Consequences of inadvertent perioperative hypothermia.
Perioperative hypothermia triples the incidence of adverse myocardial outcomes in high-risk patients. Mild hypothermia significantly increases blood loss and augments allogeneic transfusion requirement, but the molecular pathophysiology of this effect remains to be elucidated. Only 1.9 degrees C core hypothermia triples the incidence of surgical wound infection following colon resection and increases the duration of hospitalization by 20%. Hypothermia adversely affects antibody- and cell-mediated immune defences, as well as the oxygen availability in the peripheral wound tissues. Mild perioperative hypothermia changes the kinetics and action of various anaesthetic and paralysing agents, increases thermal discomfort, and is associated with delayed post-anaesthetic recovery. Finally, mild core hypothermia influences pulse oximetry monitoring and various electrophysiological indices of the nervous system, with questionable clinical significance, as yet.
Doufas
Anthony G
AG
Department of Anesthesiology/Neuroscience and Anesthesia ICU, and Outcomes Research Institute, University of Louisville Hospital, 530 South Jackson Street, Louisville, KY 40202, USA. agdoufas@Louisville.edu
D018681:Anesthetics, General / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology; D001778:Blood Coagulation Disorders / Q000209:etiology; D006801:Humans; D007035:Hypothermia / Q000150:complications* / Q000517:prevention & control; D017202:Myocardial Ischemia / Q000209:etiology; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology; D019990:Perioperative Care; D012768:Shivering; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology; D014947:Wounds and Injuries / Q000150:complications
D018681:Anesthetics, General; D009467:Neuromuscular Depolarizing Agents