주술기 저체온의 관리
Management of Perioperative Hypothermia
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Anesthesia and surgery commonly cause substantial thermal perturbations. Mild hypothermia (33.0∼36.4℃) results from a combination of anesthetic-induced impairment of thermoregulatory control, a cool operating room environment, and factors unique to surgery that promote excessive heat loss. Perioperative mild hypothermia is extremely common and associated with adverse outcomes such as excessive sympathetic nervous system stimulation, prolonged drug metabolism, impaired platelet activity, impaired immune function and postanesthetic shivering. Prevention of perioperative hypothermia and post-anesthetic shivering improves the outcome in terms of reduced cardiac morbidity and blood loss, improved wound healing and shorter hospital stay. Core temperature monitoring, accompanied by passive and active methods to maintain normothermia, should be part of routine intraoperative monitoring for patients at high risk of perioperative hypothermia, particularly patients undergoing body-cavity surgery, surgery greater than 1 hour duration, younger children and the elderly
Abstract
Anesthesia and surgery commonly cause substantial thermal perturbations. Mild hypothermia (33.0∼36.4℃) results from a combination of anesthetic-induced impairment of thermoregulatory control, a cool operating room environment, and factors unique to surgery that promote excessive heat loss. Perioperative mild hypothermia is extremely common and associated with adverse outcomes such as excessive sympathetic nervous system stimulation, prolonged drug metabolism, impaired platelet activity, impaired immune function and postanesthetic shivering. Prevention of perioperative hypothermia and post-anesthetic shivering improves the outcome in terms of reduced cardiac morbidity and blood loss, improved wound healing and shorter hospital stay. Core temperature monitoring, accompanied by passive and active methods to maintain normothermia, should be part of routine intraoperative monitoring for patients at high risk of perioperative hypothermia, particularly patients undergoing body-cavity surgery, surgery greater than 1 hour duration, younger children and the elderly