optiTHERMM: A trainee-led international collaborative survey on perioperative patient body temperature monitoring and management for major burn injuries.

Abstract

Major burn injuries are often accompanied by disturbances in thermoregulation, with perioperative hypo- and hyperthermia presenting significant challenges for clinicians. Despite its implications for patient outcomes, research into perioperative thermoregulation and its influence on surgical decision-making remains limited. Between February 2022 and June 2023, a 26-question survey was distributed to clinicians in the UK, Australia, and New Zealand to assess body temperature management practices for major burn patients. Respondents included burn surgeons, anaesthetists, and intensive care specialists, categorised by burn service complexity and patient demographics. A total of 148 responses were collected, with 96 from the UK (22 sites) and 52 from Australia and New Zealand (22 sites), achieving a response rate of 70 % among designated burn services (39/56). Most clinicians reported an absence (38 %) or lack of awareness (22 %) regarding local thermoregulation protocols. Hypothermia was more likely than hyperthermia to cause surgery delays, with 35° C cited as the most common threshold. No significant differences were found in temperature thresholds based on service complexity (p = 0.324), patient demographics (p = 0.67), or clinician roles (p = 0.238). Respondents from high-complexity hospitals reported significantly lower minimum and higher maximum preferred body temperature thresholds during surgery (p = 0.008 and p = 0.02, respectively). However, these thresholds did not differ significantly based on patient population (p = 0.259; p = 0.897) or clinician role (p = 0.409; p = 0.283). Methods used to monitor and manage body temperature were broadly consistent with those cited in other studies. This international study represents the largest investigation of thermoregulation practices in major burns to date. While a consensus on optimal monitoring and modulation methods exists, there is considerable variability in practices and temperature preferences, highlighting the need for evidence-based guidelines to ensure consistent and optimal care.