Analysis of the characteristic patterns and risk factors impacting the severity of intraoperative hypothermia in neonates

Background: Although maintaining a stable body temperature during the perioperative period is crucial for the recovery of neonates, hypothermia frequently occurs during surgical procedures in this vulnerable population. A comprehensive analysis of intraoperative details, including medical history and monitoring, is therefore essential for understanding temperature variations and identifying risk factors for severe hypothermia.

Objective: In this study, we delineated the characteristic patterns of intraoperative temperature fluctuations in neonates and determined the risk factors impacting the severity of hypothermia.

Methods: We conducted a retrospective, single-center study, enrolling 648 subjects who underwent surgery under general anesthesia and collected demographic, perioperative, and intraoperative data.

Results: Intraoperative hypothermia occurred in 79.17% of the neonates. Significant risk factors for severe hypothermia included surgery type (OR, 1.183; 95%, CI [1.028-1.358]; p = 0.018), preoperative weight (OR, 0.556; 95% CI [0.412-0.748]; p < 0.01), infusion and transfusion volume (mL/kg) (OR, 1.011; 95% CI [1.001-1.022]; p = 0.018), and duration of hypothermia (OR, 1.011; 95% CI [1.007-1.014]; p < 0.01). Preterm neonates experienced a greater temperature drop than did full-term neonates. The nadir of intraoperative temperature occurred approximately 90 min after surgery, followed by a brief stabilization period and a slow recovery process.

Conclusion: The significant incidence of intraoperative hypothermia in neonates highlights the need for efficient strategies that reduce both the frequency and severity of this condition.