Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector781210.17816/KMJ2018-070ReviewsОбзорыReview ArticlePrevention and management of inadvertent perioparatve hypothermiaПрофилактика и лечение непреднамеренной периоперационной гипотермииAkhmetzyanovF ShАхметзяновФоат Шайхутдиновичartur.pasheev@yandex.ruShaymardanovI VШаймардановИльсур Василовичartur.pasheev@yandex.ruPasheyevA VПашеевАртур Валерьевичartur.pasheev@yandex.ruSayetgarayevA KСаетгараевАйрат Кашифовичartur.pasheev@yandex.ruMuftakhutdinovaG ShМуфтахутдиноваГульсина Шамилевнаartur.pasheev@yandex.ruSadykovK KСадыковКамил Каимовичartur.pasheev@yandex.ruKhasanovA FХасановАнвар Фаридовичartur.pasheev@yandex.ruEgorovV IЕгоровВасилий Ивановичartur.pasheev@yandex.ruKazan State Medical UniversityКазанский государственный медицинский университетTatarstan Regional Clinical Cancer CenterРеспубликанский клинический онкологический диспансерKazan State Medical AcademyКазанская государственная медицинская академия15022018991VOL 99, NO1 (2018)ТОМ 99, №1 (2018)707806022018Copyright ©; 2018, Akhmetzyanov F.S., Shaymardanov I.V., Pasheyev A.V., Sayetgarayev A.K., Muftakhutdinova G.S., Sadykov K.K., Khasanov A.F., Egorov V.I.Copyright ©; 2018, Ахметзянов Ф.Ш., Шаймарданов И.В., Пашеев А.В., Саетгараев А.К., Муфтахутдинова Г.Ш., Садыков К.К., Хасанов А.Ф., Егоров В.И.2018Akhmetzyanov F.S., Shaymardanov I.V., Pasheyev A.V., Sayetgarayev A.K., Muftakhutdinova G.S., Sadykov K.K., Khasanov A.F., Egorov V.I.Ахметзянов Ф.Ш., Шаймарданов И.В., Пашеев А.В., Саетгараев А.К., Муфтахутдинова Г.Ш., Садыков К.К., Хасанов А.Ф., Егоров В.И.http://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/7812

Human body central temperature is an important monitored value for anesthesiology and intensive care practice. Present anesthetic agents influence on the central temperature regulation and lead to its decrease in the perioperative period. Inadvertent perioperative hypothermia accompanies various surgeries with general and regional anaesthesia. It considerably increases the risk of cardiac and infectious postoperative complications, and against its background blood loss and necessity for blood transfusions also increase. Patients with hypothermia wake up slower and the postoperative shivering may often occur. Perioperative hypothermia increases the length of hospital stay and the nosocomial mortality. In this regard, prevention of inadvertent perioperative hypothermia is an important part of anaesthesia assistance in all fields of surgery. Maintenance of normal temperature during the surgery is an important component of all programs of patient’s early postoperative activation.

Центральная температура тела человека служит важнейшим показателем, мониторируемым в клинической практике анестезиологии и интенсивной терапии. Современные анестетики влияют на процессы регуляции центральной температуры и приводят к её снижению в периоперационном периоде. Непреднамеренная интраоперационная гипотермия сопровождает многие операции, проводимые под общей и регионарной анестезией. Она значительно увеличивает риск кардиальных и инфекционных послеоперационных осложнений, на её фоне возрастают послеоперационная кровопотеря и потребность в гемотрансфузии. Пациенты в условиях гипотермии медленнее просыпаются, их пробуждение чаще сопровождается мышечной дрожью. Периоперационная гипотермия приводит к увеличению сроков госпитализации и внутрибольничной летальности. В связи с этим предотвращение непреднамеренной периоперационной гипотермии - важная часть анестезиологического обеспечения больного во всех областях хирургии. Поддержание нормотермии во время операции служит важной составляющей всех программ ранней послеоперационной активизации больных.

