Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 645-657 , December 2008

Perioperative complications of hypothermia

  • Andrea Kurz, MD (Vice Chair, Professor of Anesthesiology)

      Affiliations

    • Corresponding Author InformationCorresponding author. Department of Outcomes Research, Anesthesia Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, 44195 OH, USA. Tel.: +1 216 445 9924; Fax: +1 216 444 6235.

References 

  1. Leslie K, Sessler DI, Bjorksten AR, et al. Mild hypothermia alters propofol pharmacokinetics and increases the duration of action of atracurium. Anesthesia and Analgesia. 1995;80:1007–1014
  2. Leslie K, Bjorksten AR, Ugoni A, et al. Mild core hypothermia and anesthetic requirement for loss of responsiveness during propofol anesthesia for craniotomy. Anesthesia and Analgesia. 2002;94(5):1298–1303
  3. Fritz HG, Holzmayr M, Walter B, et al. The effect of mild hypothermia on plasma fentanyl concentration and biotransformation in juvenile pigs. Anesthesia and Analgesia. 2005;100(4):996–1002
  4. Heier T, Caldwell JE, Sessler DI, et al. The relationship between adductor pollicis twitch tension and core, skin and muscle temperature during nitrous oxide-isoflurane anesthesia in humans. Anesthesiology. 1989;71:381–384
  5. Heier T, Caldwell JE, Sessler DI, et al. Mild intraoperative hypothermia increases duration of action and spontaneous recovery of vecuronium blockade during nitrous oxide-isoflurane anesthesia in humans. Anesthesiology. 1991;74:815–819
  6. Caldwell JE, Heier T, Wright PMC, et al. Temperature-dependent pharmacokinetics and pharmacodynamics of vecuronium. Anesthesiology. 2000;92:84–93
  7. Heier T, Clough D, Wright PM, et al. The influence of mild hypothermia on the pharmacokinetics and time course of action of neostigmine in anesthetized volunteers. Anesthesiology. 2002;97(1):90–95
  8. Smeulers NJ, Wierda JM, van den Broek L, et al. Effects of hypothermic cardiopulmonary bypass on the pharmacodynamics and pharmacokinetics of rocuronium. Journal of Cardiothoracic and Vascular Anesthesia. 1995;9(6):700–705
  9. Sessler DI, Rubinstein EH, Moayeri A. Physiological responses to mild perianesthetic hypothermia in humans. Anesthesiology. 1991;75:594–610
  10. Eger EI, Johnson BH. MAC of I-653 in rats, including a test of the effect of body temperature and anesthetic duration. Anesthesia and Analgesia. 1987;66:974–976
  11. Liu M, Hu X, Liu J. The effect of hypothermia on isoflurane MAC in children. Anesthesiology. 2001;94:429–432
  12. Ferrell JE, Mitchell KT, Huestis WH. Membrane bilayer balance and platelet shape: morphological and biochemical responses to amphipathic compounds. Biochimica et Biophysica Acta. 1988;939(2):223–237
  13. Michelson AD, MacGregor H, Barnard MR, et al. Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro. Thrombosis and Haemostasis. 1994;71:633–640
  14. Valeri CR, Khabbaz K, Khuri SF, et al. Effect of skin temperature on platelet function in patients undergoing extracorporeal bypass. The Journal of Thoracic and Cardiovascular Surgery. 1992;104:108–116
  15. Rohrer M, Natale A. Effect of hypothermia on the coagulation cascade. Critical Care Medicine. 1992;20:1402–1405
  16. Faraday N, Rosenfeld BA. In vitro hypothermia enhances platelet GPIIb-IIIa activation and P-selectin expression. Anesthesiology. 1998;88(6):1579–1585
  17. Paul J, Cornillon B, Baguet J, et al. In vivo release of a heparin-like factor in dogs during profound hypothermia. The Journal of Thoracic and Cardiovascular Surgery. 1981;82(1):45–48
  18. Bunker JP, Goldstein R. Coagulation during hypothermia in man. Proceedings of the Society for Experimental Biology and Medicine. 1958;97:199–202
  19. Felfering M, Blaichert A, Kettner SC, et al. Effects of temperature on partial thromboplastin time in heparinized plasma in vitro. European Journal of Anaesthesiology. 2001;18:467–470
  20. Watts DD, Trask A, Soeken K, et al. Hypothermic coagulopathy in trauma: effect of varying levels of hypothermia on enzyme speed, platelet function, and fibrinolytic activity. The Journal of Trauma. 1998;44(5):846–854
