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İstenmeyen perioperatif hipotermi bakım algoritması

Yıl 2021, Cilt: 11 Sayı: 3, 431 - 440, 20.09.2021
https://doi.org/10.33631/duzcesbed.801281

Öz

Çalışmanın amacı kanıta dayalı bilgiler doğrultusunda, hemşirelerin kliniklerde İstenmeyen Perioperatif Hipotermi (İPH) bakımına yönelik karar vermesi için, yol gösterici bir araç olarak İPH bakım algoritmasının oluşturulmasıdır.
Türkçe ve İngilizce olarak 2010-2020 yılları arasını kapsayacak şekilde Pubmed, Cohrane, Google Akademi, CIHNAL, Science Direct, Clinical Key veri tabanlarında: Hipotermi (hypothermia), istenmeyen (inadvertent, unplanned, not planned, unintended), perioperatif (perioperative), rehber (guideline), protokol (protocol), algoritma (algorithm) anahtar kelimeleri ile tarama yapılmıştır. Kanıt düzeyi yüksek rehberler, sistematik derlemeler ve meta analizler değerlendirme kapsamına alınmıştır. Dahil edilme kriterlerine uyan, 6 rehber ve 2 sistematik derlemeden elde edilen bilgiler doğrultusunda, girişimler ameliyat öncesi, ameliyat sırası ve ameliyat sonrası şeklinde gruplandırılmış ve İPH’nin önlenmesi ve bakımına yönelik algoritma oluşturulmuştur. İPH’nin bakımına yönelik algoritma kullanımı hemşirelerin hızlı ve doğru karar vererek ameliyat öncesinde, sırasında ve sonrasında gelişebilecek komplikasyonların engellenmesi açısından önemlidir. Bu anlamda algoritma kullanımı klinik karar vermeyi kolaylaştırıp kanıt düzeyinde girişimlerle bakım sağlamada hemşireler için önemli bir araçtır. Geliştirilen İPH bakım algoritmasının kliniklerde uygulanarak geçerlik güvenirliğinin yapılması ve hemşirelik girişimlerine yönelik algoritmaların arttırılması önerilmektedir.

