Effects of multi-modal temperature intervention measures on perioperative hypothermia in patients undergoing orthotopic liver transplantation

Objective To investigate the effects of multi-modal temperature intervention measures on perioperative hypothermia in the patients undergoing orthotopic liver transplantation (LT). Methods One hundred and twenty patients who underwent orthotopic LT in the Third Affiliated Hospital of Sun Yat-sen University between June 2014 and October 2016 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 93 cases were males and 27 were females, aged 31-70 years old with a median age of 55 years old. According to the sequencing of the operation time, the patients were randomly divided into the multi-modal temperature intervention group (multi-modal group, n=63) and regular temperature group (control group, n=57) with the method of computer generated random number. All patients in two groups underwent classical non-bypass orthotopic LT under endotracheal general anesthesia. The temperature, liver and renal function during the perioperative period in two groups were compared using independent sample t test. Results The temperature at the anhepatic stage, 4 h of reperfusion stage and postoperative 72 h in the multi-modal group was respectively (34.5±0.7)℃, (35.6±0.7)℃ and (36.2±0.8)℃, significantly higher than (33.6±0.4)℃, (34.7±0.3)℃ and (35.6±0.6)℃ in the control group (t=6.60, 7.24, 18.68; P<0.05). The uring volume at postoperative 8, 16 and 24 h in the multi-modal group was respectively (72±16), (77±20) and (77±22) ml/h, significantly more than (50±14), (52±17) and (60±17) ml/h in the control group (t=9.24, 13.37, 16.79; P<0.05). The serum Scr and PT levels at postoperative 8, 16 and 24 h in the multi-modal group were respectively (80±19), (92±20), (115±21) μmol/L and (17.1±2.5), (17.1±4.0) and (17.1±1.5) s, significantly lower than (99±29), (105±24), (130±25) μmol/L and (22.6±2.8), (21.4±3.2), (19.5±2.3) s in the control group (t=-7.29, -11.97, -15.58 and -23.21, -11.26, -9.83; P<0.05). Conclusions For the orthotopic LT patients, multi-modal temperature intervention measures can reduce the incidence of perioperative hypothermia and accelerate the recovery of liver and renal function. Key words: Liver transplantation; Body temperature; Perioperative care