Published on Aug 1, 2013in East African Medical Journal
· DOI :10.4314/EAMJ.V90I8
P M Kioko , P Olang1
Estimated H-index: 1
+ 1 AuthorsT Chokwe4
Estimated H-index: 4
Objective : To determine the incidence and risk factors for intra-operative hypothermia in paediatric patients undergoing general anaesthesia at the Kenyatta National Hospital. Design : A prospective observational study. Setting : The Kenyatta National Hospital main operating theatres and affiliated satellite operating theatres. Subjects : A total of 100 paediatric patients (range; three days to 12 years, mean; 4.1 ± 3.3 years) were enrolled in the study. Results : Thirty out of 100 patients developed hypothermia defined as a core temperature <36oC recorded at least once during provision of general anaesthesia. Ninety percent of those developing hypothermia were male compared to 63% who remained normothermic (p = 0.006). Proportionally, more than twice as many hypothermic patients had a caudal block (43% versus 20%, p = 0.016) and received 121ml more of fluid (p = 0.002) compared to the normothermic group. The patients who became hypothermic tended to be colder at induction of anaesthesia (36.6 ± 0.5oC versus 37.0 ± 0.5oC, p = <0.0001) but there was no significant difference in the waiting time, time of  induction, environmental temperatures or theatre temperatures compared to those not developing hypothermia. There was no significant difference in the BMI between the two groups (14.0 ± 2.9 kg/ m 2 versus 15.2 ± 3.5 kg/m 2 , p = 0.101). Conclusion : The incidence of intra-operative core hypothermia in paediatric patients undergoing general anaesthesia at the Kenyatta National Hospital is 30%. Gender (male), lower body temperature at induction, use of caudal block and the volume of intravenous fluids infused were significant independent predictors of core hypothermia. The most significant predictor was body temperature at the time of induction of general anaesthesia.
#1Peter KamH-Index: 42
#2Ian Power (Edin.: University of Edinburgh)H-Index: 7
"Principles of Physiology for the Anaesthetist" is designed and written specifically with the trainee anaesthetist in mind. Ian Power and Peter Kam, anaesthetists with extensive experience of teaching physiology, have written this book to improve understanding of the fundamentals of human physiology in relation to the work of the anaesthetist. Diagrams are used throughout to support the text and to aid understanding of difficult concepts. In addition to the physiology of all major organ systems,...
29 CitationsSource
#1Nestor F. Esnaola (MUSC: Medical University of South Carolina)H-Index: 8
#2David J. Cole (MUSC: Medical University of South Carolina)H-Index: 42
Perioperative hypothermia (PH), usually defined as a temperature of less than 36.0 � C during the perioperative period, can result from anesthesiainduced thermoregulatory inhibition combined with exposure to a cold operating room environment and is estimated to occur in 50% to 70% of patients undergoing anesthesia and major surgery [1]. Almost all anesthetics, including opioids, propofol, inhalational agents, and spinal/epidural anesthetics, have been shown to impair thermoregulatory mechanisms ...
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#1Göran HeiniusH-Index: 3
#2Robert G. HahnH-Index: 53
Last. Anders SondénH-Index: 1
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Trauma registers show that hypothermia (HT) is an independent risk factor for death during hemorrhagic shock, although experimental animal studies indicate that HT may be beneficial during these co ...
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#1Bridget K. Pearce (UM: University of Michigan)H-Index: 2
#2Robert ChristensenH-Index: 11
Last. Terri Voepel-LewisH-Index: 54
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Background: Perioperative hypothermia has been associated with negative outcomes, and children may be at higher risk. This study describes the prevalence of pediatric perioperative hypothermia and evaluates its relationship to outcomes. Methods: This observational cohort study included the following electronically and prospectively recorded data from children fewer than 18 years of age undergoing general anesthesia: perioperative temperatures, warming interventions, patient characteristics, and ...
21 CitationsSource
#1Michael A. Tortorici (University of Pittsburgh)H-Index: 6
#2Patrick M. KochanekH-Index: 110
Last. Samuel M. PoloyacH-Index: 30
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Objectives:Therapeutic hypothermia has been shown to decrease neurologic damage in patients experiencing out-of-hospital cardiac arrest. In addition to being treated with hypothermia, critically ill patients are treated with an extensive pharmacotherapeutic regimen. The effects of hypothermia on dru
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#1Anselm BräuerH-Index: 19
#2Thorsten PerlH-Index: 18
Last. Michael Quintel (GAU: University of Göttingen)H-Index: 63
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: Perioperative hypothermia can influence clinical outcome negatively. It triples the incidence of adverse myocardial outcomes, significantly increases perioperative blood loss, significantly augments allogenic transfusion requirements, and increases the incidence of surgical wound infections. The major causes are redistribution of heat from the core of the body to the peripheral tissues and a negative heat balance. Adequate thermal management includes preoperative and intraoperative measures. P...
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#1Alex Macario (Stanford University)H-Index: 55
#2Franklin DexterH-Index: 76
Anesthesiologists attempt to maintain perioperative normothermia for surgical patients. We surveyed clinical anesthesiologists and physician researchers and asked them to prioritize risk factors for a patient to develop intraoperative hypothermia. The questionnaire included 41 factors associated wit
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#1Kees H. Polderman (VU: VU University Amsterdam)H-Index: 30
#2Saskia M. PeerdemanH-Index: 23
Last. Armand R. J. GirbesH-Index: 51
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Object. Induced hypothermia in patients with severe head injury may prevent additional brain injury and improve outcome. However, this treatment is associated with severe side effects, including life-threatening cardiac tachyarrhythmias. The authors hypothesized that these arrhythmias might be caused by electrolyte disorders and therefore studied the effects of induced hypothermia on urine production and electrolyte levels in patients with severe head injury. Methods. Urine production, urine ele...
227 CitationsSource
#1Nader A. El-Gamal (Alexandria University)H-Index: 2
#2Nabil El-Kassabany (Alexandria University)H-Index: 1
Last. Ahmed Said Okasha (Alexandria University)H-Index: 4
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Inadvertent hypothermia occurs frequently at typical ambient operating room (OR) temperatures, especially in elderly patients receiving general anesthesia. The aims of the current study were to 1) determine the incidence and magnitude of core hypothermia in an unusually warm OR environment, and 2) t
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#1Andrea Kurz (UCSF: University of California, San Francisco)H-Index: 54
#2Daniel I. Sessler (University of Vienna)H-Index: 135
Last. Rainer Lenhardt (University of Vienna)H-Index: 13
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Background Mild perioperative hypothermia, which is common during major surgery, may promote surgical-wound infection by triggering thermoregulatory vasoconstriction, which decreases subcutaneous oxygen tension. Reduced levels of oxygen in tissue impair oxidative killing by neutrophils and decrease the strength of the healing wound by reducing the deposition of collagen. Hypothermia also directly impairs immune function. We tested the hypothesis that hypothermia both increases susceptibility to ...
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