hypothermiaperioperative warmingtemperatureгипотермияпериоперативное согреваниетемператураMoola S., Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. Int. J. Evid. Based Health. 2011; 94: 337–345. DOI: 10.1111/j.1744-1609.2011.00227.x.Moola S., Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. Int. J. Evid. Based Health. 2011; 94: 337-345. DOI: 10.1111/j.1744-1609.2011.00227.x.Meyanci Köksal G., Dikmen Y., Utku T. et al. Perioperative patient temperature monitoring and warming: a survey study. Turk. J. Anaesth. Reanim. 2013; 41: 149–155. DOI: 10.5152/TJAR.2013.63.Meyanci Köksal G., Dikmen Y., Utku T. et al. Perioperative patient temperature monitoring and warming: a survey study. Turk. J. Anaesth. Reanim. 2013; 41: 149-155. DOI: 10.5152/TJAR.2013.63.The Order of the Ministry of Health of the Russian Federation №919n on November 15, 2012 «On approval of health care to adults in the profile “anesthesiology and critical care medicine”». (In Russ.)Приказ Министерства здравоохранения Российской Федерации от 15 ноября 2012 г. №919н «Об утверждении Порядка оказания медицинской помощи взрослому населению по профилю “анестезиология и реаниматология”».Order of the Ministry of Health of the Russian Federation N915n dated 15.11.2012. «On approval of the Procedure for providing medical care to the adult population in the field of “Oncology”». (In Russ.)Приказ Министерства здравоохранения Российской Федерации от 15 ноября 2012 г. №915н «Об утверждении Порядка оказания медицинской помощи населению по профилю “онкология”».Sund-Levander M., Forsberg C., Wahren L.K. Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review. Scand. J. Caring Sci. 2002; 16: 122–128. DOI: 10.1046/j.1471-6712.2002.00069.x.Sund-Levander M., Forsberg C., Wahren L.K. Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review. Scand. J. Caring Sci. 2002; 16: 122-128. DOI: 10.1046/j.1471-6712.2002.00069.x.Wunderlich C. Das Verhalten der Eigenwärme in Krankheiten. Leipzig. 1868.On routine determination of arterial tension in operating room and clinic. Boston Medical and Surgical Journal. 1903, 148: 250–256. DOI: 10.1056/NEJM190303051481002.On routine determination of arterial tension in operating room and clinic. Boston Medical and Surgical Journal. 1903, 148: 250-256. DOI: 10.1056/NEJM190303051481002.Matsukawa T., Kashimoto S., Miyaji T. et al. A new infrared tympanic thermometer in surgery and anesthesia. J. Anesth. 1993; 7: 33–39. DOI: 10.1007/s0054030070033.Matsukawa T., Kashimoto S., Miyaji T. et al. A new infrared tympanic thermometer in surgery and anesthesia. J. Anesth. 1993; 7: 33-39. DOI: 10.1007/s0054030070033.Imamura M., Matsukawa T., Ozaki M. et al. The accuracy and precision of four infrared aural canal thermometers during cardiac surgery. Acta. Anaesthesiol. Scand. 1998; 42: 1222–1226. DOI: 10.1111/j.1399-6576.1998.tb05281.x.Imamura M., Matsukawa T., Ozaki M. et al. The accuracy and precision of four infrared aural canal thermometers during cardiac surgery. Acta. Anaesthesiol. Scand. 1998; 42: 1222-1226. DOI: 10.1111/j.1399-6576.1998.tb05281.x.Suleman M.I., Doufas A.G., Akça O. et al. Insufficiency in a new temporal-artery thermometer for adult and pediatric patients. Anesth. Analg. 2002; 95: 67–71. DOI: 10.1097/00000539-200207000-00012.Suleman M.I., Doufas A.G., Akça O. et al. Insufficiency in a new temporal-artery thermometer for adult and pediatric patients. Anesth. Analg. 2002; 95: 67-71. DOI: 10.1097/00000539-200207000-00012.Sessler D.I., Mascha E.J. Zero-heat flux thermometry. Eur. J. Anaesthesiol. 2016; 33 (2): 140–141. DOI: 10.1097/EJA.0000000000000365.Sessler D.I., Mascha E.J. Zero-heat flux thermometry. Eur. J. Anaesthesiol. 2016; 33 (2): 140-141. DOI: 10.1097/EJA.0000000000000365.Höcker J., Bein B., Bohm R. et al. Correlation, accuracy, precision and practicability of perioperative measurement of sublingual temperature in comparison with tympanic membrane temperature in awake and anaesthetised patients. Eur. J. Anaesthesiol. 