Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 729-744 , December 2008

Thermoregulatory management for mild therapeutic hypothermia

  • Oliver Kimberger, MD (Resident Anesthesiologist)

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel./Fax: +43 1 40 400 4100.

References 

  1. Sessler DI, Rubinstein EH, Moayeri A. Physiologic responses to mild perianesthetic hypothermia in humans. Anesthesiology. 1991;75(4):594–610
  2. Xiong J, Kurz A, Sessler DI, et al. Isoflurane produces marked and nonlinear decreases in the vasoconstriction and shivering thresholds. Anesthesiology. 1996;85(2):240–245
  3. Ikeda T, Kim JS, Sessler DI, et al. Isoflurane alters shivering patterns and reduces maximum shivering intensity. Anesthesiology. 1998;88(4):866–873
  4. Annadata R, Sessler DI, Tayefeh F, et al. Desflurane slightly increases the sweating threshold but produces marked, nonlinear decreases in the vasoconstriction and shivering thresholds. Anesthesiology. 1995;83(6):1205–1211
  5. Matsukawa T, Kurz A, Sessler DI, et al. Propofol linearly reduces the vasoconstriction and shivering thresholds. Anesthesiology. 1995;82(5):1169–1180
  6. Kurz A, Sessler DI, Annadata R, et al. Midazolam minimally impairs thermoregulatory control. Anesthesia & Analgesia. 1995;81(2):393–398
  7. Wheelahan JM, Leslie K, Silbert BS. Epidural fentanyl reduces the shivering threshold during epidural lidocaine anesthesia. Anesthesia & Analgesia. 1998;87(3):587–590
  8. Kurz A, Go JC, Sessler DI, et al. Alfentanil slightly increases the sweating threshold and markedly reduces the vasoconstriction and shivering thresholds. Anesthesiology. 1995;83(2):293–299
  9. Alfonsi P, Sessler DI, Du Manoir B, et al. The effects of meperidine and sufentanil on the shivering threshold in postoperative patients. Anesthesiology. 1998;89(1):43–48pascal.alfonsi@apr.ap-hop-paris.fr
  10. Kurz A, Ikeda T, Sessler DI, et al. Meperidine decreases the shivering threshold twice as much as the vasoconstriction threshold. Anesthesiology. 1997;86(5):1046–1054
  11. Pauca AL, Savage RT, Simpson S, Roy RC. Effect of pethidine, fentanyl and morphine on post-operative shivering in man. Acta Anaesthesiologica Scandinavica. 1984;28(2):138–143
  12. Mokhtarani M, Mahgoub AN, Morioka N, et al. Buspirone and meperidine synergistically reduce the shivering threshold. Anesthesia & Analgesia. 2001;93(5):1233–1239
  13. Mackenzie JE, Frank LW. Influence of pretreatment with a monoamine oxidase inhibitor (phenelzine) on the effects of buprenorphine and pethidine in the conscious rabbit. British Journal of Anaesthesia. 1988;60(2):216–221
  14. Helgesen KG, Ellingsen O, Ilebekk A. Inotropic effect of meperidine: influence of receptor and ion channel blockers in the rat atrium. Anesthesia & Analgesia. 1990;70(5):499–506
  15. Kaya K, Babacan A, Beyazova M, et al. Effects of perineural opioids on nerve conduction of N. suralis in man. Acta Neurologica Scandinavica. 1992;85(5):337–339
  16. Kurz M, Belani KG, Sessler DI, et al. Naloxone, meperidine, and shivering. Anesthesiology. 1993;79(6):1193–1201
  17. Kammersgaard LP, Rasmussen BH, Jorgensen HS, et al. Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling: A case-control study: the Copenhagen Stroke Study. Stroke. 2000;31(9):2251–2256
  18. Dixon SR, Whitbourn RJ, Dae MW, et al. Induction of mild systemic hypothermia with endovascular cooling during primary percutaneous coronary intervention for acute myocardial infarction. Journal of the American College of Cardiology. 2002;40(11):1928–1934
