Effects of Mild Perioperative Hypothermia on Cellular Immune Responses

Beilin, Benzion; Shavit, Yehuda; Razumovsky, Jacob; Wolloch, Y; Zeidel, Alexander; Bessler, Hanna

doi:10.1097/00000542-199811000-00013

Cited by 211 publications

(114 citation statements)

References 22 publications

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“…The major rationale for preventing perioperative hypothermia is to reduce complications and to improve outcomes [7][8][9][10][11]. Further analysis of the frequency of complications, including shivering, may have…”

Section: Discussionmentioning

confidence: 99%

“…Mild perioperative hypothermia can even lead to more serious complications, such as wound infection, prolongation of postoperative care unit and hospital stays, severe cardiac complications and ventricular tachycardia, coagulopathy, shivering, and reduced immune function. Therefore, continuous monitoring of the core body temperature and careful management of the patient are required [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of warming methods for core temperature preservation during total knee arthroplasty using a pneumatic tourniquet

Kim

Koh

et al. 2016

Anesth Pain Med

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:It is important to ensure that patients are normothermic during surgery. In total knee arthroplasty, the pneumatic tourniquet affects body temperature. We compared the ability of two warming devices to preserve core temperature in patients using a lower limb tourniquet under general anesthesia. Methods: We included 132 patients with American Society of Anesthesiologists physical status I-II who were scheduled to undergo total knee arthroplasty. The patients were randomly divided into four groups (n = 33): group 1, without any heating method; group 2, with fluid warming; group 3, with forced-air warming; and group 4, with a combination of the two heating methods. After the induction of anesthesia, the esophageal and urinary bladder temperatures were monitored and recorded every 5 min before tourniquet deflation and every 1 min after tourniquet deflation. Results: Before tourniquet deflation, compared with group 1, the odds ratios of groups 3 and 4 were less than 1. After tourniquet deflation, compared with group 1, the odds ratios of all groups using warming devices were less than 1. In particular, group 4 showed the largest hypothermia-preventive effect among the four groups. There was a significant correlation between esophageal temperature and bladder temperature before and after tourniquet deflation. Conclusions: After tourniquet deflation, a combination of a fluid warmer and forced-air warmer is the most effective method to prevent hypothermia, although either a fluid warmer or forced-air warmer alone could help to prevent hypothermia. Urinary bladder temperature changes correlate well with esophageal temperature changes throughout this operation. (Anesth Pain Med 2016; 11: 91-98)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of warming methods for core temperature preservation during total knee arthroplasty using a pneumatic tourniquet

Kim

Koh

et al. 2016

Anesth Pain Med

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“…Some research indicates that the core body temperature of 85% of patients will drop 4,12) during and after surgery involving large blood transfusions and fluid infusions if the operation time is longer than 2 hours. Low temperature will cause some serious negative effects on the body, 3) such as prolonging the plasma half-life of drugs and affecting the in vivo elimination process. Many clinical and experimental studies about the effects of low temperature on muscle relaxants have been published.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intraoperative Magnetic Resonance Imaging on the Neuromuscular Blockade of Vecuronium Bromide in Neurosurgery

Guo

Zhang

Sun

2013

Neurol. Med. Chir.(Tokyo)

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The effects of intraoperative magnetic resonance (iMR) imaging on the neuromuscular blockade of vecuronium bromide were investigated in neurosurgery. Fifty patients with American Society of Anesthesiologists grades I-II scheduled for craniotomy operation were divided into two groups (n ＝ 25 each) with no difference in demographic data: the iMR imaging group and control group. Train-of-four (TOF) stimulation through an accelerometer was used to monitor onset, maintenance, and recovery of muscle relaxation caused by vecuronium. Vecuronium bromide was intravenously injected after anesthesia induction. The dosage of vecuronium bromide in the iMR imaging group was larger than in the control group, but not significantly. Duration of vecuronium bromide administration and operation time were significantly longer in the iMR imaging group than in the control group. Time from drug discontinuation to operation termination, and to return to neurosurgery intensive care unit were not different. Time taken by first twitch (T 1 ) in response to TOF stimulation to recover by 25%, and muscle relaxant recovery index were significantly greater in the control group than in the iMR imaging group. The body temperature of the patients increased gradually in the iMR imaging group but decreased in the control group. iMR imaging can prolong the operation time, increase the body temperature of the patient, and remarkably shorten the clinical action time and muscle relaxation recovery index of vecuronium.

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“…Our results show that core temperature in patients with a body weight less than 10 kg, and therefore often receiving a liver graft with a greater GRWR, decreased more than in larger recipients. Efforts to maintain normothermia or slight hyperthermia in the dissection phase are necessary to prevent severe hypothermia with subsequent complications [18][19][20] in the anhepatic and reperfusion phases.…”

Section: Discussionmentioning

confidence: 99%

The effect of liver graft-body weight ratio on the core temperature of pediatric patients during liver transplantation

Jawan

Luk

Chen

et al. 2003

Liver Transplantation

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The left lateral segment of the liver from an adult living donor sometimes is relatively too large for a small pediatric recipient. It currently is unknown whether a high graft-recipient body weight ratio (GRWR) has a significant effect on core temperature during the anhepatic and reperfusion phases of living donor liver transplantation (LDLT). Seventy-two pediatric patients undergoing LDLT were divided into two groups according to body weight. Group I (GI) consisted of patients with a body weight greater than 10 kg, and group II (GII), less than 10 kg. Core temperature, measured as nasopharyngeal temperature (NT), was compared between groups at induction of anesthesia, hourly during the following 6 hours, as the lowest core temperature at the anhepatic phase, 5 and 30 minutes after reperfusion, and the last 2 hours before the end of the operation. Mild hypothermia of 35.8°C ؎ 0.7°C and 35.9°C ؎ 0.4°C for GI and GII was noted after induction of anesthesia, respectively; this increased ؎1°C in the following 6 hours. In the anhepatic and reperfusion phases, a sudden and significant decrease in NT was observed in both groups. This decrease in NT was significantly greater in GII than GI. In conclusion, a sudden decrease in core temperature was observed during the anhepatic and reperfusion phases of LDLT in pediatric patients, likely caused by placement of the cold liver graft, which is flushed with 4°C lactated Ringer's solution during vessel reconstruction, in the anhepatic phase and return of venous blood through the cold preserved liver in the reperfusion phase. Core temperatures of pediatric patients with a body weight less than 10 kg in GII, who received grafts with a high GRWR, were more affected than those in GI. (Liver Transpl 2003;9:760-763.)

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Effects of Mild Perioperative Hypothermia on Cellular Immune Responses

Abstract: Mild perioperative hypothermia suppressed mitogen-induced activation of lymphocytes and reduced the production of certain cytokines, IL-1beta and IL-2, and in this way may contribute to the immune alterations observed in the perioperative period.

Cited by 211 publications

References 22 publications

Comparison of warming methods for core temperature preservation during total knee arthroplasty using a pneumatic tourniquet

Comparison of warming methods for core temperature preservation during total knee arthroplasty using a pneumatic tourniquet

Effects of Intraoperative Magnetic Resonance Imaging on the Neuromuscular Blockade of Vecuronium Bromide in Neurosurgery

The effect of liver graft-body weight ratio on the core temperature of pediatric patients during liver transplantation

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