ArticleTherapeutics and clinical risk management2025
The Effect of Induced Hypothermia on Postoperative Outcomes Following Hyperthermic Intraperitoneal Chemotherapy: A Negative Finding.
Article in Therapeutics and clinical risk management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The optimal strategy for body temperature management during cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial. This study aimed to assess whether intentionally cooling the core body temperature (CBT) to hypothermia (<35°C) before the HIPEC phase improves postoperative outcomes. Patients and Methods: In this retrospective cohort study, we analyzed 73 patients who underwent CRS plus HIPEC, grouped by CBT immediately before HIPEC: CBT ≥ 35°C (n=51) and CBT < 35°C (n=22). Primary outcomes including time to extubation and Clavien-Dindo classification. Secondary outcomes including length of stay (LOS), ICU stay, postoperative acute kidney injury (AKI) and reintubation event. Intraoperative parameters such as hemodynamic status, blood loss, transfusion requirements, and intravenous (IV) fluid amount were also compared. Results: Compared to the normothermia group, patients in the hypothermia group had significantly longer time to extubation (median 11.5 vs 8.0 hours, p = 0.0314), greater blood loss (median 350 vs 150 mL, p = 0.0045), higher leukocyte-poor red blood cells transfusion units (p = 0.0016) and increased total IV fluid amount (p = 0.0049). Delayed extubation, defined as occurring more than 12 hours after surgery, appeared to be independently associated with hypothermia (odds ratio [OR] 6.31, 95% confidence interval [CI] 1.11-35.70, Conclusion: Actively inducing hypothermia before the HIPEC phase did not demonstrate improved postoperative outcomes and may be associated with delayed extubation, greater blood loss, higher transfusion requirements, and increased IV fluid administration.
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