Abstract
Background Hemostasis in neurosurgery is crucial to patient and surgery outcomes, with many
techniques developed for this. One area that is not appropriately characterized despite
continuous anecdotal evidence the temperature of the irrigation fluid (IF) used and
its effects on stemming hemorrhages. Given the ubiquitous use of IF in neurosurgery
for clearing blood from the surgical field, it is important to explore its role as
a hemostat and whether or not the temperature of the IF influences its hemostatic
capacity. This review explored the literature for an optimal IF temperature for hemostasis
in neurosurgery.
Methods Database searches were conducted using MEDLINE, Scopus, Web of Science, and CINAHL,
with citation chaining occurring where applicable. Standard terms around neurosurgery,
hemostasis, and irrigation were used.
Results Seven articles were identified. No optimal temperature for hemostasis could be confidently
synthesized from the literature owing to lack of primary investigation on the subject.
After collating available information into common themes, it is suggested that that
temperatures >38°C are preferred.
Conclusion The literature in this area is limited. Despite a lack of applicable systematic investigation
on the topic, by exploring the physiology of hemostasis and IF, best practice guidelines
for IF, and the literature on the role of the temperature of IF in other surgical
specialties, it is suggested that a temperature in the range of 38 to 40°C would be
most applicable to a value optimal for neurosurgery.
Keywords
neurosurgery - irrigation fluid - temperature - hemostasis
