Volume 14 Issue 4
Jul.  2023
Turn off MathJax
Article Contents
National Center for Quality Assurance of Anesthesia. 2023 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 734-743. doi: 10.12290/xhyxzz.2023-0266
Citation: National Center for Quality Assurance of Anesthesia. 2023 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 734-743. doi: 10.12290/xhyxzz.2023-0266

2023 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia

doi: 10.12290/xhyxzz.2023-0266

National High Level Hospital Clinical Research Funding 2022-PUMCH-B-006

National High Level Hospital Clinical Research Funding 2022-PUMCH-C-011

The Capital Health Research and Development of Special 2018-2-4013

More Information

    Corresponding author: HUANG Yuguang, E-mail: garybeijing@163.com

  • Received Date: 2023-06-03
  • Accepted Date: 2023-07-17
  • Available Online: 2023-07-24
  • Publish Date: 2023-07-30
  • The 2023 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia is an update of the 2017 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia. It is intended to provide patient-centric recommendations for clinicians to prevent and manage inadvertent hypothermia. It offers advice on assessing patient's risk of hypothermia, measuring and monitoring temperature as well as preventing patients from hypothermia before, during and after surgery. It also provides new evidence on hypothermia and adverse outcomes, and temprature management for special patients care considerations including pediatric, pregnancy, trauma, liver transplantation and sepsis.
  • loading
  • [1] Sessler DI. Mild perioperative hypothermia[J]. N Engl J Med, 1997, 336: 1730-1737. doi:  10.1056/NEJM199706123362407
    [2] Mendonça FT, Ferreira J, Guilardi V, et al. Prevalence of inadvertent perioperative hypothermia and associated factors: a cross-sectional study[J]. Ther Hypothermia Temp Manag, 2021, 11: 208-215. doi:  10.1089/ther.2020.0038
    [3] Akers JL, Dupnick AC, Hillman EL, et al. Inadvertent perioperative hypothermia risks and postoperative complications: a retrospective study[J]. AORN J, 2019, 109: 741-747. doi:  10.1002/aorn.12696
    [4] Brustia R, Monsel A, Skurzak S, et al. Guidelines for Perioperative Care for Liver Transplantation: Enhanced Recovery After Surgery (ERAS) Recommendations[J]. Transplantation, 2022, 106: 552-561. doi:  10.1097/TP.0000000000003808
    [5] 国家麻醉专业质量控制中心, 中华医学会麻醉学分会. 围手术期患者低体温防治专家共识(2017)[J]. 协和医学杂志, 2017, 8: 352-358. doi:  10.3969/j.issn.1674-9081.2017.06.007
    [6] 陈颖, 王莹, 张越伦, 等. 全麻患者围手术期低体温风险预测模型的前瞻性、多中心研究[J]. 中国医学科学院学报, 2022, 44: 1028-1032. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYKX202206012.htm
    [7] 陈耀龙, 杨克虎, 王小钦, 等. 中国制订/修订临床诊疗指南的指导原则(2022版)[J]. 中华医学杂志, 2022, 102: 697-703. doi:  10.3760/cma.j.cn112137-20211228-02911
    [8] Collins S, Budds M, Raines C, et al. Risk factors for perioperative hypothermia: a literature review[J]. J Perianesth Nurs, 2019, 34: 338-346. doi:  10.1016/j.jopan.2018.06.003
    [9] Sari S, Aksoy SM, But A. The incidence of inadvertent perioperative hypothermia in patients undergoing general anesthesia and an examination of risk factors[J]. Int J Clin Pract, 2021, 75: e14103.
    [10] Scott AV, Stonemetz JL, Wasey JO, et al. Compliance with surgical care improvement project for body temperature management (SCIP Inf-10) is associated with improved clinical outcomes[J]. Anesthesiology, 2015, 123: 116-125. doi:  10.1097/ALN.0000000000000681
    [11] Sessler DI. Perioperative thermoregulation and heat balance[J]. Lancet, 2016, 387: 2655-2664. doi:  10.1016/S0140-6736(15)00981-2
