H.Z.BIAN1, W.L.CHONG2, Y.M.LEE2
Nanyang Technological University1, Tan Tock Seng Hospital2
In urological practice, many procedures require the use of continuous fluid irrigation, for example, in transurethral resection of prostate (TURP), transurethral resection of bladder tumour (TURBT), percutaneous nephrolithotomy (PCNL).
We review available literature to examine the:
- Effects of temperature of irrigation fluid on core body temperature
- How we can change our practice to improve patient safety in relation to the use of irrigation fluids
We searched PUBMED using the keywords “irrigation fluid”, “temperature”, “core temperature”, “urology”, “safety”, “hypothermia” and retrieved 24 articles. We included only English language articles. 11 articles were selected for review.
Use of warmed irrigation fluids, in comparison with room temperature irrigation fluids, resulted in a smaller decrease in core temperature. However, the decrease in core temperature was not consistently significant across all studies, which could be due to other factors such as intravenous fluid temperature and duration of surgery.
Warmed irrigation fluids decrease the fall in core temperature of patients during surgery compared to room temperature irrigation fluids. While warmed irrigation fluids appear to keep the patient warm and decrease post-operative hypothermia and shivering, there is a lack of literature studying the possible harmful effects of using warmed irrigation fluids such as the effects on bleeding. This is a possible topic for future studies. In current practice locally, irrigation fluids are pre-warmed before the surgery. A possible improvement to improve patient outcomes may be to keep the irrigation fluid in a thermostat bath where the temperature can be kept constant and measured.