Multivariate Determinates of Early Postoperative Oxygen Consumption

Frank, Steven M.; Higgins, Michael S.; Fleisher, L. A.; Gorman, Robert B.; Breslow, Michael J.; Sitzmann, James V.; Beattie, Charles

doi:10.1097/00000542-199409001-01423

Cited by 8 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, there was no doubt that amino acid infusions reduced the incidence of postoperative shivering. The present view, that shivering is an inefficient 'heater' after anaesthesia (Frank et al 1995), was demonstrated in our control patients, who had a low O 2 consumption and were hypothermic at awakening despite shivering. Thus, the absence of shivering evidently does not interfere to any extent with temperature balance.…”

Section: Post-operative Effects and Outcomesupporting

confidence: 59%

“…It is now well documented that even mild hypothermia reduces resistance to surgical wound infection, disturbs blood coagulation with increased blood loss, increases the risk of morbid cardiac events, delays drug metabolism due to impaired hepatic function and prolongs hospital stay. Postoperative adrenergic activation during shivering may be substantial (Frank et al 1995), and several patients report that in the recovery room discomfort of shivering and sensation of cold are worse than surgical pain (Kurz et al 1995).…”

Section: Why Is Hypothermia During Surgery a Clinical Problem?mentioning

confidence: 99%

See 1 more Smart Citation

Peri-operative amino acid administration and the metabolic response to surgery

Selldén

2002

Proc. Nutr. Soc.

View full text Add to dashboard Cite

General anaesthesia causes hypothermia due to decreased metabolic rate and impaired thermoregulation. Many warming devices are in use to prevent heat loss, but little attention has been paid to stimulating the body's own heat generation. All nutrients raise energy expenditure, and the highest thermic effect is ascribed to amino acids and proteins, 30–40% in the awake state. Amino acids infused during general anaesthesia exert a thermic effect that is enhanced compared with that in the awake state. At awakening from anaesthesia, post-operative hypothermia may be prevented without shivering. The tissues involved and the mechanisms by which nutrients stimulate heat production are still not completely understood. However, these findings support the existence of an inhibitory action normally exerted by central thermosensors, in order to maintain oxidative metabolism within certain limits, to prevent hyperthermia. During anaesthesia central thermosensors are silenced and, hence, amino acid thermogenesis is exaggerated. The amino acid-induced heat generation during anaesthesia predominantly occurs in extra-splanchnic tissues, most probably in skeletal muscle. It may reflect an increased protein turnover, as both protein breakdown and synthesis are energy-consuming processes known to generate heat. Possibly, amino acid infusion provides substrates, otherwise mobilized from the body's own tissues, needed for wound healing and immunological function. However, other cellular mechanisms may also contribute to this non-shivering thermogenesis.

show abstract

Section: Post-operative Effects and Outcomesupporting

confidence: 59%

Section: Why Is Hypothermia During Surgery a Clinical Problem?mentioning

confidence: 99%

Peri-operative amino acid administration and the metabolic response to surgery

Selldén

2002

Proc. Nutr. Soc.

View full text Add to dashboard Cite

show abstract

“…Moreover, due to effects on the local immunological response, the risk of surgical wound infections is tripled [44]. A reduction in body temperature during surgery leads to the development of postoperative tremors, which substantially increase the metabolic requirements of the body and oxygen consumption [45]. The proper management is to initiate temperature monitoring before the induction of anaesthesia and to continue this monitoring throughout the procedure and during the postoperative period.…”

Section: Prevention Of Hypothermiamentioning

confidence: 99%

Anaesthetic perioperative management according to the ERAS protocol

Horosz¹,

Nawrocka²,

Malec-Milewska³

2016

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

After many years of experience in surgery, a series of recommendations have been created by a group of European specialists to improve the quality of perioperative care and maximize postoperative outcomes. Early mobilization and oral feeding, preoperative oral intake of carbohydrate-rich fluids, proper fluid and pain management, intensive postoperative nausea and vomiting prophylaxis, and antimicrobial and thromboembolism prophylaxis are the interventions that may decrease surgery-induced metabolic stress and facilitate the return of bowel function and early discharge. The Enhanced Recovery After Surgery (ERAS) Society is the group that focuses on these perioperative issues. This paper aims to summarize the role of anaesthesiologists in the implementation of the ERAS protocol.

show abstract