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    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


    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.
    3. Riley C, Andrzejowski J. Inadvertent perioperative hypothermia. BJA Education.
    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.
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