Profil keselamatan pasien dalam penggunaan irigasi hangat perioperatif: A literature review
DOI: https://doi.org/10.33024/hjk.v19i5.1153
Hipotermia Irigasi Hangat Perioperative Keselamatan Pasien
Abstract
Background: Perioperative hypothermia (core temperature < 36 °C) is a frequent complication during surgery and is associated with adverse outcomes such as myocardial ischemia, coagulopathy, surgical site infections, and delayed recovery. One of the contributing factors is the use of large volumes of room-temperature irrigation fluids. Warming irrigation fluids is a simple and effective strategy to maintain perioperative normothermia, but its implementation requires a thorough understanding of patient safety profiles to ensure safe and optimal practice.
Purpose: To analyze the patient safety profile in the use of perioperative warm irrigation.
Method: A literature review was conducted on relevant literature to analyze the effectiveness and safety profile of perioperative warmed irrigation fluids. The reviewed literature included clinical studies and research discussing the use of warmed irrigation fluids in various surgical procedures, focusing on hypothermia prevention, patient thermal comfort, and safety aspects. Data were analyzed descriptively to identify key findings regarding effectiveness, safety profile, and clinical practice recommendations.
Results: Evidence from various clinical studies shows that warmed irrigation fluids improve thermal comfort, reduce the incidence of hypothermia and shivering, and support patient safety. The effectiveness is particularly notable in endoscopic and urologic procedures, and can be enhanced when combined with warmed intravenous fluids. However, the added value of combining multiple warming strategies in short-duration surgeries remains unclear. Importantly, the use of warmed irrigation fluids has not been linked to increased postoperative complications.
Conclusion: Warmed irrigation fluids demonstrate an excellent safety profile when implemented optimally. Optimal implementation requires consistent temperature control, reliable warming equipment, and adherence to safety protocols. Further standardization of safety protocols and healthcare professional training in intraoperative fluid warming practices is needed to optimize patient safety outcomes and ensure safe implementation across various clinical settings.
Keywords: Hypothermia; Patient Safety; Perioperative Warm Irrigation.
Pendahuluan: Hipotermia perioperatif (suhu inti tubuh < 36 °C) merupakan komplikasi yang sering terjadi selama pembedahan dan berhubungan dengan berbagai efek merugikan, seperti iskemia miokard, gangguan koagulasi, infeksi luka operasi, serta pemulihan yang tertunda. Salah satu faktor yang berkontribusi adalah penggunaan cairan irigasi dalam volume besar dengan suhu ruang. Pemanasan cairan irigasi merupakan strategi yang sederhana dan efektif untuk mempertahankan normotermia selama perioperatif.
Tujuan: Untuk menganalisis profil keselamatan pasien dalam penggunaan irigasi hangat perioperative.
Metode: Tinjauan naratif dilakukan terhadap literatur yang relevan untuk menganalisis efektivitas dan profil keselamatan penggunaan cairan irigasi hangat perioperatif. Literatur yang dikaji mencakup studi klinis dan penelitian yang membahas penggunaan cairan irigasi hangat dalam berbagai prosedur pembedahan, dengan fokus pada pencegahan hipotermia, kenyamanan termal pasien, dan aspek keselamatan. Data dianalisis secara deskriptif untuk mengidentifikasi temuan utama terkait efektivitas, profil keselamatan, dan rekomendasi praktik klinis.
Hasil: Bukti dari berbagai studi klinis menunjukkan bahwa cairan irigasi hangat meningkatkan kenyamanan termal, menurunkan kejadian hipotermia dan menggigil, serta mendukung keselamatan pasien. Efektivitasnya sangat menonjol pada prosedur endoskopi dan urologi, dan dapat ditingkatkan dengan kombinasi infus intravena hangat. Namun, manfaat tambahan dari penggabungan beberapa metode pemanasan pada pembedahan berdurasi pendek masih belum jelas. Penting untuk dicatat bahwa penggunaan cairan irigasi hangat tidak dikaitkan dengan peningkatan komplikasi pascaoperasi.
Simpulan: Cairan irigasi hangat menunjukkan profil keselamatan yang sangat baik. Ketika diimplementasikan secara optimal membutuhkan kontrol suhu yang konsisten, peralatan pemanas yang andal, serta kepatuhan terhadap protokol. Standarisasi lebih lanjut dalam praktik pemanasan cairan intraoperatif diperlukan untuk mengoptimalkan luaran pasien.
Kata Kunci: Hipotermia; Irigasi Hangat Perioperative; Keselamatan Pasien.
Downloads
References
Azhar, F., Dyer, J. E., & Clarke, L. (2019). Is it necessary to use forced air warming in core endourological procedures where warmed intravenous and irrigation fluids are routinely used? Journal of Clinical Urology, 12(5).
Billeter, A. T., Hohmann, S. F., Druen, D., Cannon, R., & Polk, H. C. (2014). Unintentional perioperative hypothermia is associated with severe complications and high mortality in elective operations. Surgery, 156(5), 1245–1252.
Bindu, B., Bindra, A., & Rath, G. (2017). Temperature management under general anesthesia: Compulsion or option. In Journal of Anaesthesiology Clinical Pharmacology (Vol. 33, Issue 3).
Campbell, G., Alderson, P., Smith, A. F., & Warttig, S. (2015). Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia. Cochrane Database of Systematic Reviews, 2015(4).
Cho, J., Lee, J. M., Kim, K. M., Yon, J. H., Lee, H. S., & Jun, I. J. (2024). Effect of 10 Minutes of Prewarming and Prewarmed Intravenous Fluid Administration on the Core Temperature of Patients Undergoing Transurethral Surgery under General Anesthesia. International Journal of Medical Sciences, 21(1).
