Targeting an intraoperative core temperature of 37°C significantly reduced the incidence of postoperative myocardial injury compared with routine thermal management (6.5% vs 25.0%; P<0.05).
RCT (n=144)
1:1:1
Does intensive or aggressive intraoperative thermal management reduce postoperative myocardial injury in patients undergoing laparoscopic radical resection for colorectal cancer?
Targeting an intraoperative core temperature of 37°C significantly reduces postoperative myocardial injury compared to routine thermal management in patients undergoing colorectal cancer resection.
Absolute Event Rate: 6.5% vs 25%
p-value: p=<.05
Background: Intraoperative hypothermia is common in patients undergoing laparoscopic radical resection for colorectal cancer. This study evaluated the effectiveness of maintaining 2 different intraoperative core temperature targets (36°C and 37°C) compared with routine thermal management in reducing postoperative myocardial injury in this patient population. Methods: In this randomized controlled trial, A total of 144 patients were randomly assigned to 1 of 3 groups: routine (target nasopharyngeal temperature ≥35°C), aggressive (≥36°C), or intensive (37°C) thermal management, utilizing a forced-air warming blanket and warm-water mattress. The primary outcome was postoperative myocardial injury, defined as a cardiac troponin I (cTnI) concentration of 0.04 ng/mL or greater. Secondary outcomes included severe arrhythmia, metabolic acidosis, shivering, and Quality of Recovery-15 (QoR-15) scores. Results: Postoperative cTnI levels were lower in the aggressive and intensive groups than in the routine group ( P <.05). The incidence of myocardial injury was significantly lower in the intensive group than in the routine group (6.5% vs 25.0%; P <.05). The aggressive group had a lower incidence of metabolic acidosis than the routine group ( P < .05). The incidence of shivering was lower in both the aggressive and intensive groups than in the routine group ( P <.05) and was further reduced in the intensive group compared with that in the aggressive group ( P <.05). On postoperative day 1, QoR-15 scores were higher in the aggressive and intensive groups than in the routine group ( P < .05), with the intensive group demonstrating a higher score than the aggressive group ( P <.05). Conclusion: In patients undergoing laparoscopic radical resection for colorectal cancer, targeting a core intraoperative temperature of 37°C significantly reduces the incidence of postoperative myocardial injury.
Wu et al. (Fri,) conducted a rct in Colorectal cancer undergoing laparoscopic radical resection (n=144). Aggressive (≥36°C) or intensive (37°C) thermal management vs. Routine thermal management (target nasopharyngeal temperature ≥35°C) was evaluated on Postoperative myocardial injury (cardiac troponin I ≥0.04 ng/mL) (p=<.05). Targeting an intraoperative core temperature of 37°C significantly reduced the incidence of postoperative myocardial injury compared with routine thermal management (6.5% vs 25.0%; P<0.05).