  21. Kettner SC, Kozek SA, Groetzner JP, et al. Effects of hypothermia on thrombelastography in patients undergoing cardiopulmonary bypass. British Journal of Anaesthesia. 1998;80(3):313–317
  22. Johansson T, Lisander B, Ivarsson I. Mild hypothermia does not increase blood loss during total hip arthroplasty. Acta Anaesthesiologica Scandinavica. 1999;43(10):1005–1010
  23. Winkler M, Akça O, Birkenberg B, et al. Aggressive warming reduces blood loss during hip arthroplasty. Anesthesia and Analgesia. 2000;91(4):978–984
  24. Rajagopalan, S., Mascha, E., Na, J., et al. The effects of mild perioperative hypothermia on blood loss and transfusion requirement: a meta-analysis. Anesthesiology, in press.
  25. Koch CG, Khandwala F, Li L, et al. Persistent effect of red cell transfusion on health-related quality of life after cardiac surgery. The Annals of Thoracic Surgery. 2006;82(1):13–20
  26. Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: A randomized clinical trial. JAMA: The Journal of the American Medical Association. 1997;277:1127–1134
  27. Frank SM, Higgins MS, Breslow MJ, et al. The catecholamine, cortisol, and hemodynamic responses to mild perioperative hypothermia. Anesthesiology. 1995;82:83–93
  28. Frank SM, Raja SN, Bulcao C, et al. Age-related thermoregulatory differences during core cooling in humans. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2000;279(1):R349–R354
  29. Just B, Delva E, Camus Y, et al. Oxygen uptake during recovery following naloxone. Anesthesiology. 1992;76:60–64
  30. Guffin A, Girard D, Kaplan JA. Shivering following cardiac surgery: Hemodynamic changes and reversal. Journal of Cardiothoracic and Vascular Anesthesia. 1987;1:24–28
  31. Bilotta F, Pietropaoli P, La Rosa I, et al. Effects of shivering prevention on haemodynamic and metabolic demands in hypothermic postoperative neurosurgical patients. Anaesthesia. 2001;56(6):514–519
  32. Kurz A, Plattner O, Sessler DI, et al. The threshold for thermoregulatory vasoconstriction during nitrous oxide/isoflurane anesthesia is lower in elderly than young patients. Anesthesiology. 1993;79:465–469
  33. Kurz A, Go JC, Sessler DI, et al. Alfentanil slightly increases the sweating threshold and markedly reduces the vasoconstriction and shivering thresholds. Anesthesiology. 1995;83:293–299
  34. Frank SM, Cattaneo CG, Wieneke-Brady MB, et al. Threshold for adrenomedullary activation and increased cardiac work during mild core hypothermia. Clinical Science (London, England: 1979). 2002;102(1):119–125
  35. Frank SM, Satitpunwaycha P, Bruce SR, et al. Increased myocardial perfusion and sympathoadrenal activation during mild core hypothermia in awake humans. Clinical Science (London, England: 1979). 2003;104(5):503–508
  36. Nesher N, Zisman E, Wolf T, et al. Strict thermoregulation attenuates myocardial injury during coronary artery bypass graft surgery as reflected by reduced levels of cardiac-specific troponin I. Anesthesia and Analgesia. 2003;96(2):328–335
  37. Haley RW, Culver DH, Morgan WM, et al. Identifying patients at high risk of surgical wound infection: a simple multivariate index of patient susceptibility and wound contamination. American Journal of Epidemiology. 1985;121:206–215
  38. Greif R, Akça O, Horn E-P, et al. Supplemental perioperative oxygen to reduce the incidence of surgical wound infection. The New England Journal of Medicine. 2000;342:161–167
  39. Sessler DI, Olofsson CI, Rubinstein EH. The thermoregulatory threshold in humans during nitrous oxide-fentanyl anesthesia. Anesthesiology. 1988;69:357–364
  40. Sheffield CW, Sessler DI, Hopf HW, et al. Centrally and locally mediated thermoregulatory responses alter subcutaneous oxygen tension. Wound Repair Regen. 1997;4:339–345
  41. Burke JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery. 1961;50:161–168
  42. Classen DC, Evans RS, Pestotnik SL, et al. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. The New England Journal of Medicine. 1992;326(5):281–286
  43. Kurz A, Sessler DI, Lenhardt RA, et al. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. The New England Journal of Medicine. 1996;334:1209–1215