Kaynakça

  • 1. Sajid MS, Shakir AJ, Khatri K, Baig MK. The role of perioperative warming in surgery: a systematic review. Sao Paulo Medical Journal. 2009; 127(4): 231-7.
  • 2. Sessler DI. Perioperative thermoregulation and heat balance. The Lancet. 2016; 387(10038): 2655-64.
  • 3. Giuliano KK, Hendricks J. Inadvertent perioperative hypothermia: current nursing knowledge. Aorn Journal. 2017; 105(5): 453-63.
  • 4. Nice.org.uk [Internet]. United Kingdom: National Institute for Health and Clinical Excellence; 2008 Apr 23 [Updated: 2016 Dec 14; Cited: 2020 Sep 01]. Available from: www.nice.org.uk: https://www.nice.org.uk/guidance/cg65.
  • 5. Bilgin H. Inadverdent perioperative hypothermia. Turkish Journal of Anaesthesiology and Reanimation. 2017; 45(3): 124.
  • 6. Moola S, Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. International Journal of Evidence Based Healthcare. 2011; 9(4): 337-45.
  • 7. Ralph N, Gow J, Conway A, Duff J, Edward K-L, Alexander K, et al. Costs of inadvertent perioperative hypothermia in Australia: a cost-of-illness study. Collegian. 2019; 27(4), 345-351.
  • 8. Yüksel S, Uğraş GA. Cerrahi hastasında hipotermi gelişimini önlemede hemşirenin rolü. Mersin Üniversitesi Sağlık Bilimleri Dergisi. 2016; 9(2): 113-21.
  • 9. Tamer F, Karadağ M. Cerrahi hemşirelerinin istenmeyen perioperatif hipotermi bakımına yönelik bilgi ve uygulamalarının belirlenmesi. Türkiye Klinikleri Hemşirelik Bilimleri. 2020; 12(1): 19-29.
  • 10. RycroftMalone J, Fontenla M, Seers K, Bick D. Protocol‐based care: the standardisation of decision making? Journal of Clinical Nursing. 2009; 18(10): 1490-500.
  • 11. Dickerson SS, Sackett K, Jones JM, Brewer C. Guidelines for evaluating tools for clinical decision making. Nurse Educator. 2001; 26(5): 215-20.
  • 12. Hye-rim J, Dong-Hee K. Development of algorithm for nursing interventions after percutaneous coronary intervention. Journal of Korean Academy of Fundamentals of Nursing. 2017; 24(1): 18-29.
  • 13. Park Y, Oh S, Chang H, Bang HL. Effects of the evidence-based nursing care algorithm of dysphagia for nursing home residents. Journal of gerontological nursing. 2015; 41(11): 30-9.
  • 14. Hooper VD, Chard R, Clifford T, Fetzer S, Fossum S, Godden B, et al. Aspan's evidence-based clinical practice guideline for the promotion of perioperative normothermia. J Perianesth Nurs. 2010; 25(6): 346-65.
  • 15. Campbell G, Alderson P, Smith AF, Warttig S. Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia. Cochrane Database of Systematic Reviews. 2015 (4).
  • 16. Madrid E, Urrutia G, Figuls MR, Pardo Hernandez H, Campos JM, Paniagua P, et al. Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults. Cochrane Database of Systematic Reviews. 2016 (4).
  • 17. Rehberi, İstenmeyen perioperatif hipoterminin önlemesi. Türk anesteziyoloji ve reanimasyon derneği. Turk J Anaesth Reanim. 2013; 41:188-90.
  • 18. Torossian A, Bräuer A, Höcker J, Bein B, Wulf H, Horn E-P. Preventing inadvertent perioperative hypothermia. Deutsches Ärzteblatt International. 2015; 112(10): 166.
  • 19. Bashaw MA. Guideline implementation: preventing hypothermia. Aorn Journal. 2016; 103(3): 304-13. 20. Lisa C. Guideline for prevention of hypothermia. Aorn Journal. 2019; 110(1): 8-10.
  • 21. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2008; 109(2): 318-38.
  • 22. Yeoh WK, Lee JKW, Lim HY, Gan CW, Liang W, Tan KK. Re-visiting the tympanic membrane vicinity as core body temperature measurement site. PLoS One. 2017; 12(4): 0174120.
  • 23. Salota V, Slovakova Z, Panes C, Nundlall A, Goonasekera C. Is postoperative tympanic membrane temperature measurement effective? British Journal of Nursing. 2016; 25(9): 490-3.
  • 24. Lau A, Lowlaavar N, Cooke EM, West N, German A, Morse DJ, et al. Effect of preoperative warming on intraoperative hypothermia: a randomized-controlled trial. Canadian Journal of Anesthesia. 2018; 65(9):1029-40.
  • 25. Rosenkilde C, Vamosi M, Lauridsen JT, Hasfeldt D. Efficacy of prewarming with a self-warming blanket for the prevention of unintended perioperative hypothermia in patients undergoing hip or knee arthroplasty. Journal of Perianesthesia Nursing. 2017; 32(5): 419-28.
  • 26. Mogensen CB, Wittenhoff L, Fruerhøj G, Hansen S. Forehead or ear temperature measurement cannot replace rectal measurements, except for screening purposes. BMC pediatrics. 2018; 18(1): 15.
  • 27. Tamasaki Y, Ueshima H, Yoshiyama S, Higuchi S, Otake H. New tympanic membrane temperature shows good correlation with the esophageal temperature accuracy of a noncontact continuous tympanic thermometer. Open Journal of Anesthesiology. 2019; 9(04): 51.
  • 28. Demirci S, Kartal E, Özcan L. Comparison of body temperature in adult hospitalized patients using axillary and tympanic measurement methods. SAJ Biotechnol. 2019; 6:101.
  • 29. Xu H, Xu G, Ren C, Liu L, Wei L. Effect of forced-air warming system in prevention of postoperative hypothermia in elderly patients: a prospective controlled trial. Medicine. 2019; 98(22): 15895.
  • 30. Özsaban A, Acaroğlu R. The effect of active warming on postoperative hypothermia on body temperature and thermal comfort: a randomized controlled trial. Journal of PeriAnesthesia Nursing. 2020; 34(4): 423-9.
  • 31. Sagiroglu G, Ozturk GA, Baysal A, Turan FN. Inadvertent perioperative hypothermia and ımportant risk factors during major abdominal surgeries. Journal of the College of Physicians and Surgeons Pakistan. 2020; 30(2): 123-8.
  • 32. Demirarslan E. Ameliyat sonrası hipotermi kontrolü. Sağlık Akademisi Kastamonu. 2017; 2(1): 51-70.
  • 33. Shapiro Y, Pandolf KB, Avellini BA, Pimental NA, Goldman RF. Physiological responses of men and women to humid and dry heat. Journal of Applied Physiology. 1980; 49(1): 1-8.
  • 34. Ruetzler K, Kurz A. Consequences of perioperative hypothermia. Handb Clin Neurol. 2018; 157: 687-97.
  • 35. Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: a randomized clinical trial. Jama. 1997; 277(14): 1127-34.
  • 36. Frank SM, Higgins MS, Fleisher LA, Sitzmann JV, Raff H, Breslow MJ. Adrenergic, respiratory, and cardiovascular effects of core cooling in humans. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 1997; 272(2): 557-62.
  • 37. Silva JE. Thermogenic mechanisms and their hormonal regulation. Physiological reviews. 2006; 86(2): 435-64.
  • 38. Varan Ö, Gürlek A. Adrenal yetmezlik: tanı ve tedavi algoritması, a sistemik review. Yoğun Bakım Dergisi. 2010; 9(4): 200-7.
  • 39. Anderson GJ, Frazer DM; McLaren GD. Iron absorption and metabolism. Current opinions in Gastroenterology. 2009; 25(2): 129–135.
  • 40. Brigham D, Beard J, Tobin B. Iron and thermoregulation: a review. Critical Reviews in Food Science & Nutrition. 1996; 36(8): 747-63.
  • 41. Jacobi J, Bircher N, Krinsley J, Agus M, Braithwaite SS, Deutschman C, et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Critical care medicine. 2012; 40(12): 3251-76.
  • 42. Forristal C, Van Aarsen K, Columbus M, Wei J, Vogt K, Mal S. Predictors of hypothermia upon trauma center arrival in severe trauma patients transported to hospital via ems. Prehospital emergency care. 2020; 24(1): 15-22.
  • 43. Rizzo JA, Rowan MP, Driscoll IR, Chan RK, Chung KK. Perioperative temperature management during burn care. Journal of Burn Care & Research. 2017; 38(1): 277-83.
  • 44. Woehrle T, Lichtenauer U, Bayer A, Brunner S, Angstwurm M, Schäfer S, et al. Misleading symptoms and successful noninvasive rewarming of a patient with severe hypothermia (23,1°C). Der Anaesthesist. 2018; 67(12): 931-5.
  • 45. Sarkar S, Donn SM, Bhagat I, Dechert RE, Barks JD. Esophageal and rectal temperatures as estimates of core temperature during therapeutic whole-body hypothermia. The Journal of pediatrics. 2013; 162(1): 208-10. 46. Huggins R, Glaviano N, Negishi N, Casa DJ, Hertel J. Comparison of rectal and aural core body temperature thermometry in hyperthermic, exercising individuals: a meta-analysis. Journal of athletic training. 2012; 47(3): 329-38.
  • 47. Wagner M, Lim-Hing K, Bautista MA, Blaber B, Ryder T, Haymore J, et al. Comparison of a continuous noninvasive temperature to monitor core temperature measures during targeted temperature management. Neurocritical Care. 2020; 6:1-7.

