Guidelines of the Polish Society of Anaesthesiology and Intensive Therapy regarding prevention of inadvertent intraoperative hypothermia

Abstract

Preoperative period 1. Attention should be paid to possible benefits of informing the patient about possible exposure to hypothermia during the perioperative period. 2. It is recommended to measure core temperature before anaesthesia in each case. 3. In the case of measurements from locations other than those recommended for core temperature measurements, it should be remembered to properly compare the reading with core temperature, except for the use of devices in which such read- • BMI; • the extent of the procedure*/the procedure over 1 hour; • planned combination of general and block anaesthesia; • anticipated blood loss above 500 mL. Intraoperative period 1. Continuous core temperature measurements or at least every 30 minutes are recommended during anaesthesia; the continuous measurement is preferable. 2. It is recommended to use active warming since the induction of anaesthesia, e.g. forced air warming systems or electric heating mattresses and blankets, when the anticipated duration of the procedure exceeds 60 minutes. 3. It is recommended to maintain core body temperature within the range of values accepted for normothermia. 4. The time when a significant part of the body surface of the anesthetized patient is not covered in the period preceding draping should be kept to a minimum. 5. The operating theatre temperature should not be lower than 21°C until the active warming systems have been activated. 6. If it is planned to transfuse more than 1000 mL of infusion fluids, they should be warmed to 37°C using the devices designed for this purpose. 7. Warming of whole blood, red blood cell concentrate, and other blood preparations to 37° C is indicated in transfusions with a rate above 50 mL min–1 and only with the devices designed for this purpose. 8. It is advisable to warm the fluids used for intraoperative rinsing of body cavities (irrigation) to 37–40°C. Postoperative period 1. Postoperative monitoring of body temperature, which is one of the main vital signs, is recommended. 2. During the patient’s stay in the recovery room and in the postoperative ward, forced-air warming should be provided to maintain core body temperature above 36.5°C.