Clinical importance of body temperature in the surgical patient

1. Mild hypothermia (Tc = 32-34 degrees C) is useful in protecting the brai n and spinal cord from ischemic injury during certain surgical procedures ( cerebral aneurysm, thoracic aortic aneurysm repair). 2. Postoperative shivering increases metabolic demands by approximate to 40 % in the average patient. 3. The adrenergic effects of postoperative hypothermia are manifest as incr eased norepinephrine, vasomotor tone, and arterial blood pressure. 4. Postoperative myocardial ischemia occurs 2-3 times more frequently in pa tients with Tc < 35.0 degrees C than in normothermic patients. The relative risk of postoperative cardiac morbidity can be reduced by 55% when hypothe rmia is prevented during surgery using forced-air warming. 5. Coagulation is impaired at Tc < 35.0 degrees C, predisposing to increase d surgical bleeding. The risk of wound infection is increased 3-fold in pat ients who are hypothermic (Tc < 35.0 degrees C) during surgery. (C) 2000 El sevier Science Ltd. All rights reserved.