References
Preoperative peripheral and core temperature: an observational study at a day-surgery unit
Abstract
Background:
Hypothermia is a common problem in the surgical context and can lead to serious consequences for the patient and increased costs for society.
Aims:
To study day-surgery patients' peripheral and core temperatures during the preoperative phase.
Methods:
In total, 50 day-surgery patients participated in the study. Two sets of measurements of temperatures were made: core temperature and peripheral temperatures (two measuring points on the upper body and lower extremities respectively) were measured on arrival at the day-surgery unit, as well as on arrival at the operating theatre. The data were normally distributed and a paired t-test was used for statistical analysis.
Findings:
Peripheral temperatures had significant changes, with measuring points on the upper body decreasing and measuring points on the lower extremities increasing in temperature. The results show no significant change in core temperature.
Conclusion:
The measurements show that 28% of the patients were below recommended preoperative temperature on arrival at the operating theatre. Further research is needed to study the development of body temperature perioperatively as well as at what point reheating interventions should be introduced.
The human body strives for a core temperature within a narrow interval around 37 °C (Sessler, 2015). All cellular activity is temperature dependent and a change of ±0.2 °C affects vital organs and their function and will start a range of compensatory mechanisms to maintain normal core body temperature in a healthy individual (Sessler, 2015). When a patient is anaesthetised normal temperature regulation is disturbed due to vasodilation, leading to greater heat redistribution (Sessler, 2016). Inhibition of the thermoregulatory response leads to a delay in compensatory factors, which will not occur until a temperature change of up to 4 °C (Scott, 2012).
The National Institute for Health and Care Excellence (NICE) clinical guideline defines normal body temperature as a core temperature of 36-37.5 °C and recommends a preoperative core temperature of 36.5-37.5 °C (National Collaborating Centre for Nursing and Supportive Care (NCCNSC), 2008; NICE, 2016). Hypothermia is defined as a core temperature below 36 °C. Despite a database search, the authors were unable to find any guidelines relating to recommended peripheral temperatures. National recommendations or guidelines regarding hypothermia do not currently exist in Sweden, hence the use of British guidelines. According to the NICE guideline, interventions should be put in place when a patient's core temperature drops below 36 °C, but it also states that it is better to prevent hypothermia as it is difficult to increase the temperature of an already hypothermic patient (NCCNSC, 2008: 55).
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