Development of a clinical care protocol for the prevention and treatment of perioperative hypothermia

Abstract

Objective: to develop a protocol for the prevention and treatment of perioperative hypothermia. Method: research of the technological development in health type, carried out in three stages: i) review of clinical guidelines on risk factors for the development of perioperative hypothermia; ii) identification of the occurrence of perioperative hypothermia and the risk factors associated with its development in a surgical center; and iii) development of a protocol for the prevention of perioperative hypothermia. Results: the risk factors identified in the guidelines were categorized into clinical characteristics (age, Body Mass Index, comorbidities and body temperature) and anesthetic-surgical characteristics (type and duration of anesthesia and surgery and operating room temperature). In the second stage, 90 surgical patients were evaluated. The occurrence of hypothermia was 28.9% at surgical admission, 77.8% at admission to the Post-Anesthesia Care Unit and 45.6% at discharge from the operating room. There was a statistically significant association between the occurrence of hypothermia and ASA index (p = 0.049), age (p = 0.037), comorbidities (p = 0.031) and preoperative hypothermia (p = 0.015). Conclusion: for the elaboration of the protocol, the risk factors described in the literature, the results of a local study and the access to the technologies available in the institution were considered. The actions included the following aspects: assessment of risk factors and triggering situations; monitoring and recording of temperature and other parameters; passive warming for normothermic patients; active warming for hypothermic patients; infusion of warmed intravenous solutions; oxygen support for hypothermic patients.