Inadvertent perioperative hypothermia care algorithm

Yıl 2021, Cilt: 11 Sayı: 3, 431 - 440, 20.09.2021
https://doi.org/10.33631/duzcesbed.801281

Öz

The aim of the study was to develop an Inadvertent Perioperative Hypothermia (IPH) care algorith in line with evidence-based information as a guiding tool for nurses to make decisions about IPH care in clinics. To cover the period 2010-2020, in Pubmed, Cohrane, Google Academy, CIHNAL, Science Direct, Clinical Key databases: Hypothermia, unwanted (inadvertent, unplanned, not planned, unintended), perioperative, guideline, protocol, algorithm key words were searched in Turkish and English. Guidelines with a high level of evidence, systematic reviews and meta-analyzes were included in the evaluation. In accordance with the inclusion criteria, in line with the information obtained from 6 guides and 2 systematic reviews, the interventions were grouped as preoperative, intraoperative and postoperative, and an algorithm was developed for the prevention and care of IPH. The use of algorithms for the care of IPH is important for nurses to make fast and correct decisions to prevent complications that may occur before, during and after surgery. In this context, the use of algorithms is an important tool for nurses in facilitating clinical decision making and providing care with evidence-based interventions. It is recommended to apply this IPH care algorithm in clinics, to make the validity and reliability and to increase the algorithms for nursing interventions.