2012; 29: 70–74. DOI: 10.1097/EJA.0b013e32834cd6de.Höcker J., Bein B., Bohm R. et al. Correlation, accuracy, precision and practicability of perioperative measurement of sublingual temperature in comparison with tympanic membrane temperature in awake and anaesthetised patients. Eur. J. Anaesthesiol. 2012; 29: 70-74. DOI: 10.1097/EJA.0b013e32834cd6de.Ash C.J., Cook J.R., McMurry T.A., Auner C.R. The use of rectal temperature to monitor heat stroke. MO Med. 1992; 89: 283–288. PMID: 1608386.Ash C.J., Cook J.R., McMurry T.A., Auner C.R. The use of rectal temperature to monitor heat stroke. MO Med. 1992; 89: 283-288. PMID: 1608386.Wang M., Singh A., Qureshi H. et al. Optimal depth for nasopharyngeal temperature probe positioning. Anesth. Analg. 2016; 122 (5): 1434–1438. DOI: 10.1213/ANE.0000000000001213.Wang M., Singh A., Qureshi H. et al. Optimal depth for nasopharyngeal temperature probe positioning. Anesth. Analg. 2016; 122 (5): 1434-1438. DOI: 10.1213/ANE.0000000000001213.Sessler D.I. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 2008; 109: 318–338. DOI: 10.1097/ALN.0b013e31817f6d76.Sessler D.I. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 2008; 109: 318-338. DOI: 10.1097/ALN.0b013e31817f6d76.Horrow J.C., Rosenberg H. Does urinary catheter temperature reflect core temperature during cardiac surgery? Anesthesiology. 1988; 69: 986–989. DOI: 10.1097/00000542-198812000-00037.Horrow J.C., Rosenberg H. Does urinary catheter temperature reflect core temperature during cardiac surgery? Anesthesiology. 1988; 69: 986-989. DOI: 10.1097/00000542-198812000-00037.Winkler M., Akça O., Birkenberg B. et al. Aggressive warming reduces blood loss during hip arthroplasty. Anesth. Analg. 2000; 91: 978–984. DOI: 10.1097/00000539-200010000-00039.Winkler M., Akça O., Birkenberg B. et al. Aggressive warming reduces blood loss during hip arthroplasty. Anesth. Analg. 2000; 91: 978-984. DOI: 10.1097/00000539-200010000-00039.Beck G., Becke K., Biermann E. et al. Mindestanforderungen an den anästhesiologischen Arbeitsplatz. Anästh. Intensivmed. 2013; 54: 39–42.Beck G., Becke K., Biermann E. et al. Mindestanforderungen an den anästhesiologischen Arbeitsplatz. Anästh. Intensivmed. 2013; 54: 39-42.Sessler D.I. Perioperative heat balance. Anesthesiology. 2000; 92: 578–596. DOI: 10.1097/­00000542-200002000-00042.Sessler D.I. Perioperative heat balance. Anesthesiology. 2000; 92: 578-596. DOI: 10.1097/00000542-200002000-00042.Torossian A. TEMMP (Thermoregulation in Europe Monitoring and Managing Patient Temperature) Study Group. Survey on intraoperative temperature management in Europe. Eur. J. Anaesthesiol. 2007; 24: 668–675. DOI: 10.1017/S0265021507000191.Torossian A. TEMMP (Thermoregulation in Europe Monitoring and Managing Patient Temperature) Study Group. Survey on intraoperative temperature management in Europe. Eur. J. Anaesthesiol. 2007; 24: 668-675. DOI: 10.1017/S0265021507000191.S3 Leitlinie. Vermeidung von perioperativer Hypothermie. 2014. www.awmf.org/leitlinien/detail/ll/001–018.html (access date: 09.05.2014).S3 Leitlinie. Vermeidung von perioperativer Hypothermie. 2014. www.awmf.org/leitlinien/detail/ll/001-018.html (access date: 09.05.2014).El-Gamal N., El-Kassabany N., Frank S.M. et al. Age-related thermoregulatory differences in a warm operating room environment. Anesth. Analg. 2000; 90: 694–698. DOI: 10.1097/00000539-200003000-00034.El-Gamal N., El-Kassabany N., Frank S.M. et al. Age-related thermoregulatory differences in a warm operating room environment. Anesth. Analg. 