  19. Lyden PD, Allgren RL, Ng K, et al. Intravascular Cooling in the Treatment of Stroke (ICTuS): Early Clinical Experience. Journal of Stroke and Cerebrovascular Diseases. 2005;14(3):107–114
  20. Guluma KZ, Hemmen TM, Olsen SE, et al. A trial of therapeutic hypothermia via endovascular approach in awake patients with acute ischemic stroke: methodology. Academic Emergency Medicine. 2006;13(8):820–827
  21. Doufas AG, Lin CM, Suleman MI, et al. Dexmedetomidine and meperidine additively reduce the shivering threshold in humans. Stroke. 2003;34(5):1218–1223
  22. Talke P, Tayefeh F, Sessler DI, et al. Dexmedetomidine does not alter the sweating threshold, but comparably and linearly decreases the vasoconstriction and shivering thresholds. Anesthesiology. 1997;87(4):835–841
  23. Nicolaou G, Chen AA, Johnston CE, et al. Clonidine decreases vasoconstriction and shivering thresholds, without affecting the sweating threshold. Canadian Journal of Anaesthesia. 1997;44(6):636–642
  24. Lesch KP, Poten B, Sohnle K, Schulte HM. Pharmacology of the hypothermic response to 5-HT1A receptor activation in humans. European Journal of Clinical Pharmacology. 1990;39(1):17–19
  25. Lee HS, Meltzer HY. Buspirone does not produce a 5-HT1A-mediated decrease in temperature in man. Journal of Neural Transmission General Section. 1991;86(1):71–76
  26. Heel RC, Brogden RN, Pakes GE, et al. Nefopam: a review of its pharmacological properties and therapeutic efficacy. Drugs. 1980;19(4):249–267
  27. Guirimand F, Dupont X, Bouhassira D, et al. Nefopam strongly depresses the nociceptive flexion (R(III)) reflex in humans. Pain. 1999;80(1–2):399–404
  28. Gasser JC, Bellville JW. Respiratory effects of nefopam. Clinical Pharmacology & Therapeutics. 1975;18(2):175–179
  29. Bilotta F, Ferri F, Giovannini F, et al. Nefopam or clonidine in the pharmacologic prevention of shivering in patients undergoing conscious sedation for interventional neuroradiology. Anaesthesia. 2005;60(2):124–128
  30. Alfonsi P, Adam F, Passard A, et al. Nefopam, a nonsedative benzoxazocine analgesic, selectively reduces the shivering threshold in unanesthetized subjects. Anesthesiology. 2004;100(1):37–43
  31. Piper SN, Suttner SW, Schmidt CC, et al. Nefopam and clonidine in the prevention of postanaesthetic shivering. Anaesthesia. 1999;54(7):695–699
  32. Rosa G, Dell'Utri D, Conti G, et al. Efficacy of nefopam for the prevention and treatment of amphotericin B-induced shivering. Archives of Internal Medicine. 1997;157(14):1589–1592
  33. Rosa G, Pinto G, Orsi P, et al. Control of post anaesthetic shivering with nefopam hydrochloride in mildly hypothermic patients after neurosurgery. Acta Anaesthesiologica Scandinavica. 1995;39(1):90–95
  34. Cheng C, Matsukawa T, Sessler DI, et al. Increasing mean skin temperature linearly reduces the core-temperature thresholds for vasoconstriction and shivering in humans. Anesthesiology. 1995;82(5):1160–1168
  35. Alfonsi P, Nourredine KE, Adam F, et al. Effect of postoperative skin-surface warming on oxygen consumption and the shivering threshold. Anaesthesia. 2003;58(12):1228–1234
  36. Kimberger O, Ali SZ, Markstaller M, et al. Meperidine and skin surface warming additively reduce the shivering threshold: a volunteer study. Critical Care. 2007;11(1):R29