Kaynakça

  • 1. Sajid MS, Shakir AJ, Khatri K, Baig MK. The role of perioperative warming in surgery: a systematic review. Sao Paulo Medical Journal. 2009; 127(4): 231-7.
  • 2. Sessler DI. Perioperative thermoregulation and heat balance. The Lancet. 2016; 387(10038): 2655-64.
  • 3. Giuliano KK, Hendricks J. Inadvertent perioperative hypothermia: current nursing knowledge. Aorn Journal. 2017; 105(5): 453-63.
  • 4. Nice.org.uk [Internet]. United Kingdom: National Institute for Health and Clinical Excellence; 2008 Apr 23 [Updated: 2016 Dec 14; Cited: 2020 Sep 01]. Available from: www.nice.org.uk: https://www.nice.org.uk/guidance/cg65.
  • 5. Bilgin H. Inadverdent perioperative hypothermia. Turkish Journal of Anaesthesiology and Reanimation. 2017; 45(3): 124.
  • 6. Moola S, Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. International Journal of Evidence Based Healthcare. 2011; 9(4): 337-45.
  • 7. Ralph N, Gow J, Conway A, Duff J, Edward K-L, Alexander K, et al. Costs of inadvertent perioperative hypothermia in Australia: a cost-of-illness study. Collegian. 2019; 27(4), 345-351.
  • 8. Yüksel S, Uğraş GA. Cerrahi hastasında hipotermi gelişimini önlemede hemşirenin rolü. Mersin Üniversitesi Sağlık Bilimleri Dergisi. 2016; 9(2): 113-21.
  • 9. Tamer F, Karadağ M. Cerrahi hemşirelerinin istenmeyen perioperatif hipotermi bakımına yönelik bilgi ve uygulamalarının belirlenmesi. Türkiye Klinikleri Hemşirelik Bilimleri. 2020; 12(1): 19-29.
  • 10. RycroftMalone J, Fontenla M, Seers K, Bick D. Protocol‐based care: the standardisation of decision making? Journal of Clinical Nursing. 2009; 18(10): 1490-500.
  • 11. Dickerson SS, Sackett K, Jones JM, Brewer C. Guidelines for evaluating tools for clinical decision making. Nurse Educator. 2001; 26(5): 215-20.
  • 12. Hye-rim J, Dong-Hee K. Development of algorithm for nursing interventions after percutaneous coronary intervention. Journal of Korean Academy of Fundamentals of Nursing. 2017; 24(1): 18-29.
  • 13. Park Y, Oh S, Chang H, Bang HL. Effects of the evidence-based nursing care algorithm of dysphagia for nursing home residents. Journal of gerontological nursing. 2015; 41(11): 30-9.
  • 14. Hooper VD, Chard R, Clifford T, Fetzer S, Fossum S, Godden B, et al. Aspan's evidence-based clinical practice guideline for the promotion of perioperative normothermia. J Perianesth Nurs. 2010; 25(6): 346-65.
  • 15. Campbell G, Alderson P, Smith AF, Warttig S. Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia. Cochrane Database of Systematic Reviews. 2015 (4).
  • 16. Madrid E, Urrutia G, Figuls MR, Pardo Hernandez H, Campos JM, Paniagua P, et al. Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults. Cochrane Database of Systematic Reviews. 2016 (4).
  • 17. Rehberi, İstenmeyen perioperatif hipoterminin önlemesi. Türk anesteziyoloji ve reanimasyon derneği. Turk J Anaesth Reanim. 2013; 41:188-90.
  • 18. Torossian A, Bräuer A, Höcker J, Bein B, Wulf H, Horn E-P. Preventing inadvertent perioperative hypothermia. Deutsches Ärzteblatt International. 2015; 112(10): 166.
  • 19. Bashaw MA. Guideline implementation: preventing hypothermia. Aorn Journal. 2016; 103(3): 304-13. 20. Lisa C. Guideline for prevention of hypothermia. Aorn Journal. 2019; 110(1): 8-10.
  • 21. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2008; 109(2): 318-38.
  • 22. Yeoh WK, Lee JKW, Lim HY, Gan CW, Liang W, Tan KK. Re-visiting the tympanic membrane vicinity as core body temperature measurement site. PLoS One. 2017; 12(4): 0174120.
  • 23. Salota V, Slovakova Z, Panes C, Nundlall A, Goonasekera C. Is postoperative tympanic membrane temperature measurement effective? British Journal of Nursing. 2016; 25(9): 490-3.
  • 24. Lau A, Lowlaavar N, Cooke EM, West N, German A, Morse DJ, et al. Effect of preoperative warming on intraoperative hypothermia: a randomized-controlled trial. Canadian Journal of Anesthesia. 2018; 65(9):1029-40.
  • 25. Rosenkilde C, Vamosi M, Lauridsen JT, Hasfeldt D. Efficacy of prewarming with a self-warming blanket for the prevention of unintended perioperative hypothermia in patients undergoing hip or knee arthroplasty. Journal of Perianesthesia Nursing. 2017; 32(5): 419-28.