  44. Melling AC, Ali B, Scott EM, et al. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet. 2001;358(9285):876–880
  45. Carli F, Emery PW, Freemantle CAJ. Effect of peroperative normothermia on postoperative protein metabolism in elderly patients undergoing hip arthroplasty. British Journal of Anaesthesia. 1989;63:276–282
  46. Shakhar G, Ben-Eliyahu S. Potential prophylactic measures against postoperative immunosuppression: could they reduce recurrence rates in oncological patients?. Annals of Surgical Oncology. 2003;10(8):972–992
  47. Hines R, Barash PG, Watrous G, et al. Complications occurring in the postanesthesia care unit: a survey. Anesthesia and Analgesia. 1992;74(4):503–509
  48. Bissonnette B, Sessler DI. Mild hypothermia does not impair postanesthetic recovery in infants and children. Anesthesia and Analgesia. 1993;76:168–172
  49. Kurz A, Sessler DI, Narzt E, et al. Postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia. Journal of Clinical Anesthesia. 1995;7:359–366
  50. Horn E-P, Sessler DI, Standl T, et al. Non-thermoregulatory shivering in patients recovering from isoflurane or desflurane anesthesia. Anesthesiology. 1998;89:878–886
  51. Horvath SM, Spurr GB, Hutt BK, et al. Metabolic cost of shivering. Journal of Applied Physiology. 1956;8:595–602
  52. De Witte J, Sessler DI. Perioperative shivering: physiology and pharmacology. Anesthesiology. 2002;96(2):467–484
  53. 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;39:90–95
  54. Mahajan RP, Grover VK, Sharma SL, et al. Intraocular pressure changes during muscular hyperactivity after general anesthesia. Anesthesiology. 1987;66:419–421
  55. Ostheimer GW, Datta S. Observations in the postpartum recovery room after various local anesthetic techniques. Regional Anesthesia. 1981;6:13–17
  56. Ciofolo MJ, Clergue F, Devilliers C, et al. Changes in ventilation, oxygen uptake, and carbon dioxide output during recovery from isoflurane anesthesia. Anesthesiology. 1989;70:737–741
  57. Boelhouwer RU, Bruining HA, Ong GL. Correlations of serum potassium fluctuations with body temperature after major surgery. Critical Care Medicine. 1987;15:310–312
  58. Bruining HA, Boelhouwer RU. Acute transient hypokalaemia and body temperature. Lancet. 1982;1283–1284
  59. Freysz M, Timour Q, Mazze RI, et al. Potentiation by mild hypothermia of ventricular conduction disturbances and reentrant arrhythmias induced by bupivacaine in dogs. Anesthesiology. 1989;70:799–804
  60. Lopez M, Ozaki M, Sessler DI, et al. Mild core hyperthermia does not alter electroencephalographic responses during epidural/enflurane anesthesia in humans. Journal of Clinical Anesthesia. 1993;5:425–430
  61. Levinsohn DG, Gordon L, Sessler DI. The Allen's test: Analysis of four methods. The Journal of Hand Surgery. 1991;16A:279–282
  62. Paulus DA, Monroe MC. Cool fingers and pulse oximetry (letter). Anesthesiology. 1989;71:168–169
  63. Hynson JM, Sessler DI, Belani K, et al. Thermoregulatory vasoconstriction during propofol/nitrous oxide anesthesia in humans: Threshold and SpO2. Anesthesia and Analgesia. 1992;75:947–952
  64. Schmied H, Kurz A, Sessler DI, et al. Mild intraoperative hypothermia increases blood loss and allogeneic transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289–292
  65. Beilin B, Shavit Y, Razumovsky J, et al. Effects of mild perioperative hypothermia on cellular immune responses. Anesthesiology. 1998;89(5):1133–1140
  66. Widman J, Hammarqvist F, Sellden E. Amino acid infusion induces thermogenesis and reduces blood loss during hip arthroplasty under spinal anesthesia. Anesthesia and Analgesia. 2002;95(6):1757–1762
  67. Gentilello LM, Jurkovich GJ, Stark MS, et al. Is hypothermia in the victim of major trauma protective or harmful? A randomized, prospective study. Annals of Surgery. 1997;226(4):439–447[discussion: 447–439]
  68. Lenhardt R, Marker E, Goll V, et al. Mild intraoperative hypothermia prolongs postoperative recovery. Anesthesiology. 1997;87:1318–1323

PII: S1521-6896(08)00061-X

doi: 10.1016/j.bpa.2008.07.005

Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 645-657 , December 2008