2000; 90: 694-698. DOI: 10.1097/00000539-200003000-00034.Scott E.M., Buckland R. A systematic review of intraoperative warming to prevent postoperative complications. AORN J. 2006; 83: 1090–1104, 1107–1113. DOI: 10.1016/S0001-2092(06)60120-8.Scott E.M., Buckland R. A systematic review of intraoperative warming to prevent postoperative complications. AORN J. 2006; 83: 1090-1104, 1107-1113. DOI: 10.1016/S0001-2092(06)60120-8.Frank S.M., Fleisher L.A., Breslow M.J. et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: A randomized clinical trial. JAMA. 1997; 277: 1127–1134. DOI: 10.1001/jama.1997.03540380041029.Frank S.M., Fleisher L.A., Breslow M.J. et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: A randomized clinical trial. JAMA. 1997; 277: 1127-1134. DOI: 10.1001/jama.1997.03540380041029.Rajagopalan S., Mascha E., Na J., Sessler D.I. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008; 108: 71–77. DOI: 10.1097/01.anes.0000296719.73450.52.Rajagopalan S., Mascha E., Na J., Sessler D.I. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008; 108: 71-77. DOI: 10.1097/01.anes.0000296719.73450.52.Melling A.C., Ali B., Scott E.M., Leaper D.J. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomized controlled trial. Lancet. 2001; 358: 876–880. DOI: 10.1016/S0140-6736(01)06071-8.Melling A.C., Ali B., Scott E.M., Leaper D.J. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomized controlled trial. Lancet. 2001; 358: 876-880. DOI: 10.1016/S0140-6736(01)06071-8.Heier T., Caldwell J.E., Sessler D.I., Miller R.D. Mild intraoperative hypothermia increases duration of action and spontaneous recovery of vecuronium blockade during nitrous oxide-isoflurane anesthesia in humans. Anesthesiology. 1991; 74: 815–819. DOI: 10.1097/00000542-199105000-00003.Heier T., Caldwell J.E., Sessler D.I., Miller R.D. Mild intraoperative hypothermia increases duration of action and spontaneous recovery of vecuronium blockade during nitrous oxide-isoflurane anesthesia in humans. Anesthesiology. 1991; 74: 815-819. DOI: 10.1097/00000542-199105000-00003.Alfonsi P., Nourredine K.E., Adam F. et al. Effect of postoperative skin-surface warming on oxygen consumption and the shivering threshold. Anaesthesia. 2003; 58: 1228–1234. DOI: 10.1046/j.1365-2044.2003.03444.x.Alfonsi P., Nourredine K.E., Adam F. et al. Effect of postoperative skin-surface warming on oxygen consumption and the shivering threshold. Anaesthesia. 2003; 58: 1228-1234. DOI: 10.1046/j.1365-2044.2003.03444.x.Mahoney C., Odom J. Maintaining intraoperative normothermia a meta-analysis of outcomes with costs. AANA. J. 1999; 67: 155–164. PMID: 10488289.Mahoney C., Odom J. Maintaining intraoperative normothermia a meta-analysis of outcomes with costs. AANA. J. 1999; 67: 155-164. PMID: 10488289.Roberson M.C., Dieckmann L.S., Rodriguez R.E., Austin P.N. A review of the evidence for active preoperative warming of adults undergoing general anesthesia. AANA. J. 2013; 81: 351–356. PMID: 24354070.Roberson M.C., Dieckmann L.S., Rodriguez R.E., Austin P.N. A review of the evidence for active preoperative warming of adults undergoing general anesthesia. AANA. J. 2013; 81: 351-356. PMID: 24354070.Horn E.P., Bein B., Bohm R. et al. The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia. 2012; 67: 612–617. DOI: 10.1111/j.1365-2044.2012.07073.x.Horn E.P., Bein B., Bohm R. et al. The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia. 2012; 67: 612-617. DOI: 10.1111/j.1365-2044.2012.07073.x.Horn E.P., Schroeder F., Gottschalk A. et al. Active warming during cesarean delivery. Anesth. Analg. 2002; 94: 409–414. PMID: 11812709.Horn E.P., Schroeder F., Gottschalk A. et al. Active warming during cesarean delivery. Anesth. Analg. 2002; 94: 409-414. PMID: 11812709.Bräuer A., Waeschle R.M., Heise D. et al. Preoperative prewarming as a routine measure. First experiences. Anaesthesist. 2010; 59: 842–850. DOI: 10.1007/s00101-010-1772-0.Bräuer A., Waeschle R.M., Heise D. et al. Preoperative prewarming as a routine measure. First experiences. Anaesthesist. 