Outpatient Surgery Magazine

Manager's Guide to Surgery's Ambulatory Anesthesia - July 2015

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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J U LY 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 3 1 1. Sessler D, Todd M. Perioperative heat balance. Anesthesiology 2000; 92(2):578-596. 2. Horosz B, Malec-Milewska, Małgorzata. Inadvertent intraoperative hypothermia. Anaesthesiology Intensive Therapy 2013, vol. 45, no 1, 38–43. 3. Matsukawa T, Sessler DI, Sessler, AM et al. Heat flow and distribution during induction of general anesthesia. Anesthesiology 1995; 82: 662–673. 4. Torossian, A. Thermal management during anaesthesia and thermoregulation standards for the prevention of inadvertent perioperative hypothermia. Best Practice & Research Clinical Anaesthesiology Vol. 22, No. 4, pp. 659–668, 2008. 5. Kiekkas P, Poulopoulou, M, Papahatzi, A, Souleles, P. Effects of Hypothermia and shivering on Standard PACU monitoring of Patients. AANA Journal/Feb. 2005/Vol. 73 No 1. 6. Kurz A, Sessler DI, Narzt E, et al. Postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia. J Clin Anesth. 1995;7:359-366. 7. A. Chakladar, A, Dixon, MJ, Crook, D, Harpera, CM. The effects of a resistive warming mattress during caesarean section: a randomised, controlled trial. International Journal of Obstetric Anesthesia (2014) 23, 309–316. 8. Brown Mahoney, C, Odom J. Maintaining intraoperative normothermia: A meta-analysis of outcomes with costs. AANA Journal, April 1999; Vol67, No 2. 9. Kurz, A, Sessler, D, Lenhardt, R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med 1996;334:1209-15. 10. Brauer, A, English, AM, Steinmetz, N, Lorenz, N, Perl, T, Braun, U, Weyland, W. Comparison of forced-air warming systems with upper body blankets using a copper manikin of the human body. Acta Anaeshtesiol Scan 2002; 46: 965-972. 11. Lenhardt R, Marker E, Goll V, et al. Mild intraoperative hypothermia prolongs post-anesthetic recovery. Anesthesiology. 1997;87:1318-1323. 12. Stewart SMB, Lujan E, Ruff CL. Incidence of adult hypothermia in the post anesthesia care unit. Periop Nurs Q. 1987;3:57-62. 13. Vaughan MS, Vaughan RW, Cork RC. Postoperative hypothermia in adults: relationship of age, anesthesia and shivering to rewarming. Anesth Analg. 1981;60:746-751. 14. http://www.anesthesiologynews.com/ViewArticle.aspx?d=Clinical+Anesthesiology&d_id=1&i=April+2015 &i_id=1168&a_id=30908. 15. Niven, DJ, Stelfox, HT, Laupland, KB. Hypothermia in Adult ICUs: Changing Incidence But Persistent Risk Factor for Mortality. J Intensive Care Med. Published online October 21, 2014. COVIDIEN, COVIDIEN with logo, Covidien logo and positive results for life are U.S. and internationally registered trademarks of Covidien AG. Other brands are trademarks of a Covidien company. ©2015 Covidien. 15-PM-0070 WarmTouch ™ convective warming system has one of the highest total heat flow delivery technologies of any convective warming system in the market 10 covidien.com/rms HYPOTHERMIA is Common, Costly and Debilitating The average patient loses 3°C during anesthesia 1,2 costs the hospital up to $7,000 8 The average patient that incurs hypothermia has length of stay extended by 2.6 days 9 Costly Debilitating Common The biggest loss is during the first hour of anesthesia 3 It only takes a loss of 1°C for a patient to become hypothermic 2,4 1°C Patients who undergo minor procedures have a higher risk of developing hypothermia 5 minor procedures higher risk Women in labor have higher rates of hypothermia due to epidural 7 Wound infection rates jump up to 19% when a patient becomes hypothermic 9 19% Mortality rates jump up to 31% when a patient is hypothermic 6,15 31% $$ "There is an imperative need for intraoperative forced-air warming of all patients, regardless of the type and duration of the operation" 5 "Caregivers are much more aware of the importance of maintaining normothermia, so perhaps the pressure of patient satisfaction has led nurses and other health care staff to pay closer attention to patient comfort, including their temperature." 14 The incidence of hypothermia ranges from 60-85% in all postoperative patients when forced-air warming is not used. 5,12-13 Most frequent adverse outcomes of hypothermia in the immediate postoperative period are postanesthetic shivering, markedly impaired thermal comfort, and prolonged time of recovery and PACU stay 5,6,11 $$ $$ Page 17

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