  • 26. Mogensen CB, Wittenhoff L, Fruerhøj G, Hansen S. Forehead or ear temperature measurement cannot replace rectal measurements, except for screening purposes. BMC pediatrics. 2018; 18(1): 15.
  • 27. Tamasaki Y, Ueshima H, Yoshiyama S, Higuchi S, Otake H. New tympanic membrane temperature shows good correlation with the esophageal temperature accuracy of a noncontact continuous tympanic thermometer. Open Journal of Anesthesiology. 2019; 9(04): 51.
  • 28. Demirci S, Kartal E, Özcan L. Comparison of body temperature in adult hospitalized patients using axillary and tympanic measurement methods. SAJ Biotechnol. 2019; 6:101.
  • 29. Xu H, Xu G, Ren C, Liu L, Wei L. Effect of forced-air warming system in prevention of postoperative hypothermia in elderly patients: a prospective controlled trial. Medicine. 2019; 98(22): 15895.
  • 30. Özsaban A, Acaroğlu R. The effect of active warming on postoperative hypothermia on body temperature and thermal comfort: a randomized controlled trial. Journal of PeriAnesthesia Nursing. 2020; 34(4): 423-9.
  • 31. Sagiroglu G, Ozturk GA, Baysal A, Turan FN. Inadvertent perioperative hypothermia and ımportant risk factors during major abdominal surgeries. Journal of the College of Physicians and Surgeons Pakistan. 2020; 30(2): 123-8.
  • 32. Demirarslan E. Ameliyat sonrası hipotermi kontrolü. Sağlık Akademisi Kastamonu. 2017; 2(1): 51-70.
  • 33. Shapiro Y, Pandolf KB, Avellini BA, Pimental NA, Goldman RF. Physiological responses of men and women to humid and dry heat. Journal of Applied Physiology. 1980; 49(1): 1-8.
  • 34. Ruetzler K, Kurz A. Consequences of perioperative hypothermia. Handb Clin Neurol. 2018; 157: 687-97.
  • 35. Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: a randomized clinical trial. Jama. 1997; 277(14): 1127-34.
  • 36. Frank SM, Higgins MS, Fleisher LA, Sitzmann JV, Raff H, Breslow MJ. Adrenergic, respiratory, and cardiovascular effects of core cooling in humans. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 1997; 272(2): 557-62.
  • 37. Silva JE. Thermogenic mechanisms and their hormonal regulation. Physiological reviews. 2006; 86(2): 435-64.
  • 38. Varan Ö, Gürlek A. Adrenal yetmezlik: tanı ve tedavi algoritması, a sistemik review. Yoğun Bakım Dergisi. 2010; 9(4): 200-7.
  • 39. Anderson GJ, Frazer DM; McLaren GD. Iron absorption and metabolism. Current opinions in Gastroenterology. 2009; 25(2): 129–135.
  • 40. Brigham D, Beard J, Tobin B. Iron and thermoregulation: a review. Critical Reviews in Food Science & Nutrition. 1996; 36(8): 747-63.
  • 41. Jacobi J, Bircher N, Krinsley J, Agus M, Braithwaite SS, Deutschman C, et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Critical care medicine. 2012; 40(12): 3251-76.
  • 42. Forristal C, Van Aarsen K, Columbus M, Wei J, Vogt K, Mal S. Predictors of hypothermia upon trauma center arrival in severe trauma patients transported to hospital via ems. Prehospital emergency care. 2020; 24(1): 15-22.
  • 43. Rizzo JA, Rowan MP, Driscoll IR, Chan RK, Chung KK. Perioperative temperature management during burn care. Journal of Burn Care & Research. 2017; 38(1): 277-83.
  • 44. Woehrle T, Lichtenauer U, Bayer A, Brunner S, Angstwurm M, Schäfer S, et al. Misleading symptoms and successful noninvasive rewarming of a patient with severe hypothermia (23,1°C). Der Anaesthesist. 2018; 67(12): 931-5.
  • 45. Sarkar S, Donn SM, Bhagat I, Dechert RE, Barks JD. Esophageal and rectal temperatures as estimates of core temperature during therapeutic whole-body hypothermia. The Journal of pediatrics. 2013; 162(1): 208-10. 46. Huggins R, Glaviano N, Negishi N, Casa DJ, Hertel J. Comparison of rectal and aural core body temperature thermometry in hyperthermic, exercising individuals: a meta-analysis. Journal of athletic training. 2012; 47(3): 329-38.
  • 47. Wagner M, Lim-Hing K, Bautista MA, Blaber B, Ryder T, Haymore J, et al. Comparison of a continuous noninvasive temperature to monitor core temperature measures during targeted temperature management. Neurocritical Care. 2020; 6:1-7.
Toplam 45 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Aylin Güçlü 0000-0003-2364-9366

