Perioperative Hypothermia

Inadvertent perioperative hypothermia, an unintentional decrease in core body temperature below 36°C during the surgical experience, is a widespread clinical problem that occurs during 70 percent of surgical procedures.  Core body temperature below 36°C can cause a variety of complications that include increased infection of the surgical site, increased blood loss, prolonged hospital stay, increased costs, and increased morbid cardiac events among other adverse outcomes. This decrease in core body temperature is mainly due to vasodilation and changed regulatory function associated with anesthesia, and is also affected by cool operating rooms and little clothing. The Joint Commission, together with the Center for Medicare and Medicaid Services (CMS), has also identified perioperative hypothermia as an important problem and CMS is requiring core body temperature measurements as a part of the Surgical Care Improvement Program (SCIP). Beginning in 2013 hospitals will be paid for performance; hospitals will not receive full reimbursement from Medicaid and Medicare if they do not perform to the standards set forth by SCIP. Currently available methodologies include convective air warming, circulated water warming, warming of administered fluids and humidification of patient air. These solutions are either cost prohibitive, limit necessary access to the body, do not incorporate feedback from the patient, or are limited in their ability to maintain core body temperature throughout the procedure.