MANAJEMEN HIPOTERMIA DALAM KEPERAWATAN PERIOPERATIF PADA PASIEN YANG MENJALANI PEMBEDAHAN ABDOMEN: A LITERATURE REVIEW
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https://doi.org/10.24843/coping.2021.v09.i05.p02
Abstrak
Hipotermia perioperatif didefinisikan sebagai kondisi suhu inti tubuh lebih rendah dari 36°C yang terjadi akibat respon dari induksi anestesi serta prosedur pembedahan. Pasien yang menjalani pembedahan abdomen merupakan salah satu populasi yang berisiko besar mengalami hipotermia perioperatif. Perawat mempunyai peran penting untuk melakukan intervensi manajemen hipotermia sehingga dapat mencegah terjadinya komplikasi lebih lanjut. Penelitian ini bertujuan untuk mengetahui jenis intervensi manajemen hipotermia dan gambaran penerapannya dalam keperawatan perioperatif pada pasien yang menjalani pembedahan abdomen. Rancangan penulisan yang digunakan yaitu literature review yang mencakup 10 literatur yang dicari menggunakan database PubMed, ProQuest, ScienceDirect dan Google scholar, dan diseleksi berdasarkan kriteria inklusi-eksklusi serta PRISMA flowchart. Hasil review menunjukan bahwa jenis intervensi yang dapat diberikan yaitu dengan metode penghangatan aktif dan penghangatan pasif. Metode penghangatan aktif meliputi pengaturan suhu ruang operasi, pemberian cairan yang dihangatkan, penggunaan alat forced air warming, circulating-water mattresses, resistive warming systems, self-warming blanket, dan humidification warming systems. Metode penghangatan pasif meliputi penggunaan selimut katun, surgical drapes dan pakaian yang terbuat dari reflective composite fabric. Perawat kamar bedah spesialisasi bedah abdomen memegang peranan penting dalam manajemen hipotermia secara aktif dan pasif dengan mempersiapkan alat pada tahap preoperatif dan memantau keefektifan intervensi selama intraoperatif dan pascaoperatif.
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Referensi
Ackermann, W., Fan, Q., Parekh, A. J., Stoicea, N., Ryan, J., & Bergese, S. D. (2018). Forced-air warming and resistive heating devices: Updated perspectives on safety and surgical site infections. Frontiers in Surgery, 5(64). doi: https://doi.org/10.3389/fsurg.2018.00064
Alparslan, V., Kus, A., Hosten, T., Ertargin, M., Ozdamar, D., Toker, K., & Solak, M. (2017). Comparison of forced-air warming systems in prevention of intraoperative hypothermia. Journal of Clinical Monitoring and Computing, 32(3), 343-349. doi: 10.1007/s10877-017-0017-z
Association of periOperative Registered Nurses. (2016). Guideline summary: prevention of unplanned patient hypothermia. AORN Journal, doi: https://doi.org/10.1016/j.aorn.2016.01.006
Burger, L., & Fitzpatrick, J. (2009). Prevention of inadvertent perioperative hypothermia. British Journal of Nursing, 18(18). doi: 10.12968/bjon.2009.18.18.44553
Braurer, A., Perl, T., Uyanik, Z., English, M. J. M., Weyland, W., & Braun, U. (2004). Perioperative thermal insulation: Minimal clinically important differences? British Journal of Anaesthesia, 92 (6). doi: 10.1093/bja/aeh156
Fadzlina, W., Nazaruddin, W., & Hardy, M. (2016). Passive warming using a heat-band versus a resistive heating blanket for the prevention of inadvertent perioperative hypothermia during laparotomy for gynaecological surgery. The Malaysian Journal of Medical Science, 23(2) 28-37. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976711/
Frey, J. M., Janson, M., Svanfeldt, M., Svenarud, P. K., & Van-der-Linden, J. A. (2012). Local insufflation of warm humidified CO2 increases open wound and core temperature during open colon surgery. Anesthesia & Analgesia, 115(5), 1204-1211. doi: 10.1213/ANE.0b013e31826ac49f
Giuliano, K.K., & Hendricks, J. (2017). Inadvertent perioperative hypothermia: Current nursing knowledge. AORN journal, 105(5), 453-463. doi: https://doi.org/10.1016/j.aorn.2017.03.003
Goyal, P., Kundra, S., Sharma, S., Grewal, A., Kaul, T. K., & Singh, M. R. (2011). Efficacy of intravenous fluid warming for maintenance of core temperature during lower segment cesarean section under spinal anesthesia. Journal of Obstetric Anaesthesia and Critical Care, 1(2), 73-77. doi: 10.4103/2249-4472.93990
Hart, S. R., Bordes, B., Hart, J., Corsino, D., & Harmon, D. (2011). Unintended perioperative hypothermia. The Ochsner Journal, 11(3), 259–270. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179201/
Hegarty, J., Walsh, E., Burton, A., Murphy, S., O’Gorman, F., & McPolin, G. (2009). Nurses knowledge of inadvertent hypothermia. AORN Journal, 89(4), 701-704, 707-713. doi: 10.1016/j.aorn.2008.09.003
Horn, E.P., Bein, B., Broch, O., Iden, T., Böhm, R., Latz, S.K., & Höcker, J. (2016). Warming before and after epidural block before general anaesthesia for major abdominal surgery prevents perioperative hypothermia: A randomised controlled trial. European Journal of Anaesthesiology, 33(5), 334-40. doi: 10.1097/EJA.0000000000000369.
