Peri-operative hypothermia in the high-risk surgical patient |
| |
| Institution: | 1. Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Victoria, 3050, Australia;2. Department of Anesthesia, University of California, San Francisco, 374 Parnassus Ave, 3rd Floor, San Francisco, California, 94143-0648, USA;3. Ludwig Boltzmann Anaesthesia Institute;4. University of Vienna;1. Sickle Cell Branch, National Heart Lung and Blood Institute, National Institute of Health, Bethesda, MD, USA;2. Department of Haematology, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom;1. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia;2. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia;3. Australasian Kidney Trial Network, Diamantina Institute, University of Queensland, Brisbane, Australia;4. Department of Renal Medicine, Singapore General Hospital, Singapore;5. Hôpital Maisonneuve-Rosemont, Université de Montreal, Montreal, Canada;6. Translational Research Institute, Brisbane, Australia;7. Central Northern Adelaide Renal and Transplantation Service; Royal Adelaide Hospital, Adelaide, Australia;8. Department of Nephrology, St George Hospital, Sydney, Australia;9. Department of Renal Medicine, Nepean Hospital, Sydney, Australia;10. Department of Renal Medicine, Westmead Hospital, Sydney, Australia;11. University of Sydney Medical School, Sydney, Australia;12. School of Medicine and Pharmacology, University of Western Australia, Perth, Australia;13. School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia;1. CEBE, Birmingham City University, Birmingham, UK;2. COCIS, Edinburgh Napier University, Edinburgh, UK |
| |
| Abstract: | Peri-operative hypothermia is common in high-risk surgical patients. Anaesthesia impairs central thermoregulation, allowing redistribution of body heat. Cool ambient temperatures and high-volume fluid administration accelerate loss of heat to the environment. Randomized, controlled trials have proven that mild hypothermia increases the incidence of wound infection and prolongs hospitalization, increases the incidence of morbid cardiac events and ventricular tachycardia and impairs coagulation. Other complications include enhanced anaesthetic drug effects, prolonged recovery room stays, shivering and impaired immune function. There is compelling animal evidence for cerebral protection by mild hypothermia. However, evidence for protection in surgical patients is not yet available. The most effective means of preventing peri-operative hypothermia is active pre-warming. High ambient temperatures, warmed intravenous fluids and active cutaneous warming are useful intraoperatively, while active cutaneous warming and intravenous pethidine abolish post-operative shivering. Proper thermal management may reduce complications and improve the outcome in high-risk surgical patients. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
