Transcript Patient Temperature Management

Why warm our patients?
To maintain a near normal core body temperature to aid
patient recovery, normal body temperature =
37 degrees Celsius
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Thermoregulation
The body’s normal response to temperature
Interthreshold
range 0.2
degree
Shivering, NST
Vasoconstriction
Vasodilation,
sweating
33 35 37 39 41
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Which patients need warming?
•
•
•
•
•
•
The trauma patient
Patients' undergoing anaesthesia / surgery
Recovery
ICU
Paediatrics
Labour and delivery.
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Mild hypothermia
• Promotes bleeding and increases transfusion
requirement.
• Prolongs drug metabolism.
• Increases incidence of wound infections.
• Increases postoperative recovery.
• Increases the risk of morbid myocardial events.
• Prolongs hospitalisation.
• Impaired immune function.
• Increase cost.
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Effects of anaesthesia
• Anaesthesia causes vasodilation.
• Warm blood from the core mixes with the
colder periphery.
• Skin – large surface area.
• Blood circulates, cools and returns to
heart.
• Drop in the core temperature.
• Redistribution temperature drop (RTD).
• Anaesthetic agents act on CNS and
interfere with hypothalamic control.
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Thermoregulation under anaesthesia
Anaesthesia impaired response to temperature:
Interthreshold range
4 degree
Shivering, NST
Vasoconstriction
33
35
Vasodilation,
sweating
37
39
41
Hypothermia 36 degrees
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Why warm fluids?
Fluids are generally infused into the body at room
temperature, which is over 1ºC below body temperature.
The body must then give up its own heat to warm the
infused fluids.
How do we warm fluids?
A medical device used for pre-warming blood and other
fluids being administered IV to prevent hypothermia.
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Why cool patients?
Cooling improves neurological outcome and reduces
mortality by:
• Reduction of cerebral metabolism, oxygen & glucose
demand
• Slowing of the destructive neuroexitatory process
• Decrease of free radical production
• Stabilisation of the blood-brain-barrier
• Reduction of the inflammatory process.
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