N Rose1, G P S Kwong2, D S J Pang3,4. 1. Western Veterinary Specialist and Emergency Centre, Calgary, Alberta T3C 0J8, Canada. 2. Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada. 3. Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta T2N 4N1, Canada. 4. Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada.
Abstract
OBJECTIVES: Use of clinical audits to assess and improve perioperative hypothermia management in client-owned dogs. METHODS: Two clinical audits were performed. In Audit 1 data were collected to determine the incidence and duration of perioperative hypothermia (defined as rectal temperatures <37·0°C). The results from Audit 1 were used to reach consensus on changes to be implemented to improve temperature management, including re-defining hypothermia as rectal temperature <37·5°C. Audit 2 was performed after 1 month with changes in place. RESULTS: Audit 1 revealed a high incidence of post-operative hypothermia (88·0%) and prolonged time periods (7·5 hours) to reach normothermia. Consensus changes were to use a forced air warmer on all dogs and measure rectal temperatures hourly post-operatively until temperature ≥37·5°C. After 1 month with the implemented changes, Audit 2 identified a significant reduction in the time to achieve a rectal temperature of ≥37·5°C, with 75% of dogs achieving this goal by 3·5 hours. The incidence of hypothermia at tracheal extubation remained high in Audit 2 (97·3% with a rectal temperature <37·5°C). CLINICAL SIGNIFICANCE: Post-operative hypothermia was improved through simple changes in practice, showing that clinical audit is a useful tool for monitoring post-operative hypothermia and improving patient care. Overall management of perioperative hypothermia could be further improved with earlier intervention.
OBJECTIVES: Use of clinical audits to assess and improve perioperative hypothermia management in client-owned dogs. METHODS: Two clinical audits were performed. In Audit 1 data were collected to determine the incidence and duration of perioperative hypothermia (defined as rectal temperatures <37·0°C). The results from Audit 1 were used to reach consensus on changes to be implemented to improve temperature management, including re-defining hypothermia as rectal temperature <37·5°C. Audit 2 was performed after 1 month with changes in place. RESULTS: Audit 1 revealed a high incidence of post-operative hypothermia (88·0%) and prolonged time periods (7·5 hours) to reach normothermia. Consensus changes were to use a forced air warmer on all dogs and measure rectal temperatures hourly post-operatively until temperature ≥37·5°C. After 1 month with the implemented changes, Audit 2 identified a significant reduction in the time to achieve a rectal temperature of ≥37·5°C, with 75% of dogs achieving this goal by 3·5 hours. The incidence of hypothermia at tracheal extubation remained high in Audit 2 (97·3% with a rectal temperature <37·5°C). CLINICAL SIGNIFICANCE: Post-operative hypothermia was improved through simple changes in practice, showing that clinical audit is a useful tool for monitoring post-operative hypothermia and improving patient care. Overall management of perioperative hypothermia could be further improved with earlier intervention.
Authors: Kaela L Navarro; Monika Huss; Jennifer C Smith; Patrick Sharp; James O Marx; Cholawat Pacharinsak Journal: ILAR J Date: 2021-12-31 Impact factor: 1.521