    [12] Lenhardt R. Body temperature regulation and anesthesia[J]. Handb Clin Neurol, 2018, 157: 635-644.
    [13] Joris J, Ozaki M, Sessler DI, et al. Epidural anesthesia impairs both central and peripheral thermoregulatory control during general anesthesia[J]. Anesthesiology, 1994, 80: 268-277. doi:  10.1097/00000542-199402000-00006
    [14] Sessler DI. Perioperative temperature monitoring[J]. Anesthesiology, 2021, 134: 111-118. doi:  10.1097/ALN.0000000000003481
    [15] Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial[J]. JAMA, 1997, 277: 1127-1134. doi:  10.1001/jama.1997.03540380041029
    [16] Bindu B, Bindra A, Rath G. Temperature management under general anesthesia: Compulsion or option[J]. J Anaesthesiol Clin Pharmacol, 2017, 33: 306-316. doi:  10.4103/joacp.JOACP_334_16
    [17] Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group[J]. N Engl J Med, 1996, 334: 1209-1215. doi:  10.1056/NEJM199605093341901
    [18] Balki I, Khan JS, Staibano P, et al. Effect of perioperative active body surface warming systems on analgesic and clinical outcomes: a systematic review and meta-analysis of randomized controlled trials[J]. Anesth Analg, 2020, 131: 1430-1443. doi:  10.1213/ANE.0000000000005145
    [19] Sessler DI, Pei L, Li K, et al. Aggressive intraoperative warming versus routine thermal management during non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority trial[J]. Lancet, 2022, 399: 1799-1808. doi:  10.1016/S0140-6736(22)00560-8
    [20] Pasquier M, Paal P, Kosinski S, et al. Esophageal temperature measurement[J]. N Engl J Med, 2020, 383: e93. doi:  10.1056/NEJMvcm1900481
    [21] Wang M, Singh A, Qureshi H, et al. Optimal depth for nasopharyngeal temperature probe positioning[J]. Anesth Analg, 2016, 122: 1434-1438. doi:  10.1213/ANE.0000000000001213
    [22] Pei L, Huang Y, Mao G, et al. Axillary Temperature, as Recorded by the iThermonitor WT701, Well Represents Core Temperature in Adults Having Noncardiac Surgery[J]. Anesth Analg, 2018, 126: 833-838. doi:  10.1213/ANE.0000000000002706
    [23] Thapa HP, Kerton AJ, Peyton PJ. Comparison of the EasyWarm® self-heating blanket with the Cocoon forced-air warming blanket in preventing intraoperative hypothermia[J]. Anaesth Intensive Care, 2019, 47: 169-174. doi:  10.1177/0310057X19840264
    [24] Min SH, Yoon S, Yoon SH, et al. Randomised trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position[J]. Br J Anaesth, 2018, 120: 555-562. doi:  10.1016/j.bja.2017.11.091
    [25] Cobb B, Cho Y, Hilton G, et al. Active warming utilizing combined Ⅳ fluid and forced-air warming decreases hypothermia and improves maternal comfort during cesarean delivery: a randomized control trial[J]. Anesth Analg, 2016, 122: 1490-1497. doi:  10.1213/ANE.0000000000001181
    [26] Thiel B, Mooijer BC, Kolff-Gart AS, et al. Is preoperative forced-air warming effective in the prevention of hypothermia in orthopedic surgical patients? A randomized controlled trial[J]. J Clin Anesth, 2020, 61: 109633. doi:  10.1016/j.jclinane.2019.109633
    [27] Lee Y, Kim K. Optimal application of forced air warming to prevent peri-operative hypothermia during abdominal surgery: a systematic review and meta-analysis[J]. Int J Environ Res Public Health, 2021, 18: 2517. doi:  10.3390/ijerph18052517
    [28] Roxby D, Sobieraj-Teague M, von Wielligh J, et al. Warming blood prior to transfusion using latent heat[J]. Emerg Med Australas, 2020, 32: 604-610. doi:  10.1111/1742-6723.13471
