CAN AKSU, ALPARSLAN KUŞ, Önder TOPBAŞ, Sema ERDOĞAN, Yavuz GÜRKAN

Perioperatif Hipotermi İnsidansı: 5 Yıl Sonra Neredeyiz?

Amaç: İstemsiz perioperatif hipotermi anestezi pratiğinde mortalite ve morbiditeye yol açan önemli bir sorundur. Hipoterminin önlenmesi için perioperatif sıcaklık monitörizasyonu yapılması, aktif ısıtma, oda sıcaklıklarının düzenlenmesi gibi birçok önlem alınmalıdır. Kliniğimizde yapılan önceki bir çalışmada, hipotermi insidansı %45.7 olarak bulunmuş ve gelecekte istenmeyen hipo- termi insidansını azaltmak için alınması gereken önlemler belirlenmişti. Bu çalışmada, hastaların ameliyat sonrası vücut sıcaklıklarını ölçerek kliniğimizde hipotermi insidansını ve kullanılan yön- temlerin perioperatif hipotermiyi önlemede ne kadar etkili olduğunu belirlemeyi amaçladık. Yöntem: Etik Kurul onayı ve bilgilendirilmiş hasta onamı alındıktan sonra, bir aylık bir sürede, ameliyat süreleri 30 dk.’dan uzun olan hastalar çalışmaya dahil edildi. Hastaların demografik verileri, ameliyatların tipi ve süresi, perioperatif dönemde kullanılan aktif ısıtma yöntemleri, sıcaklık monitörizasyonu varlığı, pre ve postoperatif olarak infrared termometreyle timpanik membrandan ölçülen vücut sıcaklıkları kaydedildi. Hipotermi, 36°C’den düşük vücut sıcaklığı ola- rak tanımlandı. Hipotermi insidansı ve ısıtma yöntemlerinin ve monitörizasyonunun ne sıklıkta uygulandığı hesaplandı. Bulgular: Bir ay ile 96 yaş arasında (ortalama 42±22.3) toplam 793 hasta çalışmaya alındı (461 kadın, 332 erkek). Hipotermi insidansı %31.27 olarak bulundu. Ameliyat sırasında aktif olarak ısıtılan toplam 475 (%59.89) hasta kaydedildi. Sıcaklık monitörizasyon oranı ise %9’du. Sonuç: Bu çalışma, kliniğimizde istemsiz perioperatif hipotermi insidansının daha önceki çalışma- mıza oranla azaldığını göstermektedir. Ancak, daha alınması gereken önlemler olduğunu düşün- mekteyiz.

Perioperative Hypothermia Incidence: Where are we After 5 Years?

Objective: Inadvertent perioperative hypothermia is an important problem leading to mortality and morbidity in anesthesia practice. In order to prevent hypothermia, many precautions should be taken such as perioperative temperature monitoring, active heating and regulation of room temperatures. In a previous study performed in our clinic, the incidence of hypothermia was found to be 45.7% and the precautions that should be taken to reduce the incidence of inadver- tent hypothermia in the future were determined. In this study, we aimed to determine the inci- dence of hypothermia in our clinic by measuring postoperative body temperatures of the patients and how effective are the methods used in preventing perioperative hypothermia. Method: After obtaining ethics committee approval and written consent from the patients, cases with operation times longer than 30 minutes were included in the study within a 1 month period. Demographic data of the patients, type and duration of surgeries, heating methods in the peri- operative period, presence of temperature monitoring, pre-postoperative body temperatures measured with an infrared thermometer from tympanic membranes of the patients were record- ed. Hypothermia was defined as a body temperature of less than 36°C. The incidence of hypo- thermia and the frequency of heating methods and monitoring were calculated. Results: A total of 793 patients were recruited (461 female, 332 male) aged between 1 month and 96 years (mean 42±22.3). Incidence of hypothermia was found as 31.27%. A total of 475 (59.89%) patients who were actively heated during the operation were recorded. The tempera- ture monitoring rate was 9%. Conclusion: This study showed that the incidence of inadvertent perioperative hypothermia in our clinic decreased compared to our previous study. However, we think that further precautions should be taken.

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