Hypothermia has a profound impact on the entire body – it compromises the immune system leading to a higher risk of post-operative wound infections, promotes coagulopathy, decreases drug metabolism and wound healing, delays emergence from anesthesia, alters mental status, and negatively affects hemodynamics. As an anesthesiologist and intensivist, I’m often preoccupied with minute-to-minute changes in a patient’s blood pressure, volume status, oxygenation/ventilation, antibiotics, etc, but for the aforementioned reasons, preserving normothermia is essential!
For large volume blood product and crystalloid resuscitation, I’m always turning to either the Level 1 or high flow Ranger fluid warming systems. It’s known that a liter of room temperature crystalloid or a unit of cooled packed red blood cells (pRBCs) can decrease a patient’s temperature by ~ 0.25°C (with additive effects)! Couple this with the cold operating room, exposed skin surfaces, and large surgical incisions such as those used in laparotomies and thoracotomies, and it’s clear that significant heat loss is not only probable but inevitable. Fluid warmers allow the treatment team to rapidly transfuse warm fluids while using forced air warmers, blankets, warming the room, etc. to help minimize heat loss.
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