What strategies reduce intraoperative hypothermia and why is this important?

• A. Use forced-air warming, warmed IV fluids, and OR ambient temperature management.
• B. Use cold IV fluids and lower room temperature to conserve energy.
• C. Omit warming devices; rely on patient warmth.
• D. Delay surgery until a new room is built.

Answer: (A)

Preventing intraoperative hypothermia hinges on counteracting heat loss with active warming and a warmer surrounding environment. The best approach combines forced-air warming, warming IV fluids, and keeping the operating room at a warmer temperature. Each element tackles heat loss in a different way: forced-air warming adds heat to the patient’s surface and core, reducing conductive and convective cooling and offsetting evaporative loss from exposed skin; warmed IV fluids replace cold circulating blood that would otherwise lower core temperature; and a warmer OR environment reduces heat loss to the surroundings. Together, they help maintain normothermia, which is crucial because hypothermia increases bleeding by impairing platelet function and coagulation, raises infection risk (including wound and systemic infections), causes shivering with increased oxygen demand and cardiovascular strain, and can prolong recovery. Using cold fluids or cooling the room, omitting warming devices, or delaying surgery to build a new room do not address the patient’s heat loss and would worsen outcomes.