Zusammenfassung
Zur Optimierung der perioperativen Qualität und Patientensicherheit bei ambulanten und stationären Operationen sollte die S3-Leitlinie zur Vermeidung der perioperativen Hypothermie konsequent umgesetzt werden. Perioperative Normothermie ist ein Qualitätsindikator und kann unproblematisch durch Zusammenarbeit von Anästhesisten und Operateuren entlang den Empfehlungen der Leitlinie erreicht werden. Um Hypothermie frühzeitig zu erkennen, muss die Körperkerntemperatur perioperativ gemessen werden, möglichst schon 1–2 h vor Einleitung der Anästhesie beginnend. Patienten bereits vor Einleitung einer Anästhesie aktiv 20–30 min Wärme zuzuführen, ist besonders effizient und sollte in den präoperativen Prozess integriert werden. Patienten sollen über die Risiken einer unbeabsichtigten perioperativen Hypothermie präoperativ informiert und perioperative Teammitglieder geschult werden. Ein Standard (SOP) zum Wärmemanagement sollte für die operative Einheit erstellt werden. Zur Qualitätskontrolle sollten innerhalb der OP-Einheit alle 3–6 Monate an einem OP-Tag stichprobenartig alle operativen Patienten hinsichtlich der Inzidenz postoperativer Hypothermie überprüft werden. Ziele sind, dass bei mindestens 80 % aller operativen Patienten die Körperkerntemperatur gemessen wird und diese bei >70 % am Ende der Operation >36 °C liegt.
Abstract
To improve perioperative quality and patient safety, the German S3 guideline should be consistently implemented to avoid perioperative hypothermia. Perioperative normothermia is a quality indicator and should be achieved by anesthesiologists and surgeons. To detect hypothermia early during the perioperative process, measuring body temperature should be started 1–2 h preoperatively. Patients should be actively warmed for 20–30 min before starting anesthesia. Prewarming is most effective and should be included in the preoperative process. Patients should be informed about the risks of perioperative hypothermia and members of the perioperative team should be educated. A standard operating procedure (SOP) to avoid hypothermia should be introduced in every operative unit. The incidence of postoperative hypothermia should be evaluated in operative patients every 3–6 months. The goals should be to measure body temperature in >80% of patients undergoing surgery and for >70% to exhibit a core temperature >36 °C at the end of surgery.
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E.-P. Horn, E. Klar, J. Höcker, A. Bräuer, B. Bein, H. Wulf und A. Torossian geben an, dass kein Interessenkonflikt besteht.
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Horn, EP., Klar, E., Höcker, J. et al. Vermeidung perioperativer Hypothermie. Chirurg 88, 422–428 (2017). https://doi.org/10.1007/s00104-016-0357-0
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DOI: https://doi.org/10.1007/s00104-016-0357-0