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Targeted Temperature Management on Delayed Neurocognitive Recovery in Older Patients After Major Cancer Surgery
Sponsor: Peking University First Hospital
Summary
With aging population, more older patients will receive major surgery for cancer. Older patients are at increased risk of postoperative neurocognitive complications including delayed neurocognitive recovery (dNCR), which is associated with prolonged hospital stay, raised complications, and impaired quality of life. Intraoperative hypothermia occurs in 57.1%-78.6% of patients undergoing major cancer surgery, especially in the elderly. Studies show that intraoperative hypothermia suppresses immunity, interferes with anesthetic metabolism, and delays anesthesia emergence. All these may be correlated with the occurrence of early postoperative dNCR. This study aims to verify whether intraoperative targeted temperature management (target core temperature: 36.8°C) compared with conventional temperature management (core temperature: 35.5°C) can reduce the incidence of dNCR in older patients undergoing major cancer surgery.
Official title: Intraoperative Targeted Temperature Management on Delayed Neurocognitive Recovery in Older Patients After Major Cancer Surgery: a Multicenter Randomized Trial
Key Details
Gender
All
Age Range
65 Years - Any
Study Type
INTERVENTIONAL
Enrollment
1512
Start Date
2026-06
Completion Date
2028-11
Last Updated
2026-06-18
Healthy Volunteers
Yes
Conditions
Interventions
Targeted temperature management
The operating room temperature will be maintained at approximately 22°C in accordance with routine clinical practice. Pre-warming with a full-body forced-air warming blanket and/or an electric heating mattress will be performed for 30 minutes before anesthesia induction (initial temperature set at 43°C, which may be adjusted by the investigator according to the patient's comfort or changes in body temperature). During surgery, all intravenous fluids and blood products administered intraoperatively will be pre-warmed, and fluid/blood warming devices will be used as clinically indicated. Two forced-air warming blankets (or combined with an electric heating mattress) will be used. The goal is to maintain the patient's core temperature at 36.8°C.
Conventional temperature management
The operating room temperature will be maintained at approximately 22°C in accordance with routine clinical practice. No pre-warming will be applied to patients prior to anesthesia induction. During surgery, only blood products will be pre-warmed before transfusion. One forced-air warming blanket will be placed over the patient's upper or lower body, but warming will only be initiated when the core temperature drops below 35.5°C to prevent further temperature reduction. The target core temperature is set at 35.5°C.
Locations (1)
Peking University First Hospital
Beijing, Beijing Municipality, China