Postoperative hypothermia tied to reduced length of stay after surgery in adult acute burn patients: Study

"These findings indicate possible benefit from mild hypothermia in burns surgery," Fiona M. Wood, Fiona Wood Foundation, Perth, WA, Australia, and colleagues wrote in their study. "A review of body temperature maintenance strategies for acute burn is warranted."

The findings challenge the established practice of targeting normothermia and avoiding even mild hypothermia in adult burn patients who need acute surgery. Postoperative mild hypothermia was associated independently with a reduced length of stay versus those who were normothermic.

In the study, the researchers revealed that there was no evidence for an association of perioperative hypothermia with in-hospital complications.

The hypermetabolic response following a burn predisposes patients to hypothermia due to impairment of thermoregulation. Traditionally, hypothermia is actively avoided in burn care due to reported complications linked with low body temperature. The likelihood of hypothermia with acute burn surgery is compounded by exposure to wound areas, general anesthesia, and prolonged operation times. However, not many studies have explored the effects of perioperative hypothermia on length of stay in the adult burn population.

Against the above background, Dr. Wood and the team aimed to investigate whether an association exists between postoperative hypothermia and hospital length of stay in adult burns patients.

For this purpose, they conducted a retrospective cohort study involving patients admitted to the State Adult Burn Unit in Western Australia between 2015 and 2021. The study included all adults who underwent surgery for acute burn and had postoperative recovery room body temperature recorded.

In the study, normothermia was defined as 36.5–37.5 °C and hypothermia as < 36.0 °C with mild, moderate, and severe hypothermia being 35.0–35.9 °C, 34.0–34.9 °C and < 34.0 °C, respectively. Hyperthermia patients were excluded. Multivariable general linear models determined the presence of an independent association between hypothermia and length of stay.

The study led to the following findings:

• Among 1486 adult patients, 90% were normothermic postoperatively, with temperatures 36.0–37.5 °C.
• There were 10% of patients with hypothermia (temperature <36.0 °C) postoperatively.
• Most burns in the study population were minor: 96% had burns < 15% TBSA.
• Data modeling demonstrated that hypothermia was associated with a shorter length of hospital stay (coefficient = −0.129).

"The study's positive results indicate that a review of the core temperature targets with acute burn surgery and timing of burn patient cooling practices in general is warranted," the researchers concluded.

Reference:

Mai, L., Boardman, G., Robinson, K., Edgar, D. W., & Wood, F. M. (2024). Postoperative hypothermia is associated with reduced length of stay in adult acute burn survivors. Burns. https://doi.org/10.1016/j.burns.2024.02.033