Perioperative Thermoregulation and Heat Balance

Grimm, Kurt A.

doi:10.1002/9781119421375.ch19

Cited by 10 publications

(16 citation statements)

References 54 publications

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“…Heat production in the body is due to metabolism and is regulated by thermoreceptors in the hypothalamus that initiate reflexes to increase heat production and reduce heat loss [ 36 ]. Thermoregulation normally has a very narrow set point of +/− 0.2 °C, however anesthetic drugs can increase the interthreshold range by approximately 3.5 °C [ 37 ]. Surgery increases heat loss from radiation, conduction, convection and evaporation [ 27 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thermoregulation normally has a very narrow set point of +/− 0.2 °C, however anesthetic drugs can increase the interthreshold range by approximately 3.5 °C [ 37 ]. Surgery increases heat loss from radiation, conduction, convection and evaporation [ 27 , 37 ]. Radiation has been identified as the most important cause of perianesthestic heat loss and unfortunately is not inhibited by traditional methods to prevent hypothermia (warmed water blankets, forced warmed air heaters) [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Surgery increases heat loss from radiation, conduction, convection and evaporation [ 27 , 37 ]. Radiation has been identified as the most important cause of perianesthestic heat loss and unfortunately is not inhibited by traditional methods to prevent hypothermia (warmed water blankets, forced warmed air heaters) [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

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Pneumoperitoneum in Veterinary Laparoscopy: A Review

Scott

Singh

Valverde

2020

Veterinary Sciences

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Objective: To review the effects of carbon dioxide pneumoperitoneum during laparoscopy, evaluate alternative techniques to establishing a working space and compare this to current recommendations in veterinary surgery. Study Design: Literature review. Sample Population: 92 peer-reviewed articles. Methods: An electronic database search identified human and veterinary literature on the effects of pneumoperitoneum (carbon dioxide insufflation for laparoscopy) and alternatives with a focus on adaptation to the veterinary field. Results: Laparoscopy is the preferred surgical approach for many human and several veterinary procedures due to the lower morbidity associated with minimally invasive surgery, compared to laparotomy. The establishment of a pneumoperitoneum with a gas most commonly facilitates a working space. Carbon dioxide is the preferred gas for insufflation as it is inert, inexpensive, noncombustible, colorless, excreted by the lungs and highly soluble in water. Detrimental side effects such as acidosis, hypercapnia, reduction in cardiac output, decreased pulmonary compliance, hypothermia and post-operative pain have been associated with a pneumoperitoneum established with CO2 insufflation. As such alternatives have been suggested such as helium, nitrous oxide, warmed and humidified carbon dioxide and gasless laparoscopy. None of these alternatives have found a consistent benefit over standard carbon dioxide insufflation. Conclusions: The physiologic alterations seen with CO2 insufflation at the current recommended intra-abdominal pressures are mild and of transient duration. Clinical Significance: The current recommendations in veterinary laparoscopy for a pneumoperitoneum using carbon dioxide appear to be safe and effective.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Pneumoperitoneum in Veterinary Laparoscopy: A Review

Scott

Singh

Valverde

2020

Veterinary Sciences

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“…During anaesthesia, the initial reduction of body temperature is mainly a result of changes in blood distribution caused by anaesthetic agents (Grimm 2015). In humans, body temperature drops 1-1.5°C during the first hour after induction (Grimm 2015). However, both wrapped and unwrapped cats in this study showed a greater decrease in body temperature (Figure 3a) between T start and T surgery (approximately 1 hour after induction).…”

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Effect of insulation with bubble wrap and an absorbent pad on heat loss in anaesthetised cats

Sakata

Walsh

Chambers

et al. 2020

New Zealand Veterinary Journal

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Aims: To evaluate the efficacy of insulating the limbs and thorax of cats with a combination of bubble wrap and an absorbent, plastic-lined pad in reducing heat loss during ovariohysterectomy. Methods: A preliminary study was performed to compare heat loss of 1 L bags of Hartmann's solution heated to 38°C which were either wrapped in two layers of bubble wrap and an absorbent pad (n = 6) or were unwrapped (n = 6). Bags were allowed to cool in a temperature-controlled room and the temperature of the bags was measured every 10 minutes for 60 minutes. The clinical study, included 16 intact female cats undergoing ovariohysterectomy. The cats were premedicated with I/M morphine and either medetomidine or dexmedetomidine, and anaesthesia was induced with I/V propofol and maintained with isoflurane in 100% oxygen. Cats were randomly assigned to either the treatment group (n = 8) whose limbs and thorax wrapped with two layers of bubble wrap and an absorbent pad immediately after induction, or the control group (n = 8) which were unwrapped. Body temperature (measured with an oesophageal temperature probe), heart rate, respiratory rate, mean arterial pressure and partial pressure of end-tidal CO 2 were recorded immediately after induction (T start), before surgery started (T surgery), and at the end of isoflurane administration (T end). The times from T end to extubation, from T end to when the cat could maintain sternal recumbency and from T end to when the cat was able to stand, were also recorded. Results: In the preliminary study of heat loss by fluid bags, the mean temperature at 60 minutes was higher in wrapped bags (35.4 (SD 0.2)°C) compared to unwrapped bags (33.0 (SD 0.3)°C; p < 0.01). For cats undergoing ovariohysterectomy, mean body temperature of wrapped cats was higher than that of unwrapped cats both at T surgery (36.0 (SE 0.3) vs. 34.5 (SE 0.3)°C; p = 0.001) and at T end (37.2 (SE 0.5) vs. 36.0 (SE 0.5)°C; p = 0.01). Wrapped cats regained the ability to stand more rapidly that unwrapped cats (26.4 (SE 5.8) vs. 47.0 (SE 5.8) minutes p = 0.01). Conclusions: Wrapping the limbs and thorax of cats undergoing ovariohysterectomy in a combination of bubble wrap and absorbent pads reduced heat loss, which in turn improved recovery time from general anaesthesia. Clinical relevance: This inexpensive and practical method may reduce perioperative hypothermia, in cats undergoing abdominal surgery.

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Temperature Regulation and Monitoring

Baldo

Palmer

2018

Veterinary Anesthetic and Monitoring Equipment

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Perioperative Thermoregulation and Heat Balance

Cited by 10 publications

References 54 publications

Pneumoperitoneum in Veterinary Laparoscopy: A Review

Pneumoperitoneum in Veterinary Laparoscopy: A Review

Effect of insulation with bubble wrap and an absorbent pad on heat loss in anaesthetised cats

Temperature Regulation and Monitoring

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