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Case Studies | Paramedical Science | India | Volume 12 Issue 11, November 2023
Not So Cool! Peri-Operative Hypothermia and Its Complications in Cardiac Surgery: Insights from an Indian Study
Dr. Nikhil PJ Theckumparampil [2] | Sumithra R [2] | Angel E | Dr. Paul R Ponraj | Dr. PSN Raju | Dr. D Janardhana Reddy
Abstract: This study investigates the prevalence of peri-operative hypothermia in cardiac surgery patients and its associated complications, particularly focusing on the Indian context. We analyzed data from patients undergoing both on and off-pump cardiac surgeries, tracking temperature changes and their correlation with bleeding and blood transfusion requirements. Our findings highlight a significant occurrence of hypothermia and its potential complications, underscoring the need for improved peri-operative temperature management in cardiac surgery patients. Purpose: The purpose of this study is to evaluate the prevalence and consequences of peri-operative hypothermia in patients undergoing cardiac surgery in India, with a specific focus on bleeding and blood transfusion requirements. Methods: The data set included with sixty seven patients which are observed and recorded by our perfusion students prospectively. Temperature was recorded at 3 time points, once prior to entering the operating room, and once at incision and once after chest closure. The estimated blood loss volumes were obtained from anesthesia charts. Results: Of the 67 patients, 1 was excluded due to error in data collection. One mortality was recorded. The average temperature of the entire cohort at pre-op, incision and closure were 36.6oC, 35.1oC, 34.6oC respectively. The OPCABG gp, experienced a significantly higher average drop in temperature than in ON PUMP gp (2.44oC vs. 0.95oC). The average estimated blood loss (EBL) in the OPCAB gp (726ml) was slightly more than ON PUMP gp (675 ml). The average blood product transfusion (Prod-Tfn) of the entire cohort was 1.9 Units (0-10). The OPCABG gp received significantly less Prod-Tfn compared to ONPUMP group (1.4 units vs.3.4 units). We further divided our cohort into two groups as >3oC drop in temperature (>3?Gp) and <3oC drop in temperature (<3?Gp). An EBL in the >3oGp, 820ml (259ml-1900ml) was significantly more than <3oGp, 667ml (300ml-1500ml). Among the OPCABG patients, the EBL in >3oGp was also significantly higher than the <3oGp (836ml vs 658ml). Similarly, in among the OPCABG patients, the average Prod-Tfn in>3?Gp was significantly more the <3?Gp (2.25units vs. 1.78 units). Conclusion: The magnitude of hypothermia was associated with increased risk of bleeding and blood product transfusions. This seems to affect OPCABG patients more. Maintaining normothermia might be useful in peri-operative management of patients undergoing cardiac surgery.
Keywords: Peri-operative Hypothermia, Cardiac Surgery, Blood Transfusion, Bleeding Complications, Indian Medical Research
Edition: Volume 12 Issue 11, November 2023,
Pages: 1886 - 1889