Alternative Strategies to Deal with Perioperative Hypothermia

  • F. Carli
Conference paper


Mild hypothermia in the surgical patient is the most common, non-intentional, thermal disturbance, and results from a combination of impaired thermoregulation and exposure to a cold environment. The fine balance between body heat production and dissipation that characterizes homeotherms is altered mainly by surgical stress and anesthetic drugs. Body heat production decreases significantly with induction of general anesthesia while heat loss increases.


Respiratory Exchange Ratio Rest Energy Expenditure Amino Acid Mixture Spinal Block Splanchnic Blood Flow 
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  1. 1.
    Jequier E (1986) The influence of nutrient administration on energy expenditure in man. Clin Nutr 5: 181–186PubMedCrossRefGoogle Scholar
  2. 2.
    Acheson KJ, Ravussin E, Wahren J, Jequier E (1984) Thermic effect of glucose in man. Obligatory and facultative thermogenesis. J Clin Invest 74: 1572–1580PubMedCrossRefGoogle Scholar
  3. 3.
    Brundin T, Wahren J (1994) Effects of iv amino acids on human splanchnic and whole body oxygen consumption, blood flow, and body temperature. Am J Physiol 266: E396–E402PubMedGoogle Scholar
  4. 4.
    Carlson GL, Gray P, Arnold J et al (1994) Thermogenic, hormonal and metabolic effects of a TPN mixture. Influences of glucose and amino acids. Am J Physiol 266: E845–E851PubMedGoogle Scholar
  5. 5.
    Sellden E, Brundin T, Wahren J (1994) Augmented thermic effect of amino acids under general anesthesia: a mechanism useful for prevention of anesthesia-induced hypothermia. Clin Sci 86: 611–618PubMedGoogle Scholar
  6. 6.
    Sellden E, Branstrom R, Brundin T (1996) Preoperative infusion of amino acids prevents postoperative hypothermia. Br J Anaesth 76: 227–234PubMedCrossRefGoogle Scholar
  7. 7.
    Irving M (1992) Thermogenic and hormonal responses to amino acid infusion in septic humans. Am J Physiol 263: E129–E135PubMedGoogle Scholar
  8. 8.
    Ozaki M, Kurz A, Sessler DI et al (1994) Thermoregulatory thresholds during spinal and epidural anesthesia. Anesthesiology 81: 282–288PubMedCrossRefGoogle Scholar
  9. 9.
    Matsukawa T, Sessler DI, Christensen R et al (1995) Heat flow and distribution during epidural anesthesia. Anesthesiology 83: 961–967PubMedCrossRefGoogle Scholar
  10. 10.
    Emerick TH, Ozaki M, Sessler DI et al (1994) Epidural anesthesia increases apparent leg temperature and decreases the shivering threshold. Anesthesiology 81: 289–298PubMedCrossRefGoogle Scholar
  11. 11.
    Leslie K, Sessler DI (1996) Reduction in the shivering threshold is proportional to spinal block height. Anesthesiology 84: 1327–1331PubMedCrossRefGoogle Scholar
  12. 12.
    Kurz A, Sessler DI, Schroeder M, Kurz M (1993) Thermoregulatory response thresholds during spinal anesthesia. Anesth Analg 77: 721–726PubMedGoogle Scholar
  13. 13.
    Carli F, Webster, Nandi P et al (1992) Thermogenesis after surgery: effect of perioperative heat conservation and epidural anesthesia. Am J Physiol 263: E441–E447PubMedGoogle Scholar
  14. 14.
    Carli F, Kulkarni P, Webster JD, MacDonald IA (1995) Post-surgery epidural blockade with local anaesthetics attenuates the catecholamine and thermogenic response to perioperative hypothermia. Acta Anaesthesiol Scand 39: 1041–1047PubMedCrossRefGoogle Scholar
  15. 15.
    Frank SM, Beattie C, Christopherson R et al (1992) Epidural versus general anesthesia, ambient operating room temperature, and patient age as predictors of inadvertent hypothermia. Anesthesiology 77: 252–257PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1998

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  • F. Carli

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