Eur J Pediatr Surg 2012; 22(01): 045-049
DOI: 10.1055/s-0031-1284360
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Core Temperature Falls during Laparotomy in Infants with Necrotizing Enterocolitis

R. Sim
1  Institute of Child Health, Surgery Unit, London, United Kingdom
,
N.J. Hall
2  Great Ormond Street Hospital and UCL Institute of Child Health, Surgery, London, United Kingdom
,
P. de Coppi
2  Great Ormond Street Hospital and UCL Institute of Child Health, Surgery, London, United Kingdom
,
S. Eaton
3  UCL Institute of Child Health, Paediatric Surgery, London, United Kingdom
,
A. Pierro
4  UCL Institute of Child Health, Surgery Unit, London, United Kingdom
› Author Affiliations
Further Information

Publication History

15 May 2011

24 June 2011

Publication Date:
29 September 2011 (online)

Abstract

Aim of the study Intraoperative hypothermia may have a detrimental clinical effect. Preterm infants undergoing laparotomy for necrotizing enterocolitis (NEC) are particularly at risk. We investigated the relationship between intraoperative temperature and morbidity and outcome in infants with NEC.

Methods A review of all laparotomies for NEC (n = 82, 69 infants) performed between Jan 2008 and Jan 2011 in our institution was done. Relationships between intraoperative temperature and intra- and postoperative fluid and blood product requirements, postoperative clinical status (sequential organ failure assessment [SOFA] score) and outcome were determined. Data (mean [range]) were compared using paired t-test and regression analysis.

Results Data were available for 52 laparotomies (49 infants). The lowest intraoperative core temperature was significantly lower than the preoperative temperature (peri-op 34.9°C [31.5–37.0] vs. pre-op 37.0° C [35.8–38.0]; p < 0.0001). There was a statistically significant inverse relationship between mean intraoperative temperature and intraoperative blood transfusion requirement (p = 0.01). There were no statistically significant relationships between intraoperative temperature and other blood product or volume requirements, postoperative infective complications, change in SOFA score following surgery, length of stay, or mortality.

Conclusions During laparotomy for NEC, there is a significant and profound drop in core temperature. The effect of this on short-term morbidity and long-term outcome (e.g., neurodevelopment) warrants further investigation.