Percentage of patients requiring general or neuraxial anesthesia for whom a body temperature ≥ 36 degrees Celsius (or 96.8 degrees Fahrenheit) was not recorded within 30 minutes before to 15 minutes after anesthesia end time.

Perioperative hypothermia is defined as a core temperature less than 36 degrees Celsius by both the National Institute of Health and Clinical Excellence and the American Heart Association.^1,2 It is not uncommon for a patient’s core temperature to drop during surgery due to anesthetic induced peripheral vasodilation, exposure of skin during the surgical prep or impaired heat distribution. Pediatric patients are more likely to develop perioperative hypothermia due to a high surface area to weight ratio, minimal subcutaneous fat and inability to regulate their own temperature.³ Perioperative hypothermia can result in multiple adverse effects including surgical site infections, cardiovascular events, impaired wound healing and increased hospital length of stay. Such adverse effects are prevented through maintenance of normothermia intraoperatively.^4-9

30 minutes before Anesthesia End to 15 minutes after Anesthesia End

Patients receiving general or neuraxial anesthesia (determined by Anesthesia Technique: General value code >0 and Anesthesia Technique: Neuraxial value code >0)

• Anesthesia Duration < 60 minutes
• ASA 5 & 6 including Organ Procurement (CPT: 01990)
• Cases with intraoperative note mapped to intentional hypothermia (MPOG concept: 50037)
• Emergency Cases
• MAC cases (determined by Anesthesia Technique: Sedation)
• Procedures:
  • Burn Cases (CPT: 01953)
  • Labor Epidurals (determined by the Obstetric Anesthesia Type value codes: 3 & 6 including obstetric non-operative procedures - CPT: 01958)
  • MRI only procedures
  • Open Cardiac cases (determined by Procedure Type: Cardiac value code: 1)

At least one body temperature measurement equal to or greater than 36 degrees Celsius (or 96.8 degrees Fahrenheit) achieved within the 30 minutes before or 15 minutes after anesthesia end.

For sites that do not contribute PACU data to ASPIRE, this measure will only capture data documented by the anesthesia provider on the intraoperative anesthetic record.

Conversion from F to C:  F=32 +9/5 (°C)

Artifact algorithm:

• Less than 32.0°C (89.6F)
• Greater than 40.0°C (104.0F)
• Any minute-to-minute jumps >0.5°C equivalent. 
  • Example: 0.125°C /15s, 0.25°C / 30s, 1°C / 2mins

*This measure will include only valid MPOG cases as defined by the Is Valid Case phenotype.

Not applicable.

Primary Provider - Provider(s) present for longest duration of the case per staff role. 

In the event that two or more providers in the same class are signed in for the same duration, all providers signed in for the longest duration will be attributed.

1. Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Journal of the American College of Cardiology. 2014;64(22):e77-137.
2. National Collaborating Centre for N, Supportive C. National Institute for Health and Clinical Excellence: Guidance. The Management of Inadvertent Perioperative Hypothermia in Adults. London: Royal College of Nursing (UK)National Collaborating Centre for Nursing and Supportive Care.; 2008.
3. Kim P, Taghon T, Fetzer M, Tobias JD. Perioperative hypothermia in the pediatric population: a quality improvement project. American journal of medical quality : the official journal of the American College of Medical Quality. 2013;28(5):400-406.
4. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 2008;109(2):318-338.
5. Sun Z, Honar H, Sessler DI, et al. Intraoperative core temperature patterns, transfusion requirement, and hospital duration in patients warmed with forced air. Anesthesiology. 2015;122(2):276-285.
6. Carpenter L, Baysinger CL. Maintaining perioperative normothermia in the patient undergoing cesarean delivery. Obstetrical & gynecological survey. 2012;67(7):436-446.
7. Insler SR, Sessler DI. Perioperative thermoregulation and temperature monitoring. Anesthesiology clinics. 2006;24(4):823-837.
8. Horn EP, Schroeder F, Gottschalk A, et al. Active warming during cesarean delivery. Anesthesia and analgesia. 2002;94(2):409-414, table of contents.
9. Yi J, Liang H, Song R, Xia H, Huang Y. Maintaining intraoperative normothermia reduces blood loss in patients undergoing major operations: a pilot randomized controlled clinical trial. BMC anesthesiology. 2018;18(1):126.