Spinal Diseases Clinical Trial
Official title:
Effect of Positive End Expiratory Pressure on Intraoperative Body Temperature in Patients Undergoing Spine Surgery; a Prospective Randomized Study
Intraoperative hypothermia is associated with many clinical adverse outcomes. Many techniques were applied to prevent intraoperative hypothermia, and positive end-expiratory pressure (PEEP) has been known to blunt intraoperative hypothermia by increasing thermoregulatory vasoconstriction threshold. The investigators assessed the effect of PEEP on the prevention of intraoperative hypothermia during spine surgery in prone position.
It is well known that intraoperative hypothermia is associated with postoperative adverse
clinical outcomes in various study populations. Intraoperative hypothermia has various
adverse effects including impaired drug clearance, cold diuresis and hypovolemia,
immunosuppression with increased infection risk, electrolyte disorders, coagulopathy with
impaired platelet function, negative nitrogen balance, shivering, insulin resistance, and
myocardial events. Numerous methods have been introduced to prevent intraoperative
hypothermia, such as warming of infusion fluid, forced-air warming, heat-pads, heated water
mattress, and heated humidifiers. However, in patients undergoing lumbar spine surgery in
the prone position, these methods to prevent intraoperative hypothermia may partially
effective because these methods, in clinical practice, have a significant limitation in
their application.
Positive end-expiratory pressure (PEEP) reduces the venous return by increasing
intrathoracic pressure. This causes carotid unloading, which leads to a secondary peripheral
vasoconstriction by increasing thermoregulatory vasoconstriction threshold and blunts
intraoperative hypothermia. Previous studies demonstrated that intraoperative PEEP
significantly attenuated the extent of intraoperative hypothermia in patients undergoing
tympanoplasty. However, the beneficial effect of PEEP on thermoregulation is not
investigated in patients with the prone position for spinal surgery.
The investigators hypothesized that PEEP can reduce the extent of intraoperative hypothermia
via thermoregulatory modulation. In this study, the investigators investigated the effect of
PEEP on intraoperative core body temperature and the incidence of intraoperative hypothermia
in patients undergoing spinal surgery
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Supportive Care
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