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Rewarming and cardiac surgery: a review.
1Heart Institute of the Desert, Eisenhower Medical Center, Rancho Mirage.
Heart & Lung : the Journal of Critical Care
|September 1, 1988
Summary
Post-cardiac surgery patients often remain hypothermic. Re-warming requires external methods like warming lights and internal methods such as warmed fluids and gases to restore normal body temperature.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Physiology
Background:
- Patients undergoing cardiac surgery frequently develop mild hypothermia by the end of the procedure.
- Restoring normothermia is crucial for optimal enzymatic function and recovery.
- Neuromuscular blockade can inhibit the body's natural shivering response, a key heat production mechanism.
Purpose of the Study:
- To review methods for re-warming patients after cardiac surgery.
- To highlight the importance of active re-warming strategies.
Main Methods:
- Discussion of external re-warming techniques (warming lights, increased room temperature, blankets).
- Explanation of internal re-warming techniques (warmed inhalation gases, intravenous fluids, nasogastric lavage, peritoneal dialysis).
Main Results:
- External methods focus on minimizing further heat loss.
- Internal methods actively transfer heat via convection to reverse hypothermia.
- Warmed fluids and gases are effective internal re-warming strategies.
Conclusions:
- Effective re-warming is essential for post-cardiac surgery patients.
- A combination of external and internal methods may be necessary for optimal temperature management.
- Internal convective re-warming is vital when shivering is inhibited.