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J Neurol Surg A Cent Eur Neurosurg 2024; 85(04): 405-411
DOI: 10.1055/a-2156-5285
Review Article

Optimal Temperature of Irrigation Fluid for Hemostasis in Neurosurgery: A Narrative Literature Review

Dylan Bretherton
1   Department of Neurosurgery, The University of Sydney, Sydney, New South Wales, Australia
,
Lucy Baker
1   Department of Neurosurgery, The University of Sydney, Sydney, New South Wales, Australia
,
Behzad Eftekhar
1   Department of Neurosurgery, The University of Sydney, Sydney, New South Wales, Australia
2   Department of Neurosurgery, Macquarie University, Sydney, New South Wales, Australia
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Abstract

Background Hemostasis in neurosurgery is crucial to patient and surgery outcomes, with many techniques developed for this. One area that is not appropriately characterized despite continuous anecdotal evidence the temperature of the irrigation fluid (IF) used and its effects on stemming hemorrhages. Given the ubiquitous use of IF in neurosurgery for clearing blood from the surgical field, it is important to explore its role as a hemostat and whether or not the temperature of the IF influences its hemostatic capacity. This review explored the literature for an optimal IF temperature for hemostasis in neurosurgery.

Methods Database searches were conducted using MEDLINE, Scopus, Web of Science, and CINAHL, with citation chaining occurring where applicable. Standard terms around neurosurgery, hemostasis, and irrigation were used.

Results Seven articles were identified. No optimal temperature for hemostasis could be confidently synthesized from the literature owing to lack of primary investigation on the subject. After collating available information into common themes, it is suggested that that temperatures >38°C are preferred.

Conclusion The literature in this area is limited. Despite a lack of applicable systematic investigation on the topic, by exploring the physiology of hemostasis and IF, best practice guidelines for IF, and the literature on the role of the temperature of IF in other surgical specialties, it is suggested that a temperature in the range of 38 to 40°C would be most applicable to a value optimal for neurosurgery.

Keywords

neurosurgery - irrigation fluid - temperature - hemostasis


Publication History

Received: 14 December 2022

Accepted: 14 August 2023

Accepted Manuscript online:
18 August 2023

Article published online:
13 December 2023

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