Risk Factors for Intraoperative Hypothermia in Pediatric Burn Surgery: A Single-Center University Hospital Experience.

Abstract

Burns are a significant cause of morbidity and mortality in children, ranking third among the causes of injury-related deaths. Maintaining body temperature in burn patients is challenging, with the literature reporting an incidence of hypothermia up to 60%. This study aimed to determine the incidence and independent risk factors of intraoperative hypothermia in pediatric burn surgery. This retrospective observational cohort study included pediatric burn patients who underwent surgery in the pediatric surgery operating room between January 2016 and December 2019, comprising 396 procedures. Hypothermia was defined as a decrease in body temperature to below 36°C. The patients were divided into two groups: Group I (body temperature below 36°C) and Group II (body temperature ≥ 36°C). The study included patients with a median age of 30 months (1-204), and 57.3% were male. The hypothermia group exhibited a higher burn degree (25.3% vs. 10.7%, p < 0.001) and a higher percentage (10 [2-65] vs 6 [2-60], p < 0.001). Hypothermia was significantly higher in patients with flame burns than in those with scald burns (p < 0.001) and higher in the intratracheal general anesthesia group than in the laryngeal mask and mask/sedation groups (p < 0.001). Multivariable logistic regression analysis demonstrated that female gender (odds ratio [OR]: 3.358, p = 0.013), higher American Society of Anesthesiologists (ASA) score (OR: 3.440, p = 0.032), presence of a flame burn (OR: 5.685, p = 0.003), and prolonged duration of anesthesia (OR: 1.011, p = 0.022) were all independent risk factors for hypothermia. In our patient cohort, a high rate of intraoperative hypothermia (38.9%) was identified in pediatric burn patients. Female gender, higher ASA score, presence of a flame burn, and prolonged duration of anesthesia were all independent risk factors for hypothermia.