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Reuters Health, January 2008

Perioperative hypothermia increases blood loss and transfusion need

NEW YORK (Reuters Health) - Even mild hypothermia in surgical patients increases blood loss and transfusion requirements, according to a report in the January issue of Anesthesiology.

"These are only two of the many serious complications associated with perioperative hypothermia," Dr. Daniel I. Sessler from the Cleveland Clinic Foundation, Ohio told Reuters Health. "Surgical patients should thus be kept normothermic unless hypothermia is specifically indicated -- which it rarely is."

Dr. Sessler and associates conducted a systematic review and meta-analysis to evaluate their hypothesis that mild perioperative hypothermia increases surgical blood loss and transfusion requirement.

The median temperature difference between normothermic and hypothermic studies included in the review was only 0.85 degree Celsius, the report indicates.

Total blood loss in the normothermic group was 84% of that in the hypothermic group, the authors report. Similarly, normothermic patients had a need for transfusion only 78% of that for hypothermic patients.

"The effect of hypothermia on coagulation appears to last only as long as the hypothermia," Dr. Sessler explained. "In fact, it is probably a local effect rather than a systemic one. Core temperature is nonetheless important because peripheral temperatures usually change synchronously with the core."

By Will Boggs, MD

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