  37. HACA-Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med, 346(8): 549–56.
  38. Plattner O, Kurz A, Sessler DI, et al. Efficacy of intraoperative cooling methods. Anesthesiology. 1997;87(5):1089–1095
  39. Sessler DI, Moayeri A. Skin-surface warming: heat flux and central temperature. Anesthesiology. 1990;73(2):218–224
  40. Hynson JM, Sessler DI. Intraoperative warming therapies: a comparison of three devices. Journal of Clinical Anesthesia. 1992;4(3):194–199
  41. Theard MA, Tempelhoff R, Crowder CM, et al. Convection versus conduction cooling for induction of mild hypothermia during neurovascular procedures in adults. Journal of Neurosurgical Anesthesiology. 1997;9(3):250–255
  42. Mayer SA, Kowalski RG, Presciutti M, et al. Clinical trial of a novel surface cooling system for fever control in neurocritical care patients. Critical Care Medicine. 2004;32(12):2508–2515
  43. Haugk M, Sterz F, Grassberger M, et al. Feasibility and efficacy of a new non-invasive surface cooling device in post-resuscitation intensive care medicine. Resuscitation. 2007;75(1):76–81
  44. Nesher N, Uretzky G, Insler S, et al. Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage. The Journal of Thoracic and Cardiovascular Surgery. 2005;129(6):1371–1378
  45. Hofer CK, Worn M, Tavakoli R, et al. Influence of body core temperature on blood loss and transfusion requirements during off-pump coronary artery bypass grafting: a comparison of 3 warming systems. The Journal of Thoracic and Cardiovascular Surgery. 2005;129(4):838–843
  46. Battin MR, Penrice J, Gunn TR, Gunn AJ. Treatment of term infants with head cooling and mild systemic hypothermia (35.0 degrees C and 34.5 degrees C) after perinatal asphyxia. Pediatrics. 2003;111(2):244–251
  47. Qiu W, Shen H, Zhang Y, et al. Noninvasive selective brain cooling by head and neck cooling is protective in severe traumatic brain injury. Journal of Clinical Neuroscience. 2006;13(10):995–1000
  48. Gluckman PD, Wyatt JS, Azzopardi D, et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet. 2005;365(9460):663–670
  49. Bello SO. Selective head cooling after neonatal encephalopathy. Lancet. 2005;365(9471):1619
  50. Horn AR, Woods DL, Thompson C, et al. Selective cerebral hypothermia for post-hypoxic neuroprotection in neonates using a solid ice cap. South African Medical Journal. 2006;96(9 Pt 2):976–981
  51. Rajek A, Greif R, Sessler DI, et al. Core cooling by central venous infusion of ice-cold (4 degrees C and 20 degrees C) fluid: isolation of core and peripheral thermal compartments. Anesthesiology. 2000;93(3):629–637
  52. Bernard S, Buist M, Monteiro O, Smith K. Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation. 2003;56(1):9–13
  53. Virkkunen I, Yli-Hankala A, Silfvast T. Induction of therapeutic hypothermia after cardiac arrest in prehospital patients using ice-cold Ringer's solution: a pilot study. Resuscitation. 2004;62(3):299–302
  54. Kliegel A, Losert H, Sterz F, et al. Cold simple intravenous infusions preceding special endovascular cooling for faster induction of mild hypothermia after cardiac arrest–a feasibility study. Resuscitation. 2005;64(3):347–351
  55. Polderman KH, Rijnsburger ER, Peerdeman SM, Girbes AR. Induction of hypothermia in patients with various types of neurologic injury with use of large volumes of ice-cold intravenous fluid. Critical Care Medicine. 2005;33(12):2744–2751
  56. Kliegel A, Janata A, Wandaller C, et al. Cold infusions alone are effective for induction of therapeutic hypothermia but do not keep patients cool after cardiac arrest. Resuscitation. 2007;73(1):46–53
  57. Schmutzhard E, Engelhardt K, Beer R, et al. Safety and efficacy of a novel intravascular cooling device to control body temperature in neurologic intensive care patients: a prospective pilot study. Critical Care Medicine. 2002;30(11):2481–2488
