Effects of intraoperative temperatures on postoperative infections in infants and neonates.

Abstract:

BACKGROUND:Perioperative hypothermia has been shown to increase surgical site infection (SSI) rates in adults. We sought to characterize whether intraoperative hypothermia or hyperthermia is associated with postoperative infections in infants. METHODS:We conducted a retrospective review of patients ≤6 months old who underwent surgical procedures from November 2013 to October 2015 at a Level I ACS Children's Surgical Center. The outcome was infections within 30 days after operation, with particular attention to SSI. Data obtained included weight and age at surgery, American Society of Anesthesiologists (ASA) physiologic status, wound class, case length, blood transfusion within 72 h of surgery, and administration of prophylactic antibiotics. Temperatures were classified as hypothermia (T < 36 °C), normothermia (T = 36.0 to 37.9 °C), and hyperthermia (T ≥ 38 °C). RESULTS:The 885 patients had 25 SSIs (2.8%) and 11 nonsurgical site infections (1.2%). On univariate analysis, weight at surgery, higher ASA, perioperative transfusions, and longer case length were associated with higher rate of SSI. Higher median Thigh, higher median T low, and any hyperthermia were associated with higher rate of SSI. On multivariable logistic regression adjusted analyses, hyperthermia at any time during the case was associated with SSI (OR 3.47, [95% CI 1.34, 9.04], p = 0.011). Transfusions were also associated with higher SSI rates (OR 3.60 [95% CI, 1.28, 10.3], p = 0.016). CONCLUSIONS:Intraoperative hyperthermia is associated with increased SSI rates in infants. LEVEL OF EVIDENCE:III.

journal_name

J Pediatr Surg

authors

Walker S,Amin R,Arca MJ,Datta A

doi

10.1016/j.jpedsurg.2019.09.060

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

80-85

issue

1

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(19)30713-4

journal_volume

55

pub_type

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