2010; 59: 842-850. DOI: 10.1007/s00101-010-1772-0.Vanni S.M., Braz J.R., Modolo N.S. et al. Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery. J. Clin. Anesth. 2003; 15: 119–125. DOI: 10.1016/S0952-8180(02)00512-3.Vanni S.M., Braz J.R., Modolo N.S. et al. Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery. J. Clin. Anesth. 2003; 15: 119-125. DOI: 10.1016/S0952-8180(02)00512-3.Torossian A., Bräuer A., Höcker J. et al Clinical practice guideline: Preventing inadvertent perioperative hypothermia. Dtsch. Arztebl. Int. 2015; 112: 166–172. DOI: 10.3238/arztebl.2015.0166.Torossian A., Bräuer A., Höcker J. et al. Clinical practice guideline: Preventing inadvertent perioperative hypothermia. Dtsch. Arztebl. Int. 2015; 112: 166-172. DOI: 10.3238/arztebl.2015.0166.De Witte J.L., Demeyer C., Vandemaele E. Resistive-heating or forced-air warming for the prevention of redistribution hypothermia. Anesth. Analg. 2010; 110: 829–833. DOI: 10.1213/ANE.0b013e3181cb3ebf.De Witte J.L., Demeyer C., Vandemaele E. Resistive-heating or forced-air warming for the prevention of redistribution hypothermia. Anesth. Analg. 2010; 110: 829-833. DOI: 10.1213/ANE.0b013e3181cb3ebf.Galvão C.M., Marck P.B., Sawada N.O., Clark A.M. A systematic review of the effectiveness of cutaneous warming systems to prevent hypothermia. J. Clin. Nurs. 2009; 18: 627–636. DOI: 10.1111/j.1365-2702.2008.02668.x.Galvão C.M., Marck P.B., Sawada N.O., Clark A.M. A systematic review of the effectiveness of cutaneous warming systems to prevent hypothermia. J. Clin. Nurs. 2009; 18: 627-636. DOI: 10.1111/j.1365-2702.2008.02668.x.Sessler D.I., McGuire J., Sessler A.M. Perioperative thermal insulation. Anesthesiology. 1991; 74: 875–879. DOI: 10.1097/00000542-199105000-00012.Sessler D.I., McGuire J., Sessler A.M. Perioperative thermal insulation. Anesthesiology. 1991; 74: 875-879. DOI: 10.1097/00000542-199105000-00012.Alderson P., Campbell G., Smith A.F. et al. Thermal insulation for prevention of inadvertent perioperative hypothermia. Cochrane Database Syst. Rev. 2014; 6: CD009908. DOI: 10.1002/14651858.CD009908.pub2.Andrzejowski J.C., Turnbull D., Nandakumar A. et al. A randomised single blinded study of the administration of pre-warmed fluid vs active fluid warming on the incidence of peri-operative hypothermia in short surgical procedures. Anaesthesia 2010; 65: 942–945. DOI: 10.1111/j.1365-2044.2010.06473.x.Andrzejowski J.C., Turnbull D., Nandakumar A. et al. A randomised single blinded study of the administration of pre-warmed fluid vs active fluid warming on the incidence of peri-operative hypothermia in short surgical procedures. Anaesthesia 2010; 65: 942-945. DOI: 10.1111/j.1365-2044.2010.06473.x.Jin Y., Tian J., Sun M., Yang K. A systematic review of randomized controlled trials of the effects of warmed irrigation fluid on core body temperature during endoscopic surgeries. J. Clin. Nurs. 2011; 20: 305–316. DOI: 10.1111/j.1365-2702.2010.03484.x.Jin Y., Tian J., Sun M., Yang K. A systematic review of randomized controlled trials of the effects of warmed irrigation fluid on core body temperature during endoscopic surgeries. J. Clin. Nurs. 2011; 20: 305-316. DOI: 10.1111/j.1365-2702.2010.03484.x.Arbeitskreis Kinderanästhesie der DGAI: Die häufigsten Fehler in der Kinderanästhesie. www.ak-kinderanaesthesie.de/files/Celle 2009_Simon_Fehler Kinderanaesthesie.pdf (access date: 18.02.2013).Joris J., Banache M., Bonnet F. et al. Clonidine and ketanserin both are effective treatments for postanesthetic shivering. Anesthesiology. 1993; 79: 532–539. DOI: 10.1097/00000542-199309000-00017.Joris J., Banache M., Bonnet F. et al. Clonidine and ketanserin both are effective treatments for postanesthetic shivering. Anesthesiology. 1993; 79: 532-539. DOI: 10.1097/00000542-199309000-00017.