  58. Polderman KH, Callaghan J. Equipment review: cooling catheters to induce therapeutic hypothermia?. Critical Care. 2006;10(6):234
  59. Covaciu L, Allers M, Enblad P, et al. Intranasal selective brain cooling in pigs. Resuscitation. January 2008;76(1):83–88
  60. Zviman MM, Roguin A, Jacobs A, et al. A new method for inducing hypothermia during cardiac arrest. Critical Care Medicine. 2004;32(9 Suppl.):S369–S373
  61. Safar PJ, Kochanek PM. Therapeutic hypothermia after cardiac arrest. The New England Journal of Medicine. 2002;346(8):612–613
  62. Wen YS, Huang MS, Lin MT, Lee CH. Rapid brain cooling by hypothermic retrograde jugular vein flush. The Journal of Trauma. 2005;58(3):577–581
  63. Yang SS, Jeng MJ, McShane R, et al. Cold perfluorochemical-induced hypothermia protects lung integrity in normal rabbits. Biology of the Neonate. 2005;87(1):60–65
  64. Mori K, Itoh Y, Saito J, et al. Post-resuscitative hypothermic bypass reduces ischemic brain injury in swine. Academic Emergency Medicine. 2001;8(10):937–945
  65. Mori K, Saito J, Kurata Y, et al. Rapid development of brain hypothermia using femoral–carotid bypass. Academic Emergency Medicine. 2001;8(4):303–308
  66. Kawaguchi M, Inoue S, Sakamoto T, et al. The effects of prostaglandin E1 on intraoperative temperature changes and the incidence of postoperative shivering during deliberate mild hypothermia for neurosurgical procedures. Anesthesia & Analgesia. 1999;88(2):446–451
  67. Inoue S, Kawaguchi M, Sakamoto T, et al. Amrinone can accelerate the cooling rate of core temperature during deliberate mild hypothermia for neurosurgical procedures. British Journal of Anaesthesia. 2001;86(5):663–668
  68. Inoue S, Kawaguchi M, Sakamoto T, et al. High-dose amrinone is required to accelerate rewarming from deliberate mild intraoperative hypothermia for neurosurgical procedures. Anesthesiology. 2002;97(1):116–123
  69. Hebbar K, Fortenberry JD, Rogers K, et al. Comparison of temporal artery thermometer to standard temperature measurements in pediatric intensive care unit patients. Pediatric Critical Care Medicine. 2005;6(5):557–561
  70. Kresch MJ. Axillary temperature as a screening test for fever in children. The Journal of Pediatrics. 1984;104(4):596–599
  71. Lefrant JY, Muller L, de La Coussaye JE, et al. Temperature measurement in intensive care patients: comparison of urinary bladder, oesophageal, rectal, axillary, and inguinal methods versus pulmonary artery core method. Intensive Care Medicine. 2003;29(3):414–418
  72. Jean-Mary MB, Dicanzio J, Shaw J, Bernstein HH. Limited accuracy and reliability of infrared axillary and aural thermometers in a pediatric outpatient population. The Journal of pediatrics. 2002;141(5):671–676
  73. Imamura M, Matsukawa T, Ozaki M, et al. The accuracy and precision of four infrared aural canal thermometers during cardiac surgery. Acta Anaesthesiologica Scandinavica. 1998;42(10):1222–1226
  74. Petersen-Smith A, Barber N, Coody DK, et al. Comparison of aural infrared with traditional rectal temperatures in children from birth to age three years. The Journal of Pediatrics. 1994;125(1):83–85
  75. Rhoads FA, Grandner J. Assessment of an aural infrared sensor for body temperature measurement in children. Clinical Pediatrics. 1990;29(2):112–115
  76. Cattaneo CG, Frank SM, Hesel TW, et al. The accuracy and precision of body temperature monitoring methods during regional and general anesthesia. Anesthesia & Analgesia. 2000;90(4):938–945
  77. Callanan D. Detecting fever in young infants: reliability of perceived, pacifier, and temporal artery temperatures in infants younger than 3 months of age. Pediatric Emergency Care. 2003;19(4):240–243
