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Perioperative temperature management: a survey of 6 Asia–Pacific countries

BACKGROUND: Anesthesia leads to impairments in central and peripheral thermoregulatory responses. Inadvertent perioperative hypothermia is hence a common perioperative complication, and is associated with coagulopathy, increased surgical site infection, delayed drug metabolism, prolonged recovery, a...

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Autores principales: Koh, Wenjun, Chakravarthy, Murali, Simon, Edgard, Rasiah, Raveenthiran, Charuluxananan, Somrat, Kim, Tae-Yop, Chew, Sophia T. H., Bräuer, Anselm, Ti, Lian Kah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365903/
https://www.ncbi.nlm.nih.gov/pubmed/34399681
http://dx.doi.org/10.1186/s12871-021-01414-6
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author Koh, Wenjun
Chakravarthy, Murali
Simon, Edgard
Rasiah, Raveenthiran
Charuluxananan, Somrat
Kim, Tae-Yop
Chew, Sophia T. H.
Bräuer, Anselm
Ti, Lian Kah
author_facet Koh, Wenjun
Chakravarthy, Murali
Simon, Edgard
Rasiah, Raveenthiran
Charuluxananan, Somrat
Kim, Tae-Yop
Chew, Sophia T. H.
Bräuer, Anselm
Ti, Lian Kah
author_sort Koh, Wenjun
collection PubMed
description BACKGROUND: Anesthesia leads to impairments in central and peripheral thermoregulatory responses. Inadvertent perioperative hypothermia is hence a common perioperative complication, and is associated with coagulopathy, increased surgical site infection, delayed drug metabolism, prolonged recovery, and shivering. However, surveys across the world have shown poor compliance to perioperative temperature management guidelines. Therefore, we evaluated the prevalent practices and attitudes to perioperative temperature management in the Asia–Pacific region, and determined the individual and institutional factors that lead to noncompliance. METHODS: A 40-question anonymous online questionnaire was distributed to anesthesiologists and anesthesia trainees in six countries in the Asia–Pacific (Singapore, Malaysia, Philippines, Thailand, India and South Korea). Participants were polled about their current practices in patient warming and temperature measurement across the preoperative, intraoperative and postoperative periods. Questions were also asked regarding various individual and environmental barriers to compliance. RESULTS: In total, 1154 valid survey responses were obtained and analyzed. 279 (24.2%) of respondents prewarm, 508 (44.0%) perform intraoperative active warming, and 486 (42.1%) perform postoperative active warming in the majority of patients. Additionally, 531 (46.0%) measure temperature preoperatively, 767 (67.5%) measure temperature intraoperatively during general anesthesia, and 953 (82.6%) measure temperature postoperatively in the majority of patients. The availability of active warming devices in the operating room (p < 0.001, OR 10.040), absence of financial restriction (p < 0.001, OR 2.817), presence of hospital training courses (p = 0.011, OR 1.428), and presence of a hospital SOP (p < 0.001, OR 1.926) were significantly associated with compliance to intraoperative active warming. CONCLUSIONS: Compliance to international perioperative temperature management guidelines in Asia–Pacific remains poor, especially in small hospitals. Barriers to compliance were limited temperature management equipment, lack of locally-relevant standard operating procedures and training. This may inform international guideline committees on the needs of developing countries, or spur local anesthesiology societies to publish their own national guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12871-021-01414-6.
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spelling pubmed-83659032021-08-17 Perioperative temperature management: a survey of 6 Asia–Pacific countries Koh, Wenjun Chakravarthy, Murali Simon, Edgard Rasiah, Raveenthiran Charuluxananan, Somrat Kim, Tae-Yop Chew, Sophia T. H. Bräuer, Anselm Ti, Lian Kah BMC Anesthesiol Research BACKGROUND: Anesthesia leads to impairments in central and peripheral thermoregulatory responses. Inadvertent perioperative hypothermia is hence a common perioperative complication, and is associated with coagulopathy, increased surgical site infection, delayed drug metabolism, prolonged recovery, and shivering. However, surveys across the world have shown poor compliance to perioperative temperature management guidelines. Therefore, we evaluated the prevalent practices and attitudes to perioperative temperature management in the Asia–Pacific region, and determined the individual and institutional factors that lead to noncompliance. METHODS: A 40-question anonymous online questionnaire was distributed to anesthesiologists and anesthesia trainees in six countries in the Asia–Pacific (Singapore, Malaysia, Philippines, Thailand, India and South Korea). Participants were polled about their current practices in patient warming and temperature measurement across the preoperative, intraoperative and postoperative periods. Questions were also asked regarding various individual and environmental barriers to compliance. RESULTS: In total, 1154 valid survey responses were obtained and analyzed. 279 (24.2%) of respondents prewarm, 508 (44.0%) perform intraoperative active warming, and 486 (42.1%) perform postoperative active warming in the majority of patients. Additionally, 531 (46.0%) measure temperature preoperatively, 767 (67.5%) measure temperature intraoperatively during general anesthesia, and 953 (82.6%) measure temperature postoperatively in the majority of patients. The availability of active warming devices in the operating room (p < 0.001, OR 10.040), absence of financial restriction (p < 0.001, OR 2.817), presence of hospital training courses (p = 0.011, OR 1.428), and presence of a hospital SOP (p < 0.001, OR 1.926) were significantly associated with compliance to intraoperative active warming. CONCLUSIONS: Compliance to international perioperative temperature management guidelines in Asia–Pacific remains poor, especially in small hospitals. Barriers to compliance were limited temperature management equipment, lack of locally-relevant standard operating procedures and training. This may inform international guideline committees on the needs of developing countries, or spur local anesthesiology societies to publish their own national guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12871-021-01414-6. BioMed Central 2021-08-16 /pmc/articles/PMC8365903/ /pubmed/34399681 http://dx.doi.org/10.1186/s12871-021-01414-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://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.
spellingShingle Research
Koh, Wenjun
Chakravarthy, Murali
Simon, Edgard
Rasiah, Raveenthiran
Charuluxananan, Somrat
Kim, Tae-Yop
Chew, Sophia T. H.
Bräuer, Anselm
Ti, Lian Kah
Perioperative temperature management: a survey of 6 Asia–Pacific countries
title Perioperative temperature management: a survey of 6 Asia–Pacific countries
title_full Perioperative temperature management: a survey of 6 Asia–Pacific countries
title_fullStr Perioperative temperature management: a survey of 6 Asia–Pacific countries
title_full_unstemmed Perioperative temperature management: a survey of 6 Asia–Pacific countries
title_short Perioperative temperature management: a survey of 6 Asia–Pacific countries
title_sort perioperative temperature management: a survey of 6 asia–pacific countries
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365903/
https://www.ncbi.nlm.nih.gov/pubmed/34399681
http://dx.doi.org/10.1186/s12871-021-01414-6
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