Observational Examination of Thermoregulation in Total Joint Arthroplasty
| Status: | Completed |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/26/2019 |
| Start Date: | August 2014 |
| End Date: | June 2015 |
Total joint patients have poor outcomes with infection since they are having permanent
hardware implanted. Infection prevention in this group is therefore critical and a major
source of discussion in both the orthopedic and anesthesia literature.
Hypothermia has been shown to increase the risk of infection and blood loss. However, studies
have not examined when in the operation or how fast patients temperatures drop. This study
will observe how patients' temperatures change during total joint arthroplasty. By
identifying when body temperature changes occur, prevention strategies may be developed and
implemented.
hardware implanted. Infection prevention in this group is therefore critical and a major
source of discussion in both the orthopedic and anesthesia literature.
Hypothermia has been shown to increase the risk of infection and blood loss. However, studies
have not examined when in the operation or how fast patients temperatures drop. This study
will observe how patients' temperatures change during total joint arthroplasty. By
identifying when body temperature changes occur, prevention strategies may be developed and
implemented.
Peri-operative hypothermia can have deleterious effects. While there is no standard
consistent definition within the literature mild hypothermia is commonly defined as a core
temperature between 34 and 36 °C. Mild hypothermia has been shown to increase the occurrence
of surgical site infections, cardiac morbidity, coagulopathy leading to increased blood loss
and transfusion requirements, impaired drug metabolism, and prolonged emergence from
anesthesia. In addition, there is evidence that maintaining intra-operative normothermia can
shorten hospital length of stay. Despite the fact that intra-operative temperature monitoring
and warming are considered standard of care, peri-operative hypothermia in total joint
arthroplasty patients remains an issue for several reasons. A large proportion of patient
undergoing joint replacement are elderly, making them susceptible to peri-operative
hypothermia. In addition, regional anesthesia causes vasodilation and promotes heat flow from
the core to the periphery and impairs central and autonomic thermoregulation such that
patients receiving neuraxial anesthesia can be particularly susceptible to perioperative
hypothermia. Finally, core temperature monitoring is typically not used during regional
anesthesia and hypothermia may go undetected for long periods of time.
The primary goal of this study was to examine the incidence of hypothermia during lower
extremity arthroplasty. A secondary aim was to identify patient and operative factors
associated with hypothermia in order to improve future preventative strategies. Our
hypothesis was that peri-operative hypothermia occurs in the majority of patients undergoing
lower extremity arthroplasty. In addition, we hypothesized that certain patient and
anesthetic factors (such as low body mass index and receiving general anesthesia) would
increase the incidence of hypothermia.
consistent definition within the literature mild hypothermia is commonly defined as a core
temperature between 34 and 36 °C. Mild hypothermia has been shown to increase the occurrence
of surgical site infections, cardiac morbidity, coagulopathy leading to increased blood loss
and transfusion requirements, impaired drug metabolism, and prolonged emergence from
anesthesia. In addition, there is evidence that maintaining intra-operative normothermia can
shorten hospital length of stay. Despite the fact that intra-operative temperature monitoring
and warming are considered standard of care, peri-operative hypothermia in total joint
arthroplasty patients remains an issue for several reasons. A large proportion of patient
undergoing joint replacement are elderly, making them susceptible to peri-operative
hypothermia. In addition, regional anesthesia causes vasodilation and promotes heat flow from
the core to the periphery and impairs central and autonomic thermoregulation such that
patients receiving neuraxial anesthesia can be particularly susceptible to perioperative
hypothermia. Finally, core temperature monitoring is typically not used during regional
anesthesia and hypothermia may go undetected for long periods of time.
The primary goal of this study was to examine the incidence of hypothermia during lower
extremity arthroplasty. A secondary aim was to identify patient and operative factors
associated with hypothermia in order to improve future preventative strategies. Our
hypothesis was that peri-operative hypothermia occurs in the majority of patients undergoing
lower extremity arthroplasty. In addition, we hypothesized that certain patient and
anesthetic factors (such as low body mass index and receiving general anesthesia) would
increase the incidence of hypothermia.
Inclusion Criteria:
- Adults 18 years of age and over that are scheduled to undergo total hip or total knee
joint arthroplasty.
Exclusion Criteria:
- Patients unable to give informed consent will be excluded.
We found this trial at
1
site
171 Ashley Avenue
Charleston, South Carolina 29425
Charleston, South Carolina 29425
843-792-1414
Medical University of South Carolina The Medical University of South Carolina (MUSC) has grown from...
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