Proactive Temperature Management in CRS-HIPEC for Prevention of Delirium

Inclusion Criteria: * Adult patients (aged 18-80 years). American Society of Anesthesiologists (ASA) physical status of I to III. Scheduled for elective Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Pseudomyxoma Peritonei (PMP). Written informed consent obtained from the participant or legally authorized representative. Exclusion Criteria: * Known diagnosis of dementia, major neurocognitive disorder, or severe psychiatric illness (e.g., schizophrenia) documented in the medical record. Acute central nervous system pathology likely to confound delirium assessment (e.g., recent stroke, active seizure disorder, or traumatic brain injury). Severe sensory or language barriers precluding valid cognitive screening (e.g., profound deafness or blindness, or language barriers not correctable with translation). Preoperative coma, mechanical ventilation, or deep sedation precluding reliable baseline assessment. Emergency surgery or repeat CRS-HIPEC during the same hospital admission. History of alcohol or substance abuse likely to precipitate withdrawal symptoms.