  78. Suleman MI, Doufas AG, Akca O, et al. Insufficiency in a new temporal-artery thermometer for adult and pediatric patients. Anesthesia & Analgesia. 2002;95(1):67–71[table of contents]
  79. Kimberger O, Cohen D, Illievich U, Lenhardt R. Temporal artery versus bladder thermometry during perioperative and intensive care unit monitoring. Anesthesia & Analgesia. 2007;105(4):1042–1047[table of contents]
  80. Moran JL, Peter JV, Solomon PJ, et al. Tympanic temperature measurements: are they reliable in the critically ill? A clinical study of measures of agreement. Critical Care Medicine. 2007;35(1):155–164
  81. Greenes DS, Fleisher GR. When body temperature changes, does rectal temperature lag?. The Journal of Pediatrics. 2004;144(6):824–826
  82. Aziz L, Ono K, Ohta Y, et al. Effect of hypothermia on the in vitro potencies of neuromuscular blocking agents and on their antagonism by neostigmine. British Journal of Anaesthesia. 1994;73(5):662–666
  83. Smeulers NJ, Wierda JM, van den Broek L, et al. Hypothermic cardiopulmonary bypass influences the concentration–response relationship and the biodisposition of rocuronium. European Journal of Anaesthesiology Supplement. 1995;11:91–94
  84. Cammu G, Coddens J, Hendrickx J, Deloof T. Dose requirements of infusions of cisatracurium or rocuronium during hypothermic cardiopulmonary bypass. British Journal of Anaesthesia. 2000;84(5):587–590
  85. England AJ, Wu X, Richards KM, et al. The influence of cold on the recovery of three neuromuscular blocking agents in man. Anaesthesia. 1996;51(3):236–240
  86. Fritz HG, Holzmayr M, Walter B, et al. The effect of mild hypothermia on plasma fentanyl concentration and biotransformation in juvenile pigs. Anesthesia & Analgesia. 2005;100(4):996–1002
  87. Tortorici MA, Kochanek PM, Poloyac SM. Effects of hypothermia on drug disposition, metabolism, and response: A focus of hypothermia-mediated alterations on the cytochrome P450 enzyme system. Critical Care Medicine. 2007;35(9):2196–2204
  88. Bernard SA, Buist M. Induced hypothermia in critical care medicine: a review. Critical Care Medicine. 2003;31(7):2041–2051
  89. Schmied H, Kurz A, Sessler DI, et al. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347(8997):289–292
  90. Winkler M, Akca O, Birkenberg B, et al. Aggressive warming reduces blood loss during hip arthroplasty. Anesthesia & Analgesia. 2000;91(4):978–984
  91. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. The New England Journal of Medicine. 1996;334(19):1209–1215
  92. Hopf HW, Hunt TK, West JM, et al. Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Archives of Surgery. 1997;132(9):997–1004[discussion 1005]
  93. Beilin B, Shavit Y, Razumovsky J, et al. Effects of mild perioperative hypothermia on cellular immune responses. Anesthesiology. 1998;89(5):1133–1140
  94. Wenisch C, Narzt E, Sessler DI, et al. Mild intraoperative hypothermia reduces production of reactive oxygen intermediates by polymorphonuclear leukocytes. Anesthesia & Analgesia. 1996;82(4):810–816
  95. Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. The Journal of the American Medical Association. 1997;277(14):1127–1134
  96. Nolan JP, Morley PT, Hoek TL, Hickey RW. Therapeutic hypothermia after cardiac arrest. An advisory statement by the Advancement Life support Task Force of the International Liaison committee on Resuscitation. Resuscitation. 2003;57(3):231–235
  97. Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. The New England Journal of Medicine. 2002;346(8):557–563

PII: S1521-6896(07)00107-3

doi: 10.1016/j.bpa.2007.11.002

Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 729-744 , December 2008