This is a randomized, single-blinded, multi-center study clinical trial to determine both clinical and health outcomes of stratified warm strategy to prevent intraoperative hypothermia. Participants enrolled into this trial will be from elective major surgery population in PUMC Hospital, Beijing Hospital and Xuanwu Hospital. investigators plan to enroll approximately 800 participants. Hypothermia risk will be evaluated through PREDICTOR model in all participants. According to hypothermia risk level, these participants will be stratefied into high, moderate and low risk group. Participants in each group will be randomly categorize into warm group and control group. Active warm and fluid warm strategy, prewarm and fluid warm strategy and only prewarm strategy are used for high risk, moderate risk and low risk patients seperately. For controll group traditional passive warm was used.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
800
Bair HuggerTM Forced-air Warming System to 30min pre- and entire operation warming, combined fluid warming
30 min prewarming The Bair HuggerTM Forced-air Warming System cotton blanket warming and fluid warming through operation
30 min prewarming The Bair HuggerTM Forced-air Warming System and cotton blanket warming through operation
cotton blanket warming through operation
Incidence of intraoperative hypothermia
Core temperature\<36℃
Time frame: During operation
The amount of Intraoperative blood loss/blood transfusion
Time frame: During operation
Length of stay in PACU
Time frame: Postoperative during in postanaesthesia care unit， up to 24 hours after surgery
The incidence of Surgical site infection
Time frame: WIthin 30 days postoperative
Lenght of Stay in hospital
Time frame: impatient period， up to 6 month after surgery
Lenght of Stay in ICU
Time frame: impatient period， up to 6 month after surgery
Incidence of Adverse cardiovascular events
Time frame: WIthin 6 month post operation
Incidence of shiver
Time frame: during in postanaesthesia care unit， up to 24 hours after surgery
Mini-Mental State Examination (MMSE),
It's a scare to evaluate cognitive function. Total score is 30 . Higher values represent a better cognitive function.
Time frame: One day preoperation and 1 , 7，30 days postoperation
digit symbol substitution test
The digit symbol substitution test is an evaluation tool used to assess cognitive functioning. It initially was part of the Wechsler Adult Intelligence Test (WAIS), a well-known test that measures an individual's attention. lower digit symbol test scores were correlated with a higher risk of developing dementia in both the five and 10 year groups.Higher values represent a better cognitive function.
Time frame: One day preoperation and 1 , 7，30 days postoperation
Auditory Verbal Learning Test,
a memory test that involves learning verbal material, usually single words presented in a list, that is continually presented over repeated trials. Higher values represent a better memory functions.
Time frame: One day preoperation and 1 , 7，30 days postoperation
Color Word Stroop Test
The Stroop Colour and Word Test (SCWT) is a neuropsychological test extensively used to assess the ability to inhibit cognitive interference that occurs when the processing of a specific stimulus feature impedes the simultaneous processing of a second stimulus attribute, well-known as the Stroop Effect. Higher values represent a better ability to inhibit cognitive interference.
Time frame: One day preoperation and 1 , 7，30 days postoperation
digit span test.
a memory test that involves remember a series of numbers test short time memory Higher values represent a better memory functions.
Time frame: One day preoperation and 1 , 7，30 days postoperation
postoperative cognitive dysfunction incidence
* Z score=（postoperative score-preoperative core）/SD of non-surgical group * Two or more than two item in cognitive examination Z score\<-1.96 * Z score=（postoperative score-preoperative core）/SD of non-surgical group Two or more than two item in cognitive examination Z score\<-1.96
Time frame: One day preoperation and 1 , 7，30 days postoperation
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