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Hypothermia and Prolonged Time From Procedure End to Extubation After Endovascular Thoracic Aortic Surgery

Published:September 11, 2022DOI:https://doi.org/10.1053/j.jvca.2022.09.077

      Objective

      Perioperative hypothermia (core temperature <36°C) occurs in 50%-to-80% of patients recovering from thoracic aortic surgery, though its effects have not been described fully in this context. The authors, therefore, sought to characterize the incidence of perioperative hypothermia and its association with time from procedure end to extubation in endovascular aortic surgical patients.

      Design

      A retrospective cohort study.

      Setting

      At a single academic tertiary center.

      Participants

      Patients recovering from thoracic aortic surgery with lumbar drains.

      Intervention

      None.

      Measurements and Main Results

      A total of 196 patients were included in this study, 55 of whom were hypothermic with temperatures <35.0°C at the end of surgery. Though the unadjusted time to extubation was not statistically different in the hypothermic group (median 8 minutes, IQR 5-13.5 minutes) compared to the normothermic group (median 7 minutes, IQR 4-12 minutes; p = 0.062), multivariate predictors of increased time from procedure end to extubation included hypothermia (p = 0.011), age (p = 0.009), diabetes (p = 0.015), history of carotid disease (p = 0.040), and crystalloid volume (p = 0.019).

      Conclusions

      Hypothermia in patients recovering from endovascular aortic surgery was associated with prolonged time from procedure end to extubation. Because of the retrospective observational nature of the authors’ analysis, it was not possible to determine the extent to which prolonged mechanical ventilation was influenced by low temperature.

      Key Words

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      Linked Article

      • Earlier studies of prolonged times to tracheal extubation after end of surgery
        Journal of Cardiothoracic and Vascular Anesthesia
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          Arora and colleagues examined time to extubation after thoracic aortic surgery.1 In their very interesting study, they found negligible differences in median times to extubation between normothermic patients (7 minutes [95% confidence interval (CI) 6-to-8 minutes]) versus hypothermic patients (8 minutes [95% confidence interval 7-to-12 minutes]).1 There were significantly greater incidences of prolonged times to extubation among hypothermic patients (hazard ratio 2.06 [95% confidence interval 1.18-to-3.59]).
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