Improving Surgical Patient Outcomes
Improving Surgical Patient Outcomes Through the Utilization of Forced-air Warming Devices to Regulate Core Body Temperature
Presenter: Caroline Klimowski, UNC Charlotte School of Nursing
Collaborators: Tuesday Berning; Emily Stanfield; Sean Brannan
Faculty: Dr. Florence Okoro
Abstract:
Background and Objective. Perioperative hypothermia is often associated with adverse surgical outcomes including: impaired pharmacodynamics, surgical site infections, blood loss and impaired coagulopathy, prolonged recovery, thermal discomfort, myocardial ischemia, and mortality. Despite this knowledge, roughly 45% to 70% of patients undergoing anesthetic surgical procedures will experience perioperative hypothermia. Current recommendations emphasize the use of forced-air warming (FAW) systems perioperatively in the prevention of hypothermia an associated adverse outcome. Thus, the purpose of the current systematic review was to determine the effectiveness of forced-air warming versus competing warming devices, as well as explore the effect of forced-air warming on surgical patient outcomes, specifically surgical site infections as well as patient comfort.
Methods. Comprehensive literature review was conducted via credible database selection by four independent investigators. A total of 3,729 relevant articles were initially identified based on precise keyword selection; removing duplicates, studies were then assessed for inclusion as well as exclusion criteria, full-text eligibility, and CASP endorsement ensuring relevance, validity, and dependability of selected articles. A total of 14 studies were selected to be included in systematic review.
Results. Common themes noted throughout review included: (1) reduced perioperative complications; (2) duration; (3) warming device used; (4) prewarming; (5) passive/active warming; (6) risk of surgical site infections; (7) shivering; and (8) surgery times. Conclusion. The studies for review all appeared to agree that forced-air warming is the superior choice versus competing devices in reducing the incidence of perioperative hypothermia; however, several studies do indicate that devices can be used in congruence of one another for optimal patient outcomes. Secondly, in terms of adverse outcomes, patients who were able to maintain normothermia perioperatively experiences lower levels of surgical site infections, experienced reduced recovery times, and reported higher levels of patient comfort.
Keywords. hypothermia · perioperative · forced-air warming · surgical site infections · surgery · patient outcomes · warming devices · normothermia · adverse events