Horosz, B., & Malec, M. M. (2013). Inadvertent intraoperative hypothermia. Anaesthesiol Intensive Therapy, 45(1), 38-43. doi: 10.5603/AIT.2013.0009
Knaepel, A. (2012). Inadvertent perioperative hypothermia: A literature review. Journal Perioperative Practice, 22(3), 86-90. doi: 10.1177/175045891202200302
Lee, Y., & Kim, K. (2021). Optimal application of forced air warming to prevent peri-operative hypothermia during abdominal surgery: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(5), doi: 10.3390/ijerph18052517
Moysés, A. M., Trettene, Armando. D. S., Navarro, L. H. C., & Ayres, J. A. (2014). Hypothermia prevention during surgery: Comparison between thermal mattress and thermal blanket. Revista da Escola de Enfermagem da USP, 48(2), 228-235. doi:https://dx.doi.org/10.1590/S0080-623420140000200005
National Institute for Health and Care Excellence. (2016). Clinical guideline of hypothermia: Prevention and management in adults having surgery. Retrieved from https://www.nice.org.uk/guidance/cg65/resources/hypothermia-prevention-and-management-in-adults-having-surgery-pdf-975569636293
Oshvandi, K., Shiri, F.H., Fazel, M.R., Safari, M., & Ravari, A. (2014). The effect of pre-warmed intravenous fluids on prevention of intraoperative hypothermia in cesarean section. Iranian Journal of Nursing and Midwifery Research, 19(1), 64-9. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917187/
Pearce, B., Mattheyse, L., Ellard, L., Desmond, F., Pillai, P., & Weinberg, L. (2018). Comparison of the warmcloud and bair hugger warming devices for the prevention of intraoperative hypothermia in patients undergoing orthotopic liver transplantation: A randomized clinical trial. Transplantation Direct, 4(4). doi: 10.1097/TXD.0000000000000775
Prado, C.B.C., Barichello, E., Pires, P.S., Haas, V.J., & Barbosa, M.H. (2015). Occurrence and factors associated with hypothermia during elective abdominal surgery. Acta Paulista de Enfermagem, 28(5), 475–481. doi: https://doi.org/10.1590/1982-0194201500079
Santos, R. M. S. F., Boin, I. F. S. F., Caruy, C. A. A., Cintra, E. A., Torres, N. A., & Duarte, H. N. (2019). Randomized clinical study comparing active heating methods for prevention of intraoperative hypothermia in gastroenterology. Revista Latino-Americana De Enfermagem, 27. doi: http://dx.doi. org/10.1590/1518-8345.2589.3103
Seyed, N. L. F., Mohammad, R. A., Amir, E. Z., Aria, S., & Farshad, H. K. (2016) Inadvertent perioperative hypothermia: A literature review of an old overlooked problem. Acta Facultatis Medicae Naissensis, 33(1), 5-11. doi: 10.1515/afmnai-2016-0001
Shaw, C. A., Steelman, V. M., DeBerg, J., & Schweizer, M. L. (2017). Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: A systematic review and meta-analysis of randomized controlled trials. Journal of clinical anesthesia, 38, 93–104. doi: https://doi.org/10.1016/j.jclinane.2017.01.005
Shenoy, L., Krishna, H. M., Kalyan, N., & Prasad, K. H. (2019). A prospective comparative study between prewarming and cowarming to prevent intraoperative hypothermia. Journal of Anaesthesiology Clinical Pharmacology, 35(2), 231-235. doi: 10.4103/joacp.JOACP_353_17
Soysal, G. E., Ilce, A., & Erkol, M. H. (2018). Effect of ‘‘an innovative technology’’ active warming and passive warming on unplanned hypothermia during perioperative period: A clinical trial. Therapeutic Hypothermia and Temperature Management, 8(4), 216-224. doi: 10.1089/ther.2017.0048
