Characteristics and Risk Factors of Inadvertent Intraoperative Hypothermia in Pediatric Surgery: A Study in Zhejiang Province, China

Background: This study aims to explore the characteristics and risk factors of inadvertent intraoperative hypothermia (IIH) in pediatric surgical patients. Methods: Data from 291 pediatric surgical patients were retrospectively analyzed. Demographic and surgical data were collected. Intraoperative nasopharyngeal temperature was recorded as the core temperature. Patients were divided into two groups: The hypothermic group (core temperature < 36℃) and the normothermic group (core temperature ≥ 36℃). This study included 291 pediatric patients who underwent pediatric surgery at our center between January 2020 and June 2020. A logistic regression model was used to compare 17 parameters between the two groups. Subgroup analyses were conducted for neonates and infants (0 - 1 year) and older children (> 1 year). Results: Among 291 pediatric patients, 73.5% experienced intraoperative hypothermia, mostly mild. In neonates and infants, younger age (OR = 0.88, P = 0.031) and longer preoperative preparation (OR = 1.03, P = 0.050) were associated with a higher risk. In older children, male sex (OR = 7.06, P = 0.001), supine (OR = 5.53, P = 0.017) or lateral position (OR = 5.94, P = 0.033), level 4 surgery (OR = 12.15, P = 0.001), laparotomy (OR = 5.71, P = 0.037), and lower weight for age Z-score (WAZ) (OR = 0.48, P = 0.008) were significant risk factors. Conclusions: Pediatric surgical patients are at high risk of IIH. Factors such as gender, age, WAZ, surgical position, surgical levels, surgical types, and preparation duration were related to IIH. Risk factors of IIH varied by age groups. Targeted interventions are needed to reduce the incidence of IIH among pediatric patients.