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8 3 F E B R U A R Y 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E delayed emergence from anesthesia. And it can all happen surprising- ly fast. Unintended hypothermia can develop in the hour immediately following the induction of anesthesia. Even mild hypothermia can be associated with significant morbidity and mortality. Much has been written about how to prevent this frequent complication of surgery, but here's a quick refresher on the top 5 consequences of hypothermia that afflict millions of U.S. surgical patients every year. • Increased wound infection. Hypothermia may increase patients' sus- ceptibility to perioperative wound infections by causing vasoconstric- tion and impaired immunity. Hypothermia impairs the immune func- tion and decreases cutaneous blood flow that reduces tissue oxygen delivery. This in turn increases the chance of a wound infection and also impairs the wound-healing process. Vasoconstriction occurs when the core body temperature decreases, which is a protective mechanism to divert blood to the center of the body and help main- tain the normal body temperature. The reduction of nutrient and oxy- gen supply to wounds will increase the frequency of surgical wound infection. A threefold increase in the frequency of surgical site infec- tions is reported in colorectal surgery patients who experience peri- operative hypothermia. • Cardiac dysfunction . Ventricular tachycardia in particular is associat- ed with mild hypothermia. Angina, decreased cardiac output, and dys- rhythmias can also be related to unintentional hypothermia. As little as 2°C core hypothermia can significantly increase the incidence of a myocardial ischemia in high-risk patients undergoing peripheral vas- cular surgery. • Increased blood loss. Mild hypothermia reduces platelet function and decreases activation of the coagulation cascade. Therefore, hypothermia can increase blood loss and require transfusions during surgery. The liter- ature shows that an approximately H Y P O T H E R M I A BAD OUTCOMES Unintended perioperative hypothermia is associated with negative patient out- comes, including an increased rate of wound infections, increased length of hospital stay and higher mortality rates. Pamela Bevelhymer, RN, BSN OSE_1402_part2_Layout 1 2/6/14 2:58 PM Page 83