    [29] Wittenborn J, Mathei D, van Waesberghe J, et al. The effect of warm and humidified gas insufflation in gynecolo-gical laparoscopy on maintenance of body temperature: a prospective randomized controlled multi-arm trial[J]. Arch Gynecol Obstet, 2022, 306: 753-767. doi:  10.1007/s00404-022-06499-z
    [30] Shaw CA, Steelman VM, DeBerg J, et al. Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials[J]. J Clin Anesth, 2017, 38: 93-104. doi:  10.1016/j.jclinane.2017.01.005
    [31] Kim HY, Lee KC, Lee MJ, et al. Comparison of the efficacy of a forced-air warming system and circulating-water mattress on core temperature and post-anesthesia shivering in elderly patients undergoing total knee arthroplasty under spinal anesthesia[J]. Korean J Anesthesiol, 2014, 66: 352-357. doi:  10.4097/kjae.2014.66.5.352
    [32] Yasar PO, Uzumcugil F, Pamuk AG, et al. Comparison of combined forced-air warming and circulating-water-mattress and forced-air warming alone in patients undergoing open abdominal surgery in lithotomy position: a randomized controlled trial[J]. Indian J Surg, 2022, 84: 72-78. doi:  10.1007/s12262-021-02829-8
    [33] Soysal GE, Ilçe A, Erkol MH. Effect of "an innovative technology" active warming and passive warming on unplanned hypothermia during perioperative period: a clinical trial[J]. Ther Hypothermia Temp Manag, 2018, 8: 216-224. doi:  10.1089/ther.2017.0048
    [34] Cao J, Sheng X, Ding Y, et al. Effect of warm bladder irrigation fluid for benign prostatic hyperplasia patients on perioperative hypothermia, blood loss and shiver: a meta-analysis[J]. Asian J Urol, 2019, 6: 183-191. doi:  10.1016/j.ajur.2018.07.001
    [35] Oderda M, Cerutti E, Gontero P, et al. The impact of warmed and humidified CO(2) insufflation during robotic radical prostatectomy: results of a randomized controlled trial[J]. Urologia, 2019, 86: 130-140. doi:  10.1177/0391560319834837
    [36] Jiang R, Sun Y, Wang H, et al. Effect of different carbon dioxide (CO2) insufflation for laparoscopic colorectal surgery in elderly patients: a randomized controlled trial[J]. Medicine (Baltimore), 2019, 98: e17520. doi:  10.1097/MD.0000000000017520
    [37] Pei L, Huang Y, Xu Y, et al. Effects of ambient temperature and forced-air warming on intraoperative core temperature: a factorial randomized trial[J]. Anesthesiology, 2018, 128: 903-911. doi:  10.1097/ALN.0000000000002099
    [38] National Institute for Health and Care Excellence. Hypothermia: prevention and management in adults having surgery[EB/OL]. (2016-12-14)[2023-06-03]. https://www.nice.org.uk/guidance/CG65/chapter/Recommendations#intraoperative-phase.
    [39] Duryea EL, Nelson DB, Wyckoff MH, et al. The impact of ambient operating room temperature on neonatal and maternal hypothermia and associated morbidities: a randomized controlled trial[J]. Am J Obstet Gynecol, 2016, 214: 505. e1-505. e7.
    [40] Lai LL, See MH, Rampal S, et al. Significant factors influencing inadvertent hypothermia in pediatric anesthesia[J]. J Clin Monit Comput, 2019, 33: 1105-1112. doi:  10.1007/s10877-019-00259-2
    [41] Rauch S, Miller C, Bräuer A, et al. Perioperative hypothermia: a narrative review[J]. Int J Environ Res Public Health, 2021, 18: 8749. doi:  10.3390/ijerph18168749
    [42] Palanisamy S, Rudingwa P, Panneerselvam S, et al. Effect of low dose phenylephrine infusion on shivering and hypothermia in patients undergoing cesarean section under spinal anesthesia: a randomized clinical trial[J]. Int J Obstet Anesth, 2022, 50: 103542. doi:  10.1016/j.ijoa.2022.103542