Mevlüde Karadağ 0000-0003-3258-6459

Yayımlanma Tarihi 20 Eylül 2021
Gönderilme Tarihi 28 Eylül 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 11 Sayı: 3

Kaynak Göster

APA Güçlü, A., & Karadağ, M. (2021). İstenmeyen perioperatif hipotermi bakım algoritması. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 11(3), 431-440. https://doi.org/10.33631/duzcesbed.801281
AMA Güçlü A, Karadağ M. İstenmeyen perioperatif hipotermi bakım algoritması. DÜ Sağlık Bil Enst Derg. Eylül 2021;11(3):431-440. doi:10.33631/duzcesbed.801281
Chicago Güçlü, Aylin, ve Mevlüde Karadağ. “İstenmeyen Perioperatif Hipotermi bakım Algoritması”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 11, sy. 3 (Eylül 2021): 431-40. https://doi.org/10.33631/duzcesbed.801281.
EndNote Güçlü A, Karadağ M (01 Eylül 2021) İstenmeyen perioperatif hipotermi bakım algoritması. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 11 3 431–440.
IEEE A. Güçlü ve M. Karadağ, “İstenmeyen perioperatif hipotermi bakım algoritması”, DÜ Sağlık Bil Enst Derg, c. 11, sy. 3, ss. 431–440, 2021, doi: 10.33631/duzcesbed.801281.
ISNAD Güçlü, Aylin - Karadağ, Mevlüde. “İstenmeyen Perioperatif Hipotermi bakım Algoritması”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 11/3 (Eylül 2021), 431-440. https://doi.org/10.33631/duzcesbed.801281.
JAMA Güçlü A, Karadağ M. İstenmeyen perioperatif hipotermi bakım algoritması. DÜ Sağlık Bil Enst Derg. 2021;11:431–440.
MLA Güçlü, Aylin ve Mevlüde Karadağ. “İstenmeyen Perioperatif Hipotermi bakım Algoritması”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 11, sy. 3, 2021, ss. 431-40, doi:10.33631/duzcesbed.801281.
Vancouver Güçlü A, Karadağ M. İstenmeyen perioperatif hipotermi bakım algoritması. DÜ Sağlık Bil Enst Derg. 2021;11(3):431-40.