Effects of Intraoperative Hypothermia on the Incidence of Post-operative Infection and Responses of Peripheral White Blood Cells

Kim, Myung Hee; Kang, Yeong Lan

Abstract

BACKGROUND: Hypothermia occurs commonly during surgery. An increased incidence of hypothermia- induced morbidity of surgical patients has been reported. Immunosuppression has also been demonstrated after major surgery. Therefore, we investigated the rate of infection and the changes of white blood cells depending on body temperature during a gastrectomy.
METHODS
Sixty patients were randomly divided into be warmed intraoperatively with a circulating warm water mattress (group 1) or warm intravenous fluid/humidifier filter/circulating warm water mattress (group 2). Core temperature was recorded every 15 min during surgery and every 30 min in the recovery room. Blood samples for measurement of white blood cells were obtained preoperatively, immediately, post-op day 1 and day 2 after surgery.
RESULTS
Group 1 began to have a decrease in temperature at 30 min after surgery and a significantly lower temperature than group 2 during the surgery and 60 min in the recovery room (P<0.05). Compared with preoperative values, surgery caused an increase in neutrophils, and a decrease in lymphocytes in both groups (P<0.05). Compared with group 2, more concentrations of neutrophils and less concentration of lymphocytes and monocytes were found in group 1 on the post-operative 2nd day (P<0.05). Fever above 37.3degrees C was found in 17 of 30 patients in group 1, but in only 14 of 30 patients in group 2. Pneumonia (one patient), urinary tract infection (one) and surgical wound infection (two) were only found in group 1, but the incidence of infection was not statistically significant between the groups.
CONCLUSIONS
Intraoperative hypothermia was associated with a delayed recovery of changes in white blood cells.