    [43] Gupta N, Bharti SJ, Kumar V, et al. Comparative evaluation of forced air warming and infusion of amino acid-enriched solution on intraoperative hypothermia in patients undergoing head and neck cancer surgeries: a prospective randomised study[J]. Saudi J Anaesth, 2019, 13: 318-324. doi:  10.4103/sja.SJA_839_18
    [44] Mizobe T, Nakajima Y, Ueno H, et al. Fructose administration increases intraoperative core temperature by augmenting both metabolic rate and the vasoconstriction threshold[J]. Anesthesiology, 2006, 104: 1124-1130. doi:  10.1097/00000542-200606000-00005
    [45] Yi J, Zhan L, Lei Y, et al. Establishment and validation of a prediction equation to estimate risk of intraoperative hypothermia in patients receiving general anesthesia[J]. Sci Rep, 2017, 7: 13927. doi:  10.1038/s41598-017-12997-x
    [46] Dai Z, Zhang Y, Yi J, et al. Validation of a prediction model for intraoperative hypothermia in patients receiving general anesthesia[J]. Int J Clin Pract, 2022, 2022: 6806225.
    [47] Yoo JH, Ok SY, Kim SH, et al. Efficacy of active forced air warming during induction of anesthesia to prevent inadvertent perioperative hypothermia in intraoperative warming patients: comparison with passive warming, a randomized controlled trial[J]. Medicine (Baltimore), 2021, 100: e25235. doi:  10.1097/MD.0000000000025235
    [48] Xiong Z, Zhu J, Li Q, et al. The effectiveness of warming approaches in preventing perioperative hypothermia: systematic review and meta-analysis[J]. Int J Nurs Pract, 2022. doi:  10.1111/ijn.13100.
    [49] Van Duren A. Perioperative prewarming: heat transfer and physiology[J]. AORN J, 2022, 115: 407-422. doi:  10.1002/aorn.13667
    [50] Connelly L, Cramer E, DeMott Q, et al. The optimal time and method for surgical prewarming: a comprehen-sive review of the literature[J]. J Perianesth Nurs, 2017, 32: 199-209. doi:  10.1016/j.jopan.2015.11.010
    [51] Ni TT, Zhou ZF, He B, et al. Effects of combined warmed preoperative forced-air and warmed perioperative intravenous fluids on maternal temperature during cesarean section: a prospective, randomized, controlled clinical trial[J]. BMC Anesthesiol, 2020, 20: 48. doi:  10.1186/s12871-020-00970-7
    [52] Liu J, Wang Y, Ma W. Shivering prevention and treatment during cesarean delivery under neuraxial anesthesia: a systematic review[J]. Minerva Anestesiol, 2018, 84: 1393-1405.
    [53] Zhuo Q, Xu JB, Zhang J, et al. Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials[J]. BMC Pregnancy Childbirth, 2022, 22: 720. doi:  10.1186/s12884-022-05054-7
    [54] Dendis M, Hooven K. Preventing hypothermia during cesarean birth: an integrative review[J]. MCN Am J Matern Child Nurs, 2020, 45: 102-108. doi:  10.1097/NMC.0000000000000599
    [55] Sun Y, Jia LL, Yu WL, et al. The changes of intraoperative body temperature in adult liver transplantation: A retrospective study[J]. Hepatobiliary Pancreat Dis Int, 2018, 17: 496-501. doi:  10.1016/j.hbpd.2018.08.006
    [56] Perlman R, Callum J, Laflamme C, et al. A recommended early goal-directed management guideline for the prevention of hypothermia-related transfusion, morbidity, and mortality in severely injured trauma patients[J]. Crit Care, 2016, 20: 107. doi:  10.1186/s13054-016-1271-z
  • 加载中


    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Article Metrics

    Article views (1309) PDF downloads(1377) Cited by()
    Proportional views


    DownLoad:  Full-Size Img  PowerPoint