Hypothermia during head and neck surgery.
OBJECTIVE
To determine the predictors and incidence of hypothermia in patients undergoing head and neck surgery.


METHODS
Retrospective analysis.


METHODS
Patients were either not warmed (n = 43) or actively warmed with forced-air warming (n = 25). Clinical variables that were assessed as predictors of core body temperature included age, body mass, duration of procedure, estimated blood loss, amount of intravenous fluids administered, and the use of forced-air warming. The incidence of severe intraoperative hypothermia and potential hypothermia-related complications was also examined.


RESULTS
The study demonstrated that advanced age is a risk factor for hypothermia and decreased body mass is associated with lower final body temperatures in the groups of patients that was not warmed. After adjusting for differences in the ages and weights between the two groups, the mean core body temperature was found to be 0.4 degrees C lower in the patients who were not warmed. Severe intraoperative hypothermia occurred in 5 of 38 patients (11.6%) who were not warmed and 2 of 23 patients (8.0%) who were warmed. The complications associated with hypothermia included delayed time to extubation, the development of neck seromas, and flap dehiscence.


CONCLUSIONS
Patients undergoing head and neck surgery are at risk for the development of intraoperative hypothermia and require careful temperature monitoring. Elderly patients and patients with low body mass are more prone to develop low intraoperative core body temperatures. Active warming with forced-air warmers should be considered for patients at risk for intraoperative hypothermia and for patients who develop hypothermia intraoperatively, to avoid hypothermia-related complications.
Agrawal
Nishant
N
Department of Otolayngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sewell
Duane A
DA
Griswold
Michael E
ME
Frank
Steven M
SM
Hessel
Todd W
TW
Eisele
David W
DW
D000367:Age Factors; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D001831:Body Temperature; D005260:Female; D005440:Fluid Therapy; D006257:Head / Q000601:surgery*; D006358:Hot Temperature; D006801:Humans; D007035:Hypothermia / Q000209:etiology*; D007430:Intraoperative Care; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009333:Neck / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors