Prevention and management of perioperative hypothermia in adult elective surgical patients: A systematic review

Background: Body temperature is tightly regulated with hormonal and cellular metabolism for normal functioning; however perioperative hypothermia is common secondary to anesthesia and surgical exposure. Prevention and maintaining body temperature should be started 1-2hrs before induction of anesthesia, to do this both active and passive warming system are effective to prevent complications associated with perioperative hypothermia. Methods: The aim of this systematic review is to develop a clear clinical practice protocol in prevention and management of perioperative hypothermia for elective adult surgical patients. The study is conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline 2020. After formulating clear criteria for the evidences to be included an appropriate method of searching was conducted by using the Pub Med, Google scholar and Cochrane library using the following MeSH terms: (inadvertent hypothermia AND anesthesia, hypothermia AND perioperative management and thermoregulation AND anesthesia) were used to draw evidences. After a reasonable amount of evidences were collected, appraisal and evaluation of study quality was based on WHO 2011 level of evidence and degree of recommendation. Final conclusions and recommendations are done by balancing the benefits and downsides of alternative management strategies for perioperative management of hypothermia. This systematic review registered with research registry unique identifying number (UIN) of "revie-wregistry1253" in addition the overall AMSTAR 2 quality of this systematic review is moderate level. Discussion: Preserving a patient's body temperature during anesthesia and surgery is to minimize heat loss by reducing radiation and convection from the skin, evaporation from exposed surgical areas, and cooling caused by the introduction of cold intravenous fluids. Conclusion: Hypothermia is least monitored complication during anesthesia and surgery results cardiac abnormalities, impaired wound healing, increased surgical site infections, shivering and delayed postoperative recovery, and coagulopathies.