A clinical audit cycle of post-operative hypothermia in dogs.

Autor: Rose N; Western Veterinary Specialist and Emergency Centre, Calgary, Alberta T3C 0J8, Canada., Kwong GP; Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada., Pang DS; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta T2N 4N1, Canada.; Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada.
Jazyk: angličtina
Zdroj: The Journal of small animal practice [J Small Anim Pract] 2016 Sep; Vol. 57 (9), pp. 447-52.
DOI: 10.1111/jsap.12547
Abstrakt: Objectives: Use of clinical audits to assess and improve perioperative hypothermia management in client-owned dogs.
Methods: Two clinical audits were performed. In Audit 1 data were collected to determine the incidence and duration of perioperative hypothermia (defined as rectal temperatures <37·0°C). The results from Audit 1 were used to reach consensus on changes to be implemented to improve temperature management, including re-defining hypothermia as rectal temperature <37·5°C. Audit 2 was performed after 1 month with changes in place.
Results: Audit 1 revealed a high incidence of post-operative hypothermia (88·0%) and prolonged time periods (7·5 hours) to reach normothermia. Consensus changes were to use a forced air warmer on all dogs and measure rectal temperatures hourly post-operatively until temperature ≥37·5°C. After 1 month with the implemented changes, Audit 2 identified a significant reduction in the time to achieve a rectal temperature of ≥37·5°C, with 75% of dogs achieving this goal by 3·5 hours. The incidence of hypothermia at tracheal extubation remained high in Audit 2 (97·3% with a rectal temperature <37·5°C).
Clinical Significance: Post-operative hypothermia was improved through simple changes in practice, showing that clinical audit is a useful tool for monitoring post-operative hypothermia and improving patient care. Overall management of perioperative hypothermia could be further improved with earlier intervention.
(© 2016 British Small Animal Veterinary Association.)
Databáze: MEDLINE
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