Skip to main content

Role of hypothermia in the immediate postoperative period on mortality in a surgical ICU

Introduction

Surgical patients are submitted to numerous factors that may cause postoperative hypothermia, such as a cool operating room environment, cold intravenous fluids and blood, cold antiseptic skin preparations and anesthetic-induced impairment of thermoregulatory control. Hypothermia may increase susceptibility to surgical wound infection, length of stay, intraoperative blood loss, morbid cardiac events, postoperative shivering, coagulopathy and also altered duration of drug action. The objective of this study was to evaluate the impact of hypothermia at ICU admission on hospital length of stay and mortality in a surgical ICU.

Methods

A prospective cohort study conducted on patients admitted to the ICU of Hospital Santa Luzia, Brasilia, Brazil, during the period of 1 year. Hypothermia was defined as axillary temperature inferior to 35.5°C (95.9°F). Patients were divided into groups with hypothermia (HG) and without hypothermia (NG).

Results

A total of 484 patients were enrolled. Mean age was 59 ± 16 years and 52.5% were male. Seventy-eight patients (16.1%) were submitted to emergency surgeries. Mean APACHE II score was 8 ± 5, mean SAPS II was 16 ± 10. Twenty-four patients (5%) had hypothermia at the time of ICU admission. The general mortality rate at 7 days, 28 days and hospital mortality was 0.8% (n = 4), 1.9% (n = 9) and 4.1% (n = 20), respectively. Patients with hypothermia had higher APACHE II score (15 ± 12 vs. 8 ± 4, P = 0.00) and SAPS II (25 ± 17 vs. 26 ± 10, P = 0.00). There was no difference regarding the age of the groups and the hospital length of stay (4 ± 6 days in NG vs. 5 ± 12 days in HG, P = 0.76). However, the group with hypothermia had higher mortality rates (20% vs. 4.3%, P = 0.00). The relative risk for hospital mortality in patients with hypothermia at ICU admission was 4.6 (95% CI: 1.02 to 29.88).

Conclusion

Few patients were hypothermic at the time of ICU admission in the immediate postoperative period. This may reflect the effectiveness of perioperative warming of the patients. Hypothermia at ICU admission was associated with greater severity scores and increased hospital mortality in this sample of surgical patients studied.

References

  1. 1.

    Sajid MS, et al.: Sao Paulo Med J. 2009, 127: 231-237.

    Article  PubMed  Google Scholar 

  2. 2.

    Buggy DJ, Crossley AWA: Br J Anaesth. 2000, 84: 615-628. 10.1093/bja/84.5.615

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Sessler DI: Anesthesiology. 2001, 95: 531-543. 10.1097/00000542-200108000-00040

    CAS  Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to AR Santana.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Santana, A., Amorim, F., Soares, F. et al. Role of hypothermia in the immediate postoperative period on mortality in a surgical ICU. Crit Care 17, P59 (2013). https://doi.org/10.1186/cc12675

Download citation

Keywords

  • Hospital Mortality
  • Hospital Length
  • Cool Operating
  • High Apache
  • General Mortality