Overview

Maintaining patient normothermia is a key measure to prevent infections1.   

Among the millions of surgeries occurring annually in the world, it is estimated that 50-90% suffer from hypothermia2

Even mild hypothermia triples the incidence of surgical-wound infection and increases the duration of hospitalization by approximately 20%3.   

Hypothermia is caused by a variety of factors3, including : 

  • low operating room temperatures 

  • surgical incisions 

  • a core-to-peripheral redistribution of body heat from anesthetics 

  • volume of chilled fluid administration   


1: SCIP –Inf- 10: Surgical Care Improvement Project (SCIP), a national collaboration of healthcare organizations working to reduce surgical complications   
2: Young, V. Watson, M. Prevention of Perioperative Hypothermia in Plastic Surgery. Aesthetic Surgery Journal. 2006; 551-571.
3: Kurz A, Sessler DI, Lenkhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med 1996;334:1209-15.

Benefits

Hypothermia and surgical wound infections. 

Mild hypothermia is defined in the literature as a patient core temperature of below 36°C1.   

There are 3 mechanisms by which mild hypothermia facilitates the development of surgical wound infections2.

  1. Triggers thermoregulatory vasoconstriction, which
    decreases tissue oxygenation. 

  2. Impairs the production of superoxide radicals and other reactive oxygen intermediates. 

  3. Decreases scar formation and, therefore, the integrity of
    the healing wound.

The consequence of these impairments: 

Even mild hypothermia triples the risk of surgical wound infection. Mild hypothermia also significantly prolongs the duration of hospitalization by approximately 20 percent, even among uninfected patients. Because hypothermia causes so many adverse outcomes, normothermia should be maintained during surgery2.   

Causes of Hypothermia 

During surgery, all general anesthetic agents impair thermoregulatory responses and decrease the vasoconstriction and shivering threshold. Anesthetic agents, however, are not the only culprits: Even fluids at room temperature can markedly decrease body temperature3.

  • Each liter of intravenous fluids infused into adult surgical patients at ambient temperature, or each unit of blood infused at 4 °C, decreases the mean body temperature approximately 0.25 °C3.

  • According to one study, the combination of convective and fluid warming was associated with a decreased likelihood of patients leaving the operating room hypothermic4

The enFlow* IV Fluid/Blood Warming System allows the intraoperative staff to keep warming constant as anesthetic is applied in the OR to either treat unplanned hypothermic responses or stop them from developing in the first place. 

1: NICE guidance, The management of perioperative hypothermia, CG65
2: Sessler Daniel I, Nonpharmacological Prevention of Surgical Wound Infections, Clinical Infectious Diseases 2002; 35:1397–404
3: Sessler, Mild perioperative hypothermia, NEJM, 1997, 336, N°24: 1730-1737 
4: Smith CE, Preventing Hypothermia: convective & intravenous fluid warming versus convective warming alone. J Clin Anesth 1998, Aug; 10(5):380-5

One compact cartridge. So much mobility. 

With enFlow all you need is ONE disposable cartridge to warm across multiple areas. It attaches in-line at the start of a patient case and can move with the patient across the surgical department. On other fluid warming devices warming across rooms can be difficult and expensive, often adding the cost of multiple disposables, disrupting workflow, and compromising infection prevention protocols.