Duff, J., Di Staso, R., Cobbe, K. A., Draper, N., Tan, S., Halliday, E., Middleton, S., Lam, L., & Walker, K. (2012). Preventing hypothermia in elective arthroscopic shoulder surgery patients: A protocol for a randomised controlled trial. BMC Surgery, 12.
Garceau, C., Cosgrove, M. S., & Gonzalez, K. (2023). Inadvertent Perioperative Hypothermia. AANA Journal, 91(4).
Harahap, A. M., Kadarsah, R. K., & Oktaliansah, E. (2014). Angka kejadian hipotermia dan lama perawatan di ruang pemulihan pada pasien geriatri pascaoperasi elektif bulan oktober 2011–maret 2012 di Rumah Sakit Dr. Hasan Sadikin Bandung. Jurnal Anestesi Perioperatif, 2(1), 36–44.
Jin, Y., Tian, J., Sun, M., & Yang, K. (2011). A systematic review of randomised controlled trials of the effects of warmed irrigation fluid on core body temperature during endoscopic surgeries. In Journal of Clinical Nursing (Vol. 20, Issues 3–4).
Koleini, E., Cohen, J. S., Darwish, O. M., Pourafkari, L., Rein, L., & Nader, N. D. (2020). Perioperative hypothermia after transurethral surgeries: Is it necessary to heat the irrigation fluids? Turkish Journal of Anaesthesiology and Reanimation, 48(5).
Lindahl, S. B. (2020). Intraoperative Irrigation: Fluid Administration and Management Amidst Conflicting Evidence. AORN Journal, 111(5).
Link, T. (2020). Guidelines in Practice: Hypothermia Prevention. AORN Journal, 111(6).
Lista, F., Doherty, C. D., Backstein, R. M., & Ahmad, J. (2012). The impact of perioperative warming in an outpatient aesthetic surgery setting. Aesthetic Surgery Journal, 32(5).
Mamaril, M. E. (2003). Standards of perianesthesia nursing practice: Advocating patient safety. Journal of Perianesthesia Nursing, 18(3).
National Institute for Health and Care Excellence. (2016). Hypothermia: prevention and management in adults having surgery (Clinical guideline CG65). NICE Clinical Guidelines, December 2016. Diakses dari: https://www.nice.org.uk/guidance/cg65
Okeke, L. I. (2007). Effect of warm intravenous and irrigating fluids on body temperature during transurethral resection of the prostate gland. BMC Urology, 7.
Quiroz, Y. Y., Llorens, E., Motta, G., Tobia, S., & Bujons, A. (2021). Ultra-mini Pcnl with clear Petra® suction–evacuation access sheath and warming irrigation fluid system (Rocamed®) for stone treatment in children. Journal of Pediatric Urology, 17(5).
Rajagopalan, S., Mascha, E., Na, J., & Sessler, D. I. (2008). The Effects of Mild Perioperative Hypothermia on Blood Loss and Transfusion Requirement. Anesthesiology, 108(1), 71–77.
Rumantika, R., Suandika, M., & Handayani, R. N. (2022). Gambaran Kejadian Hipotermia, Mual Dan Muntah Post Operasi Dengan General Anestesi Di Rs Jatiwinangun Purwokerto. Jurnal Inovasi Penelitian, 3(7), 7049–7058.
Sessler, D. I. (2016). Perioperative thermoregulation and heat balance. The Lancet, 387(10038), 2655–2664.
Sessler, D. I. (2021). Perioperative Temperature Monitoring. Anesthesiology, 134(1), 111–118.
Setiyanti, W. (2016). Efektifitas Selimut Alumunium Foil terhadap Kejadian Hipotermi pada Pasien Post Operasi di RSUD Kota Salatiga. Seminar Dan Workshop Nasional Keperawatan.
Spruce, L. (2018). Back to basics: unplanned patient hypothermia: 1.3 www. aornjournal. org/content/cme. AORN journal, 108(5), 533-541.
Torossian, A., Bräuer, A., Höcker, J., Bein, B., Wulf, H., & Horn, E.-P. (2015). Preventing Inadvertent Perioperative Hypothermia. Deutsches Ärzteblatt International.
Warner, M. A., & Warner, M. E. (2021). The Evolution of the Anesthesia Patient Safety Movement in America: Lessons Learned and Considerations to Promote Further Improvement in Patient Safety. Anesthesiology, 135(6).
World Health Organization. (2019). WHO | 10 facts on patient safety. Who, REPORT. Diakses dari: https://www.who.int/news-room/photo-story/detail/10-facts-on-patient-safety.
Yi, J., Lei, Y., Xu, S., Si, Y., Li, S., Xia, Z., Shi, Y., Gu, X., Yu, J., Xu, G., Gu, E., Yu, Y., Chen, Y., Jia, H., Wang, Y., Wang, X., Chai, X., Jin, X., Chen, J., & Huang, Y. (2017). Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China. PLOS ONE, 12(6), e0177221.
Yılmaz, H., & Khorshid, L. (2023). The Effects of Active Warming on Core Body Temperature and Thermal Comfort in Patients After Transurethral Resection of the Prostate: A Randomized Clinical Trial. Clinical Nursing Research, 32(2).
Young, V. L., & Watson, M. E. (2006). Prevention of perioperative hypothermia in plastic surgery. Aesthetic Surgery Journal, 26(5).
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Holistik Jurnal Kesehatan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
