BMJ  2003;326:1457 (28 June), doi:10.1136/bmj.326.7404.1457-a

Letter

Maintaining perioperative normothermia

Hyperthermia must be avoided

The first 100% of the full text of this article appears below.

EDITOR—We agree with Harper et al about the importance of maintaining a normal temperature perioperatively but think that an important point has been overlooked—namely, the potential complications of actively warming patients.¹

Clearly, direct thermal injury is a possibility, particularly with warm air blankets. A less obvious complication is that of hyperthermia. Smith et al had an incidence of hyperthermia (core temperature greater than 37°C) requiring cessation of convective warming in 33% of their patients receiving convective and fluid warming.²

We believe that if patients are going to be warmed actively then continuous core temperature monitoring should be obligatory to avoid accidental hyperthermia. Thus any business plan must also include provision for temperature monitoring, although it is very likely that there will still be a strong economic as well as clinical argument for actively warming patients.

Magill Department of Anaesthesia, Queen Mary's Hospital, Sidcup, Kent DA14 6LT

chandra.chandradeva@qms-tr.sthames.nhs.uk, Magill Department of Anaesthesia, Queen Mary's Hospital, Sidcup, Kent DA14 6LT

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Competing interests: None declared.

1. Harper CM, McNicholas T, Gowrie-Mohan S. Maintaining perioperative normothermia. BMJ 2003;326: 721-2. (5 April.)[Free Full Text]
2. Smith CE, Desai R, Glorioso V, Cooper A, Pinchak AC, Hagen KF. Preventing hypothermia: convective and intravenous fluid warming versus convective warming alone. J Clin Anesth Aug 1998;10: 380-5.

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Maintaining perioperative normothermia

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