Thapa, H. P., Kerton, A. J., & Peyton, P. J. (2019). Comparison of the easywarm® self-heating blanket with the cocoon forced-air warming blanket in preventing intraoperative hypothermia. Anaesthesia and Intensive Care, 47(2), 169-174. doi: 10.1177/0310057X19840264
Torossian, A., Van-Gerven, E., Geertsen, K., Horn, B., Van-deVelde, M., & Raeder, J. (2016). Active perioperative patient warming using a self-warming blanket (BARRIER® EasyWarm®) is superior to passive thermal insulation: A multinational, multicenter, randomized trial. Journal of Clinical Anesthesia, 34, 547–554. doi: https://doi.org/10.1016/j.jclinane.2016.06.030
Weinberg, L., Huang, A., Alban, D., Jones, R., Story, D., McNicol, L., & Pearce, B. (2017). Prevention of hypothermia in patients undergoing orthotopic liver transplantation using the humigard® open surgery humidification system: A prospective randomized pilot and feasibility clinical trial. BMC surgery, 17(1). doi: https://doi.org/10.1186/s12893-017-0208-z
Wittenborn, J., Clausen, A., Zeppernick, F., Stickeler, E., & Heerlein, I. V. (2019). Prevention of intraoperative hypothermia in laparoscopy by the use of body-temperature and humidified CO2: A pilot study. Geburtshilfe und Frauenheilkunde 79(9). doi: https://doi.org/10.1055/a-0903-2638
Yasar, P.O., Uzumcugil, F., Pamuk, A.G., & Kanbak, M. (2021). Comparison of combined forced-air warming and circulating-water-mattress and forced-air warming alone in patients undergoing open abdominal surgery in lithotomy position: A randomized controlled trial. Indian Journal of Surgery. doi: https://doi.org/10.1007/s12262-021-02829-8
Zaman, S. S., Rahmani, F., Majedi, M. A., Roshani, D., & Valiee, S. (2017). A clinical trial of the effect of warm intravenous fluids on core temperature and shivering in patients undergoing abdominal surgery. Journal of PeriAnesthesia Nursing, 33(5), 616-625. doi:http://dx.doi.org/10.1016/j.jopan.2016.12.010
Alparslan, V., Kus, A., Hosten, T., Ertargin, M., Ozdamar, D., Toker, K., & Solak, M. (2017). Comparison of forced-air warming systems in prevention of intraoperative hypothermia. Journal of Clinical Monitoring and Computing, 32(3), 343-349. doi: 10.1007/s10877-017-0017-z
Association of periOperative Registered Nurses. (2016). Guideline summary: prevention of unplanned patient hypothermia. AORN Journal, doi: https://doi.org/10.1016/j.aorn.2016.01.006
Burger, L., & Fitzpatrick, J. (2009). Prevention of inadvertent perioperative hypothermia. British Journal of Nursing, 18(18). doi: 10.12968/bjon.2009.18.18.44553
Braurer, A., Perl, T., Uyanik, Z., English, M. J. M., Weyland, W., & Braun, U. (2004). Perioperative thermal insulation: Minimal clinically important differences? British Journal of Anaesthesia, 92 (6). doi: 10.1093/bja/aeh156
Fadzlina, W., Nazaruddin, W., & Hardy, M. (2016). Passive warming using a heat-band versus a resistive heating blanket for the prevention of inadvertent perioperative hypothermia during laparotomy for gynaecological surgery. The Malaysian Journal of Medical Science, 23(2) 28-37. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976711/
Frey, J. M., Janson, M., Svanfeldt, M., Svenarud, P. K., & Van-der-Linden, J. A. (2012). Local insufflation of warm humidified CO2 increases open wound and core temperature during open colon surgery. Anesthesia & Analgesia, 115(5), 1204-1211. doi: 10.1213/ANE.0b013e31826ac49f
Giuliano, K.K., & Hendricks, J. (2017). Inadvertent perioperative hypothermia: Current nursing knowledge. AORN journal, 105(5), 453-463. doi: https://doi.org/10.1016/j.aorn.2017.03.003
