270 - Implementation of a simplified bundle for the prevention of perioperative hypothermia

Description: A well-defined approach to perioperative temperature management is essential for improving outcomes given the adverse effects that can produce. Inadvertent hypothermia continues to occur in 70% of non-cardiological surgeries, highlighting the need for improved prevention strategies.
Main objective: to evaluate the effectiveness of a simplified bundle for hypothermia prevention; secondary objectives were to analyze surgical site infection, shivering, and comfort in patients undergoing surgery.

Methods: Randomized controlled trial. A total 148 patients who underwent osteosynthesis surgery were included: 77 in the intervention group (IG) and 71 controls (CG). Patients who met the eligibility criteria were randomly allocated. The IG received the thermal care bundle, which consisted in pre-warming patients 10 minutes prior to anesthesia delivery and maintaining it with a forced air system during surgery and in the immediate postoperative period; the operating room environmental temperature was kept at 21°C, and fluids were warmed to 38°C.

Results: At the start of surgery and at post-anesthesia care unit admission, the incidence of hypothermia was significantly lower in the IG, p = .021 and p = .024 respectively. No significant differences were found for surgical site infection (p= .33), shivering (p= .454) although a drop in core temperature of 0.33°C during the first 30 minutes of surgery was associated with a greater likelihood of shivering (p= .010). Significant differences in thermal comfort were reported (p= .034).

Conclusion: The bundle was effective in preventing hypothermia and improving comfort but did not impact on surgical site infection and shivering in this young and healthy population.