Perioperative temperature management and coagulation: effects of mild hypothermia in a prospective study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F25%3A00082264" target="_blank" >RIV/65269705:_____/25:00082264 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/25:00141744

Výsledek na webu

<a href="https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1536782/full" target="_blank" >https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1536782/full</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3389/fmed.2025.1536782" target="_blank" >10.3389/fmed.2025.1536782</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Perioperative temperature management and coagulation: effects of mild hypothermia in a prospective study

Popis výsledku v původním jazyce

Background: Perioperative hypothermia is a common complication of general and regional anesthesia in children and is a known risk factor for the development of coagulation disorders. The primary aim of the study was to assess the occurrence of coagulopathy in hypothermic pediatric patients (0-18 years) undergoing arthroscopic surgery and open abdominal surgery. The secondary objective was to identify potential risk factors for the development of both hypothermia and coagulopathy.Methods: A prospective cohort study was conducted, forming the second part of our study &quot;Perioperative Management of Temperature in Children and the Influence of Hypothermia on Blood Clotting in Children&quot; (Peritemp). We observed the incidence of body temperatures below normal values-specifically, below 36.5oC and 36oC-as well as the incidence of pathological values in thromboelastometry (ROTEM) (EXTEM and FIBTEM) and standard coagulation tests, including activated partial thromboplastin time (aPTT) and prothrombin time (PT).Results: A total of 102 patients (55 female and 47 male patients) were enrolled from 22nd January 2018 to 27th August 2021 at the Department of Pediatric Anesthesiology and Intensive Medicine, University Hospital Brno. An incidence of body temperature below 36.5oC was observed in 86 cases, and temperatures below 36.0oC were observed in 43 cases. The incidence of abnormalities in the individual parameters of the coagulation tests ranged from 5.9 to 32.4%. The ROTEM results were abnormal in 18.7% of the patients, while the standard coagulation test showed abnormalities in 15.9% of the cases. In the statistical comparison between the first and second coagulation test results, only the prothrombin time ratio (PT-R) showed a statistically significant difference. Low operating room (OR) temperature and patient age emerged as significant risk factors for the incidence of hypothermia. In addition, older age was associated with an increased likelihood of body temperature falling below 36.5oC and 36oC.Conclusion: Our study confirmed that mild hypothermia (core temperature below 36.0oC) is common during pediatric surgeries, but it does not appear to result in clinically significant coagulation disorders requiring intervention. Despite the incidence of coagulation abnormalities, the absence of significant changes in coagulation parameters, outside of the PT-R, suggests that mild hypothermia may be well tolerated by the coagulation system in pediatric patients. Our study confirmed the previously established association between variability in operating room temperature and intraoperative hypothermia. Future research should focus on larger, more diverse pediatric populations to validate these findings and optimize perioperative temperature management strategies.

Název v anglickém jazyce

Perioperative temperature management and coagulation: effects of mild hypothermia in a prospective study

Popis výsledku anglicky

Background: Perioperative hypothermia is a common complication of general and regional anesthesia in children and is a known risk factor for the development of coagulation disorders. The primary aim of the study was to assess the occurrence of coagulopathy in hypothermic pediatric patients (0-18 years) undergoing arthroscopic surgery and open abdominal surgery. The secondary objective was to identify potential risk factors for the development of both hypothermia and coagulopathy.Methods: A prospective cohort study was conducted, forming the second part of our study &quot;Perioperative Management of Temperature in Children and the Influence of Hypothermia on Blood Clotting in Children&quot; (Peritemp). We observed the incidence of body temperatures below normal values-specifically, below 36.5oC and 36oC-as well as the incidence of pathological values in thromboelastometry (ROTEM) (EXTEM and FIBTEM) and standard coagulation tests, including activated partial thromboplastin time (aPTT) and prothrombin time (PT).Results: A total of 102 patients (55 female and 47 male patients) were enrolled from 22nd January 2018 to 27th August 2021 at the Department of Pediatric Anesthesiology and Intensive Medicine, University Hospital Brno. An incidence of body temperature below 36.5oC was observed in 86 cases, and temperatures below 36.0oC were observed in 43 cases. The incidence of abnormalities in the individual parameters of the coagulation tests ranged from 5.9 to 32.4%. The ROTEM results were abnormal in 18.7% of the patients, while the standard coagulation test showed abnormalities in 15.9% of the cases. In the statistical comparison between the first and second coagulation test results, only the prothrombin time ratio (PT-R) showed a statistically significant difference. Low operating room (OR) temperature and patient age emerged as significant risk factors for the incidence of hypothermia. In addition, older age was associated with an increased likelihood of body temperature falling below 36.5oC and 36oC.Conclusion: Our study confirmed that mild hypothermia (core temperature below 36.0oC) is common during pediatric surgeries, but it does not appear to result in clinically significant coagulation disorders requiring intervention. Despite the incidence of coagulation abnormalities, the absence of significant changes in coagulation parameters, outside of the PT-R, suggests that mild hypothermia may be well tolerated by the coagulation system in pediatric patients. Our study confirmed the previously established association between variability in operating room temperature and intraoperative hypothermia. Future research should focus on larger, more diverse pediatric populations to validate these findings and optimize perioperative temperature management strategies.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30218 - General and internal medicine

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Frontiers in Medicine

ISSN

2296-858X

e-ISSN

2296-858X

Svazek periodika

12

Číslo periodika v rámci svazku

JUN 2025

Stát vydavatele periodika

CH - Švýcarská konfederace

Počet stran výsledku

10

Strana od-do

1536782

Kód UT WoS článku

001519277000001

EID výsledku v databázi Scopus

2-s2.0-105009527801