Goyal, P., Kundra, S., Sharma, S., Grewal, A., Kaul, T. K., & Singh, M. R. (2011). Efficacy of intravenous fluid warming for maintenance of core temperature during lower segment cesarean section under spinal anesthesia. Journal of Obstetric Anaesthesia and Critical Care, 1(2), 73-77. doi: 10.4103/2249-4472.93990
Hart, S. R., Bordes, B., Hart, J., Corsino, D., & Harmon, D. (2011). Unintended perioperative hypothermia. The Ochsner Journal, 11(3), 259–270. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179201/
Hegarty, J., Walsh, E., Burton, A., Murphy, S., O’Gorman, F., & McPolin, G. (2009). Nurses knowledge of inadvertent hypothermia. AORN Journal, 89(4), 701-704, 707-713. doi: 10.1016/j.aorn.2008.09.003
Horn, E.P., Bein, B., Broch, O., Iden, T., Böhm, R., Latz, S.K., & Höcker, J. (2016). Warming before and after epidural block before general anaesthesia for major abdominal surgery prevents perioperative hypothermia: A randomised controlled trial. European Journal of Anaesthesiology, 33(5), 334-40. doi: 10.1097/EJA.0000000000000369.
Horosz, B., & Malec, M. M. (2013). Inadvertent intraoperative hypothermia. Anaesthesiol Intensive Therapy, 45(1), 38-43. doi: 10.5603/AIT.2013.0009
Knaepel, A. (2012). Inadvertent perioperative hypothermia: A literature review. Journal Perioperative Practice, 22(3), 86-90. doi: 10.1177/175045891202200302
Lee, Y., & Kim, K. (2021). Optimal application of forced air warming to prevent peri-operative hypothermia during abdominal surgery: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(5), doi: 10.3390/ijerph18052517
Moysés, A. M., Trettene, Armando. D. S., Navarro, L. H. C., & Ayres, J. A. (2014). Hypothermia prevention during surgery: Comparison between thermal mattress and thermal blanket. Revista da Escola de Enfermagem da USP, 48(2), 228-235. doi:https://dx.doi.org/10.1590/S0080-623420140000200005
National Institute for Health and Care Excellence. (2016). Clinical guideline of hypothermia: Prevention and management in adults having surgery. Retrieved from https://www.nice.org.uk/guidance/cg65/resources/hypothermia-prevention-and-management-in-adults-having-surgery-pdf-975569636293
Oshvandi, K., Shiri, F.H., Fazel, M.R., Safari, M., & Ravari, A. (2014). The effect of pre-warmed intravenous fluids on prevention of intraoperative hypothermia in cesarean section. Iranian Journal of Nursing and Midwifery Research, 19(1), 64-9. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917187/
Pearce, B., Mattheyse, L., Ellard, L., Desmond, F., Pillai, P., & Weinberg, L. (2018). Comparison of the warmcloud and bair hugger warming devices for the prevention of intraoperative hypothermia in patients undergoing orthotopic liver transplantation: A randomized clinical trial. Transplantation Direct, 4(4). doi: 10.1097/TXD.0000000000000775
Prado, C.B.C., Barichello, E., Pires, P.S., Haas, V.J., & Barbosa, M.H. (2015). Occurrence and factors associated with hypothermia during elective abdominal surgery. Acta Paulista de Enfermagem, 28(5), 475–481. doi: https://doi.org/10.1590/1982-0194201500079
Santos, R. M. S. F., Boin, I. F. S. F., Caruy, C. A. A., Cintra, E. A., Torres, N. A., & Duarte, H. N. (2019). Randomized clinical study comparing active heating methods for prevention of intraoperative hypothermia in gastroenterology. Revista Latino-Americana De Enfermagem, 27. doi: http://dx.doi. org/10.1590/1518-8345.2589.3103
Seyed, N. L. F., Mohammad, R. A., Amir, E. Z., Aria, S., & Farshad, H. K. (2016) Inadvertent perioperative hypothermia: A literature review of an old overlooked problem. Acta Facultatis Medicae Naissensis, 33(1), 5-11. doi: 10.1515/afmnai-2016-0001
