The effect of body temperature on perioperative bleedig in idiopatic adolescent scoliosis surgery

Aim: The aim of this study is to show that intraoperative blood loss is reduced compared to mild-moderate hypothermia in patients in whom intraoperative normothermia is maintained with multiple active warming devices. The secondary aim of this study is to show that the need for blood and blood products, the amount of drains, the length of stay in intensive care unit (ICU) and hospital, the rate of infection and complications will increase, the neuromonitoring, complete blood count (CBC), coagulation, arterial blood gas (ABG) values will deteriorate in the hypothermic group. Material and Method: Following the approval of the ethics committee and the consent of patients and their parents, 39 patients were randomly divided into two group as working group, which was heated by multiple active warming systems (multiple forced air warming, heat mattress, intravenous fluid warmer) and as control group, which was heated by a standard single forced air warming device. Intraoperative tympanic, esophageal, axillary body temperatures, pulse, mean arterial pressure, hourly gas values were recorded. At the end of the operation, the amount of total bleeding, blood and blood product, colloid, crystalloid used, duration of surgery, number and region of posterior instrumentation and extubation time were recorded. In the postoperative period, the amount from de drains, the blood and blood products used, the length of stay in the ICU and hospital, the developement of infection and complications were recorded. CBC and coagulation test results were recorded preoperatively and postoperatively on days 0, 1 and 2. Results: Among 39 patients, the mean body temperature of the multiple warming group was normothermic (36,680,18), whereas mild-moderate hypothermia (35,930,18) observed in the standard warming group (p=0,001). In the normothermic group (617285ml) the amount of intraoperative bleeding was lower than the control group (1120728ml, p=0,027). In normothermic group, the duration of surgery (p=0,025), extubation (p=0,015), length of hospital stay (p=0,002) was shorter and the amount of drain at postoperative 48th hour was lower (p=0,014). Length of stay in ICU is lower in normothermic group but not statistically significant (p=0,052). There was no difference between groups in the other parameters. Conclusion: It was found that maintaining intraoperative normothermia with multiple active warming systems is associated with decreased blood loss, surgical time, extubation time, postoperative 48th hour drains and shortened length of stay in hospital compared to hypothermia. The relationship between body temperature change and intraoperative tranfusion amount, CBC, ABG and neuromonitoring values could not be found.