Study Links Intraoperative Hypothermia and Transfusion Requirements

Daniel Sessler, M.D. Michael Cudahy Professor and Chair of the Department of Outcomes Research Cleveland ClinicMedicalResearch.com Interview with:
Daniel Sessler, M.D.
Michael Cudahy Professor and Chair of the Department of Outcomes Research
Cleveland Clinic

Medical Research: What is the background for this study? What are the main findings?

Dr. Sessler: That intraoperative hypothermia is well established. However, temperature patterns during surgery are not. We thus evaluated core temperature in more tan 50,000 surgical patients, all of whom were actively warmed with forced air.

Medical Research: What should clinicians and patients take away from your report?

Dr. Sessler: The major results are:
1) Redistribution makes most patients hypothermic during the first hour of anesthesia;
2) Hypothermia is common during surgery; hypothermia is associated with transfusions; and
3) Most patients are normothermic by the end of surgery. The implications are that final intraoperative temperature poorly characterizes what happens during surgery. The study also generalizes the relationship between hypothermia and transfusion requirements that has been shown in many randomized trials.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Sessler: Myocardial infarctions are the leading cause of 30-day mortality after otherwise routine surgery. The extent to which hypothermia contributes to this serious complication remains poorly understood. A large randomized trial of strict normothermia and infarctions would be helpful.

Citation:

Intraoperative Core Temperature Patterns, Transfusion Requirement, and Hospital Duration in Patients Warmed with Forced Air

February 2015 Issue of Anesthesiology