Mild hypothermia does not increase blood loss during total hip arthroplasty

Acta Anaesthesiol Scand. 1999 Nov;43(10):1005-10. doi: 10.1034/j.1399-6576.1999.431006.x.

Abstract

Background: The effects of mild hypothermia on blood loss are little known.

Methods: Patients, undergoing primary prosthetic hip surgery under spinal anaesthesia, were randomised to the operative procedure, with (n=25) or without (n=25) forced air warming. Core temperature was repeatedly measured from the tympanic membrane. The blood loss was calculated by three different methods; the intraoperative loss was estimated visually. The loss during and after the operation was obtained by determination of lost haemoglobin (the Hb-method). The blood loss during hospital stay was also calculated from the haemoglobin balance.

Results: Among controls, core temperature decreased by 1.3+/-0.6 degrees C (mean+/-SD) and in the warmed patients 0.5+/-0.4 degrees C (P<0.0001). Preoperative variables and the number of allogeneic units transfused did not differ between the groups. In controls, the blood loss during operation was, with the visual method, 698+/-314 ml, compared with 665+/-292 ml in warmed patients. With the Hb-method, the loss was 662+/-319 and 657+/-348 ml, respectively. With this method, the external loss during the entire hospital stay was, in controls, 1066+/-441 ml and in the warmed group, 1047+/-413 ml. The balance method yielded 1674+/-646 ml and 1507+/-652 ml, respectively. Indices of blood loss did not differ significantly between groups and there was no covariation between those variables and the decrease in core temperature.

Conclusions: Forced air warming did not decrease the blood loss. Methods for determination of blood loss yielded widely differing results.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anesthesia, Spinal
  • Arthroplasty, Replacement, Hip*
  • Blood Loss, Surgical*
  • Blood Transfusion
  • Body Temperature*
  • Female
  • Hemoglobins / analysis
  • Humans
  • Hypothermia / physiopathology*
  • Intraoperative Complications / physiopathology
  • Male

Substances

  • Hemoglobins