Becker's ASC Review

65 Executive Briefing Sponsored by: S urgical patients may experience unintended perioperative hypothermia while in the operating room, which can result in complications. The use of warm blankets and fluids can help patients maintain the appropriate core body temperature during surgery, but the traditional methods of patient warming can fall short for busy surgical teams aiming to provide high value care. Around 20 percent of patients experience unintended perioperative hypothermia, which can contribute to negative care outcomes. When body's core temperature drops 1.5°C within 30 minutes of anesthesia administration, the average patient's surgical blood loss increases by 16 percent and patients are at a 22 percent increased risk of needing a transfusion. 1 Patients with unintended perioperative hypothermia are also at three-times higher risk for surgical site infection and three-fold greater risk for morbid cardiac events. Clinical complications are just the beginning; treating patients with unintended perioperative hypothermia often requires the use of additional hospital resources. Hypothermic patients typically take around 40 minutes longer to recover from surgery and on average report 20 percent longer hospitalization than non-hypothermic patients. 2 However, surgical teams are not without solutions. Clinical studies suggest 30 minutes of prewarming can reduce the risk of subsequent hypothermia. 3 Clinicians can also monitor the patient's body temperature to prevent complications. This article examines the clinical benefits of patient warming and outlines the advantages of the Enthermics ivNow fluid warmer. With a focus on improving quality of care and OR efficiency, this innovative technology can help providers succeed in value-based care. The benefits of patient warming Launched in 1980 as a pioneer in whole body hypothermia research, Enthermics has developed a host of patient warming technologies including blanket and fluid warming cabinets. Since then, Enthermics has continued to develop patient warming products that can help reduce complications and improve patient satisfaction. "The main benefit of patient warming is the improved SSI rate, which significantly affects the outcome," Matthew Rotterman, vice president of sales for Enthermics said. "Maintaining the body temperature can reduce the rehospitalization rate as well." In the United States, around 2 to 5 percent of inpatient surgical patients contract an SSI, adding approximately $11,000 to $35,000 to the episode of care per procedure. 4 Vancouver General Hospital in Canada was able to reduce SSIs by 77 percent during open heart surgeries by using a five- step process including: • Ensuring clean hands • Leaving patient dressing on for 72 hours • Engaging staff and patients on SSI prevention • Using antibiotics appropriately • Keeping the patient's body temperature normal • Ensuring patients have the appropriate blood glucose level, eats nutritious meals and don't smoke Patient warming is an integral aspect of providing quality care, but healthcare facilities aren't always designed to warm patients in the most efficient way. Better outcomes, lower costs: How an innovative approach to patient warming supports value-based care goals 1 Rajagopaian S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiol- ogy. 2008;108(1):71-77 2 Kurz A, Sessler DI, Lenhardt RA Study of wound infections and temperature group: Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med 1996; 334: 1209–15Kurz, A Sessler, DI Lenhardt, R 3 Kurz A, Sessler DI, Lenhardt RA Study of wound infections and temperature group: Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med 1996; 334: 1209–15Kurz, A Sessler, DI Lenhardt, R 4 Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999). Guideline for prevention of surgical site infection, 1999. Hospital Infection Con- trol Practices Advisory Committee. Infect Control Hosp Epidemiol 20:250–278; quiz 279–280. media/pressrel/r2k0306b.htm

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