Control of body temperature and immune function in patients undergoing open surgery for gastric cancer

Li Shao; Nannan Pang; Ping Yan; Fengju Jia; Qi Sun; Wenjuan Ma; Yi Yang

doi:10.17305/bjbms.2018.2552

Authors

Li Shao Operating Room, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
Nannan Pang Hematologic Disease Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
Ping Yan Nursing Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
Fengju Jia Operating Room, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
Qi Sun Medical Research and Statistics Process Center, Hospital of Traditional Chinese Medicine, Urumqi, Xinjiang Uygur Autonomous Region, China
Wenjuan Ma Operating Room, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
Yi Yang Operating Room, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China

DOI:

https://doi.org/10.17305/bjbms.2018.2552

Keywords:

Gastric cancer, heating methods, infection, perioperative period, CD4 CD25 Treg, TGF-β, IL-10

Abstract

The influence of mild perioperative hypothermia on the immune function and incidence of postoperative wound infections has been suggested, but the specific mechanism is unclear. This study aimed to analyze the body temperature, immune function, and wound infection rates in patients receiving open surgery for gastric cancer. Body temperature was controlled in each patient using one of four different methods: wrapping limbs, head and neck; insulated blankets; warming infusion fluids and insulated blankets; and warming fluids without insulated blankets. One hundred patients were randomly divided into four groups of 25 patients each, and every group received a different intraoperative treatment for maintaining normal body temperature. Nasopharyngeal and rectal temperatures, transforming growth factor beta (TGF-β), interleukin 10 (IL-10) levels, and cluster of differentiation (CD)3⁺T and CD4⁺/CD25⁺ regulatory T cell (Treg) counts were measured before surgery and at 2 and 4 hours postoperatively. Patients were evaluated at one week after surgery for signs of infection. Intraoperative body temperature and measures of immune function varied significantly between the four groups, with the largest temperature changes observed in the group in which only the limbs were wrapped in cotton pads to control the body temperature. The lowest temperature change (i.e., close to normal temperature) and cytokine response after surgery were observed in the group in which infusion fluids and transfused blood (if needed) were heated to 37℃, peritoneal irrigation fluid was heated to 37℃, and an insulation blanket was heated to 39℃ and placed under the patient. No intergroup differences were found in the infection rates at one week after surgery. In conclusion, body temperature variation during surgery affects the immune function of patients, and maintaining body temperature close to normal results in the least variation of immune function.

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Author Biography

Ping Yan, Nursing Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China

Nursing Department

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