{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:05:50Z","timestamp":1787843150378,"version":"build-2784847793"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010804","name":"Faculty of Medicine, Prince of Songkla University","doi-asserted-by":"publisher","award":["REC 65-226-8-9"],"award-info":[{"award-number":["REC 65-226-8-9"]}],"id":[{"id":"10.13039\/501100010804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to explore the association between intraoperative hypothermia and outcomes in adult patients undergoing laparoscopic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of 2048 adult laparoscopic surgery patients treated between 2020 and 2021 was conducted at Songklanagarind Hospital, Thailand. Intraoperative hypothermia, defined as a core temperature below 36\u00b0C, was recorded as either one or more than one episode. Patient demographics, clinical information and postoperative outcomes were extracted from the hospital information system. The outcomes were intraoperative and postoperative cardiac arrhythmias, postoperative oxygen requirement, length of post-anesthetic care unit (PACU) stay, and length of hospital stay. Univariate and multivariate logistic\/linear regression models were fit to assess the association between hypothermia and outcomes, presented as odds ratio (OR) or beta-coefficient (\u03b2) with 95% confidence interval (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of intraoperative hypothermia was 34.9%, with 688 experiencing one episode and 27 experiencing multiple episodes. On multivariate analysis, patients with one and more than one episode of hypothermia had an increased risk of intraoperative cardiac arrhythmia compared to normothermic patients (OR [95%CI]: 1.67[1.24,2.25] and 3.65[1.53,8.74], respectively, P&lt;0.001). Normothermic patients and hypothermic patients with more than one-episode had a higher odds of postoperative oxygen requirement compared to hypothermic patients with only one episode (OR [95%CI]:1.32[1.02,1.7] and 2.64[1.1,6.32], respectively, P = 0.019). Hypothermic patients with one and more than one-episode also had longer PACU stays compared to normothermic patients (\u03b2[95%CI]:3.82[1.34,6.29] and 12.43[2.29,22.57] minutes, respectively, P = 0.001). No significant differences were observed in the other outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intraoperative hypothermia in laparoscopic surgery is associated with a higher likelihood of intraoperative cardiac arrhythmias, prolonged PACU stay and higher postoperative oxygen requirement. Further research and prospective studies are warranted to validate these results and develop strategies to manage intraoperative hypothermia effectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0314968","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T13:28:38Z","timestamp":1738243718000},"page":"e0314968","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effects of intraoperative hypothermia on patients undergoing laparoscopic surgery: A retrospective cohort study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2692-3714","authenticated-orcid":true,"given":"Tashi","family":"Penjore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5840-5965","authenticated-orcid":true,"given":"Maliwan","family":"Oofuvong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunisa","family":"Chatmongkolchart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1504-9336","authenticated-orcid":true,"given":"Chanatthee","family":"Kitisiripant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrung","family":"Rueangchira-urai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaranya","family":"Leeratiwong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"pone.0314968.ref001","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1097\/00000542-200108000-00040","article-title":"Complications and treatment of mild hypothermia","volume":"95","author":"DI Sessler","year":"2001","journal-title":"Anesthesiology"},{"key":"pone.0314968.ref002","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1016\/S0140-6736(15)00981-2","article-title":"Perioperative thermoregulation and heat balance","volume":"387","author":"DI Sessler","year":"2016","journal-title":"Lancet"},{"key":"pone.0314968.ref003","doi-asserted-by":"crossref","first-page":"e0136136","DOI":"10.1371\/journal.pone.0136136","article-title":"Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey.","volume":"10","author":"J Yi","year":"2015","journal-title":"PLoS One."},{"key":"pone.0314968.ref004","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.bjae.2018.05.003","article-title":"Inadvertent perioperative hypothermia.","volume":"18","author":"C Riley","year":"2018","journal-title":"BJA Educ."},{"key":"pone.0314968.ref005","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ijsu.2015.06.079","article-title":"Risk factors for hypothermia in patients under general anesthesia: Is there a drawback of laminar airflow operating rooms? A prospective cohort study","volume":"21","author":"L Yang","year":"2015","journal-title":"Int J Surg."},{"key":"pone.0314968.ref006","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1001\/jamasurg.2015.77","article-title":"Association of Perioperative Hypothermia During Colectomy with Surgical Site Infection","volume":"150","author":"RB Baucom","year":"2015","journal-title":"JAMA Surg"},{"key":"pone.0314968.ref007","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s12871-020-01065-z","article-title":"Safety of intraoperative hypothermia for patients: meta-analyses of randomized controlled trials and observational studies.","volume":"20","author":"H Xu","year":"2020","journal-title":"BMC Anesthesiol."},{"key":"pone.0314968.ref008","doi-asserted-by":"crossref","first-page":"103059","DOI":"10.1016\/j.amsu.2021.103059","article-title":"Prevention and management of perioperative hypothermia in adult elective surgical patients: a systematic 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hypothermia in patients undergoing laparoscopic surgery","volume":"10","author":"M Wang","year":"2021","journal-title":"Gland Surg"},{"key":"pone.0314968.ref012","first-page":"e17128","article-title":"Mean Temperature Loss During General Anesthesia for Laparoscopic Cholecystectomy: Comparison of Males and Females.","volume":"13","author":"U Ahmed","year":"2021","journal-title":"Cureus."},{"key":"pone.0314968.ref013","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1089\/109264202320884108","article-title":"Impact of temperature and humidity of carbon dioxide pneumoperitoneum on body temperature and peritoneal morphology.","volume":"12","author":"EJ Hazebroek","year":"2002","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"pone.0314968.ref014","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jss.2008.03.039","article-title":"Heated and humidified CO2 prevents hypothermia, peritoneal injury, and intra-abdominal adhesions during prolonged laparoscopic 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colorectal surgery: a cohort study with cost-effectiveness analysis","volume":"31","author":"SE Mason","year":"2017","journal-title":"Surg Endosc."},{"key":"pone.0314968.ref018","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/ases.12350","article-title":"Warmed, humidified CO2 insufflation benefits intraoperative core temperature during laparoscopic surgery: A meta-analysis","volume":"10","author":"M Dean","year":"2017","journal-title":"Asian J Endosc Surg"},{"key":"pone.0314968.ref019","doi-asserted-by":"crossref","first-page":"e0190711","DOI":"10.1371\/journal.pone.0190711","article-title":"A retrospective analysis on the relationship between intraoperative hypothermia and postoperative ileus after laparoscopic colorectal surgery","volume":"13","author":"JW Choi","year":"2018","journal-title":"PLoS One"},{"key":"pone.0314968.ref020","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1111\/ans.17493","article-title":"Perioperative hypothermia in open and 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