Disturbance; Temperature Regulation Clinical Trial
Official title:
Perioperative Hypothermia: A Multi-center Study of Incidence, Risk Factors and Preventive Measures.
Aims:-
Primary:
To identify the incidence of intra-operative and post-operative hypothermia
Secondary:
To identify factors contributing to peri-operative hypothermia. To identify current
anaesthetic practice in peri-operative temperature monitoring, use of active/warming measures
by anaesthetists in various hospitals.
To increase awareness of the problem of IPH and guidelines available.
Inadvertent peri-operative hypothermia (IPH) affects patients across all ages, occurring up
to 50% in the unwarmed surgical patient. It carries significant morbidity and mortality
including increased risk of myocardial infarction, bleeding, and surgical site infection,
increased shivering and patient discomfort, as well as increased length of hospital stay.
Guidelines have been published by the UK National Institute for Clinical Excellence (NICE) as
well as the American Society of Anaesthesiologists. However, the compliance to such
guidelines have been poor, and no local guidelines have been developed as yet.
A one month audit was conducted in KKH Department of Paediatric Anaesthesia in 2014 which
collected data on the incidence of perioperative hypothermia in patients undergoing general
anaesthesia for a variety of surgeries. This preliminary audit demonstrated a 33.7% incidence
of hypothermia in PACU among 164 patients.
The investigators wish to carry out a more comprehensive audit to find out the incidence of
IPH in both adult and paediatric surgical patients, identify risk factors and assess the
current practice to prevent IPH across various healthcare institutions.
The study aims to find out the incidence of IPH, identify the risk factors involved and find
out the current preventive measures in various local hospitals; if not already in place,
bring awareness to this problem and improve patient outcomes. This is a cross-sectional
observational study, aiming to recruit 4000 patients of all ages, across 5 institutions over
the course of 6 months.
Patients will receive the current standard of care, as per the anaesthetist in charge, with
regards to temperature monitoring, and the use of passive/active warming strategies. The
method of temperature monitoring, warming or heat conservation techniques would be recorded
and the patient's temperature would be measured at the recovery area post-operatively by the
recovery nurse. In addition, patient demographics, surgical time, anaesthetic time, surgical
procedure and method of anaesthetic, total fluids given, will also be recorded on a
prospectively-designed data collection form.
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