Sheffield Medical School; Andrzejowski J, Wiles M, Royal Hallamshire Hospital, Sheffield.

Inadvertent perioperative hypothermia (IPH) is defined as a core body temperature less than 36°C.² Both regional and general anaesthesia can result in IPH, with the risk increasing for patients with a high ASA grade, undergoing emergency surgery or low BMI.³

IPH is a serious complication of surgery which has been linked to infections, shivering, bleeding, adverse cardiac events and changes to drug metabolism.³ NICE guidelines recommend that all patients are warmed for a minimum of 30 minutes before anaesthesia is administered,⁴ however it has been demonstrated that pre-warming for just 10 minutes is effective at reducing hypothermia rates.⁵

A recent quality improvement study that sought to determine whether pre-warming patients in the anaesthetic room had a positive effect on the incidence of postoperative hypothermia. Show that with an average duration of pre-induction warming of 13 minutes, hypothermia rates in the post-anaesthesia care unit (PACU) reduced by 27.5%.¹

References

1. Rona J, Andrzejowski J, Wiles M. The effect of anaesthetic room pre-warming on the incidence of inadvertent perioperative hypothermia: a quality improvement project.
   Anaesthesia 2022, 77 (Suppl.4), 6–44.
2. Torossian A, Bräuer A, Höcker J, Bein B, Wulf H, Horn E. Preventing Inadvertent Perioperative Hypothermia. Deutsches Ärzteblatt international.
   2015;112(10):166–172.
3. Riley C, Andrzejowski J. Inadvertent perioperative hypothermia. BJA Education.
   2018;18(8):227–233.
4. National Institute for Health and Care Excellence. NICE Clinical Guideline. [CG65].
   Apr 2008.
5. Horn E, Bein B, Böhm R, Steinfath M, Sahili N, Höcker J. The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia.
   Anaesthesia. 2012;67(6):612–617.