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Vol. 65. Issue 10.
Pages 564-588 (December 2018)
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Vol. 65. Issue 10.
Pages 564-588 (December 2018)
Special article
Clinical practice guideline. Unintentional perioperative hypothermia
Guía de práctica clínica de hipotermia perioperatoria no intencionada
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J.M. Calvo Vecinoa,
Corresponding author
, R. Casans Francésb, J. Ripollés Melchorc, C. Marín Zaldívara, M. Gómez Ríosd, A. Pérez Ferrere, J.M. Zaballos Bustingorrif, A. Abad Gurumetac, Grupo de trabajo de la GPC de Hipotermia Perioperatoria No Intencionada de la SEDAR 1
a Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain
b Hospital MAZ, Zaragoza, Spain
c Hospital Universitario Infanta Leonor, Madrid, Spain
d Complejo Asistencial Universitario de A Coruña, A Coruña, Spain
e Hospital Universitario Infanta Sofía, Madrid, Spain
f Policlínica Guipúzcoa, Donostia, Spain
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Tables (14)
Table 1. GRADE levels of Evidence.
Table 2. GRADE grades of recommendation.
Table 3. CPG recommendations.
Table 4. Response to the 1st CPG question.
Table 5. Response to the 2nd CPG question.
Table 6. Response to the 3rd CPG question.
Table 7. Recommendation 1 for the Prevention of Perioperative Hypothermia.
Table 8. Recommendation 1 for the Prevention of Perioperative Hypothermia.
Table 9. Recommendation 1 for the Prevention of Perioperative Hypothermia.
Table 10. Response to the 4th CPG question.
Table 11. Response to the 5th CPG question.
Table 12. Characteristics of studies, timing of warming, type of anaesthesia and main results.
Table 13. Common errors that favour the onset of perioperative hypothermia.
Table 14. Final recommendations.
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Additional material (5)
Resumen

La importancia de la seguridad de nuestros pacientes en el entorno quirúrgico ha impulsado multitud de proyectos dirigidos al mejor control y actuación clínica de las variables que intervienen o modulan los resultados de los procesos quirúrgicos y que tienen relación directa sobre los mismos.

La Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor –SEDAR– mantiene una constante preocupación por una variable que determina claramente los resultados de nuestros procesos clínicos, la hipotermia no intencionada que se desarrolla en todos los pacientes sometidos a un procedimiento anestésico-quirúrgico.

SEDAR ha promovido, en colaboración con otras sociedades científicas y asociaciones de pacientes, la elaboración de esta guía de práctica clínica, que pretende dar respuesta a cuestiones clínicas no resueltas aun y para las cuales no existen hasta ahora documentos basados en la mejor evidencia científica disponible.

Con metodología GRADE y la asistencia técnica de la oficina de Colaboración Cochrane Iberoamericana, esta guía de práctica clínica presenta 3 recomendaciones (débil a favour) para los métodos activos de calentamiento para la prevención de la hipotermia (cutáneos, de líquidos o gases); 3 para la priorización de las estrategias de prevención de la hipotermia (2 débil a favour y una fuerte a favour); 2 para las estrategias de precalentamiento previas a la inducción anestésica (2 débil a favour); y 2 para investigación.

Palabras clave:
Temperatura
Hipotermia perioperatoria
Hipotermia no intencionada
Estrategias de prevención
Calentamiento activo
Precalentamiento
Abstract

The importance of the safety of our patients in the surgical theatre has driven many projects. The majority of them aimed at better control and clinical performance, mainly of the variables that intervene or modulate the results of surgical procedures and have a direct relationship with them.

The Spanish Society of Anaesthesiology, Critical Care and Therapeutic Pain (SEDAR) maintains a constant concern for a variable that clearly determines the outcomes of our clinical processes, “unintentional hypothermia” that develops in all patients undergoing an anaesthetic or surgical procedure.

SEDAR has promoted, in collaboration with other scientific Societies and patient Associations, the elaboration of this clinical practice guideline, which aims to answer clinical questions not yet resolved and for which, up to now, there are no documents based in the best scientific evidence available.

With GRADE methodology and technical assistance from the Ibero-American Cochrane Collaboration office, this clinical practice guideline presents three recommendations (weak in favour) for active heating methods for the prevention of hypothermia (skin, fluid or gas); three for the prioritisation of strategies for the prevention of hypothermia (too weak in favour and one strongly in favour); two of preheating strategies prior to anaesthetic induction (both weak in favour); and two for research.

Keywords:
Temperature
Perioperative hypothermia
Unintentional hypothermia
Prevention strategies
Active heating methods
Preheating strategies

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