Anaesthesia
-
We proposed that many Intensive Care Unit (ICU) patients would be hypothermic in the early postoperative period and that hypothermia would be associated with increased mortality. We retrospectively reviewed patients admitted to ICU after surgery. We recorded the lowest temperature in the first 24 h after surgery using tympanic membrane thermometers. ⋯ In-hospital mortality was 5.6% for normothermic patients, 8.9% for all hypothermic patients (p < 0.001), and 14.7% for severely hypothermic patients (p < 0.001). Hypothermia was associated with in-hospital mortality: OR 1.83 for each degree Celsius ( degrees C) decrease (95% CI: 1.2-2.60, p < 0.001). Given the evidence for improved outcome associated with active patient warming during surgery we suggest conducting prospective studies of active warming of patients admitted to ICU after surgery.
-
We report two cases of postoperative iatrogenic tetraparesis, which occurred in different hospitals after surgery for parathyroidectomy. Both patients were on long-term haemodialysis. ⋯ Spinal abnormalities associated with chronic renal failure may have made these patients more vulnerable. In our opinion, it is advisable to investigate thoroughly any sign of spinal stenosis in patients who undergo any procedure requiring significant neck extension, particularly if on long-term haemodialysis.