Shaw, C. A., Steelman, V. M., DeBerg, J., & Schweizer, M. L. (2017). Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: A systematic review and meta-analysis of randomized controlled trials. Journal of clinical anesthesia, 38, 93–104. doi: https://doi.org/10.1016/j.jclinane.2017.01.005
Shenoy, L., Krishna, H. M., Kalyan, N., & Prasad, K. H. (2019). A prospective comparative study between prewarming and cowarming to prevent intraoperative hypothermia. Journal of Anaesthesiology Clinical Pharmacology, 35(2), 231-235. doi: 10.4103/joacp.JOACP_353_17
Soysal, G. E., Ilce, A., & Erkol, M. H. (2018). Effect of ‘‘an innovative technology’’ active warming and passive warming on unplanned hypothermia during perioperative period: A clinical trial. Therapeutic Hypothermia and Temperature Management, 8(4), 216-224. doi: 10.1089/ther.2017.0048
Thapa, H. P., Kerton, A. J., & Peyton, P. J. (2019). Comparison of the easywarm® self-heating blanket with the cocoon forced-air warming blanket in preventing intraoperative hypothermia. Anaesthesia and Intensive Care, 47(2), 169-174. doi: 10.1177/0310057X19840264
Torossian, A., Van-Gerven, E., Geertsen, K., Horn, B., Van-deVelde, M., & Raeder, J. (2016). Active perioperative patient warming using a self-warming blanket (BARRIER® EasyWarm®) is superior to passive thermal insulation: A multinational, multicenter, randomized trial. Journal of Clinical Anesthesia, 34, 547–554. doi: https://doi.org/10.1016/j.jclinane.2016.06.030
Weinberg, L., Huang, A., Alban, D., Jones, R., Story, D., McNicol, L., & Pearce, B. (2017). Prevention of hypothermia in patients undergoing orthotopic liver transplantation using the humigard® open surgery humidification system: A prospective randomized pilot and feasibility clinical trial. BMC surgery, 17(1). doi: https://doi.org/10.1186/s12893-017-0208-z
Wittenborn, J., Clausen, A., Zeppernick, F., Stickeler, E., & Heerlein, I. V. (2019). Prevention of intraoperative hypothermia in laparoscopy by the use of body-temperature and humidified CO2: A pilot study. Geburtshilfe und Frauenheilkunde 79(9). doi: https://doi.org/10.1055/a-0903-2638
Yasar, P.O., Uzumcugil, F., Pamuk, A.G., & Kanbak, M. (2021). Comparison of combined forced-air warming and circulating-water-mattress and forced-air warming alone in patients undergoing open abdominal surgery in lithotomy position: A randomized controlled trial. Indian Journal of Surgery. doi: https://doi.org/10.1007/s12262-021-02829-8
Zaman, S. S., Rahmani, F., Majedi, M. A., Roshani, D., & Valiee, S. (2017). A clinical trial of the effect of warm intravenous fluids on core temperature and shivering in patients undergoing abdominal surgery. Journal of PeriAnesthesia Nursing, 33(5), 616-625. doi:http://dx.doi.org/10.1016/j.jopan.2016.12.010
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2021-10-30
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PRATIWI, Ni Komang Dewi Trisia; RAYA, Nyoman Agus Jagat; PUSPITA, Luh Mira.
MANAJEMEN HIPOTERMIA DALAM KEPERAWATAN PERIOPERATIF PADA PASIEN YANG MENJALANI PEMBEDAHAN ABDOMEN: A LITERATURE REVIEW.
Coping: Community of Publishing in Nursing, [S.l.], v. 9, n. 5, p. 497-506, oct. 2021.
ISSN 2715-1980.
Tersedia pada: <http://103.29.196.112/index.php/coping/article/view/74560>. Tanggal Akses: 04 mar. 2026
doi: https://doi.org/10.24843/coping.2021.v09.i05.p02.
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