1. TERMOREGULATION IN PERIOPERATIVE PERIOD
VESNA VEGAR BROZOVIĆ
KLINIKA ZA ANESTEZIOLOGIJU, REANIMATOLOGIJU I INTENZIVNO LIJEČENJE,KBC ZAGREB, MEDICINSKI FAKULTET SVEUČILIŠTE U ZAGREBU,HRVATSKA

2. CAUSES OF HYPOTHERMIA ALTERED RESPONSES TO HEAT
INCREASE HEAT LOSS TO ENVIROMENT EXPOSURE
COOLING EFFECT OF COLD ANAESTHETIC GASES AND INTRAVENOUS FLUIDS
REDUCE HEAT PRODUCTION- METABOLIC ACTIVITY

3. CLINICALLY HYPOTHERMIC DURING SURGERY
ANESTHESIA
WET SKIN PREPARATION
SKIN EXPOSURE TO COLD
ASPAN, 2001 –GUIDELINES FOR HYPOTHERMIC PERIOD

4. REDUCING INCIDENCE OF COMPLICATIONS
TRIGERRING THERMOREGULATION VASOCONSTRICTION

5. METHODS FOR NORMOTHERMIA
1. PREOPERATIVE PATIENT WARMING
2. INTRAOPERATIVE AIR FORCED METHOD
3.WARMED INTRAOPERATIVE FLUIDS
4.AVOIDING RISK OF POSTOPERATIVE MORBIDITY
5.MINIMISE THE REDISTRIBUTION OF HYPOTHERMIC ATTACS

7. HOW TO REDUCE HYPOTHERMIA
PREWARMING
START TO WARM AS EARLY AS POSSIBLE
COST/RISK BENEFIT
AVOID THERMAL DISCOMFORT
LONG HOSPITAL STAY......DEATH

8. BODY TEMPERATURE CORE TEMPERATURE IN MEASURED TISSUE
THERMOREGULATORY CONTROL
DURING ANESTHESIA
NEUROAXIAL ANESTHESIA
FIRST 30 MIN
HEAT BALANCE IN SURGICAL PATIENT
THERMAL PERTURBATION
POSTOPERATIVE SHIVERING

9. ASPAN, 2012
EVIDENCE BASED CLINICAL PRACTICE
QUALITY PATIENT CARE

10. THE MAJOR CAUSE OF HYPOTHERMIA
PATIENTS UNDER GENERAL ANESTHESIA IS AN INTRNAL CORE-TO- PERPHERAL REDISTRIBUTION OF BODY HEAT THAT USUALLY REDUCES CORE TEMPERATURE BY 0,5 TO 1,5* IN FIRST 30 MINUTES FOLLOWING INDUCTION OF ANESTHESIA AND OF VARIETY OF OTHER FACTORS WHO ARE OF IMPORTANCE IN INDIVIDUAL PATIENT WHAT IS HARD TO PREDICT

11. HIGH RISK PATIENTS CHILDREN, ELDERLY PREOP.TEMPERATURE<36*
COMBINED GENERAL AND REGIONAL ANESTHESIA
MAJOR SURGERY
PROLONGED OPERATIONS
ASA 3-5 PATIENTS

12. HYPOTHERMIA CONFUSION MEMORY LOSS BODY TEMPERATURE <35* DROWSINES
SHALLOW BREATHING
LOSS OF CONSCIOUSNESS
LOW ENERGY LEVEL

13. ANAESTHETICS
GENERAL ANETHESIA
NEUROAXIAL ANESTHESIA

14. SURGERY EXPOSURE TO COLD ENVIROMENT
ADMINISTRATION OF UNWARMED INTRAVENOUS FLUIDS
EVAPORATION
REFLECT A FAILURE OF EFFECTIVE THERMOREGULATORY DEFENSES

15. BODY TEMPERATURE NOT HOMOGENOUS
2-4* COOLER THORAX,ABDOMEN,CNS THEN LEGS,ARMS, SKIN SURFACE
CORE TEMPERATUREV TIGHTLY REGULATED, SKIN DEPENDS ABOUT CURRENT EXPOSURE

16. PERIOPERATIVE DISTURBANCES
MILD HYPOTHERMIA
ADVERSE OUTCOMES
POST OPERATIVE COMPLICATIONS

17. COMPLICATIONS MORBID MYOCARDIAL OUTCOME
ACTIVATION OF SYMPATHIC NERVOUS SYSTEM
SURGICAL WOUND INFECTION

18. COMPLICATIONS IN VARIETY OF POPULATION WHAT WAS NOT EXPECTED
INTRAOPERATIVE HYPOTHERMIA REQUIERES DIAGNOSTIC ATTENTION

19. COMPLICATIONS COAGULOPATHY INCREASED ALLOGENIC TRANSFUSION
DELAYED POSTANESTHETIC RECOVERY

20. ADVERSE EFFECT NEGATIVE NITROGEN BALANCE SHIVERING
PROLONGED HOSPITALISATION
PATIENT DISCOMFORT

21. TEMPERATURE
MEASURING BODY TEMPERATURE AND MAINTAINING NORMOTHERMIA IS NOW:
ESSENTIAL IN STANARD-OF-CARE DURING LARGE OPERATION AND PROLONGED ANESTHESIA

23. FORCED AIR WARMING BEFORE NO GOOD WAY TO KEEP THE PATIENT WARM
MILLION PATIENTS
DR. D.SESSLER : SAFE, EFFECTIVE
EASY TO USE
INNEXPENSIVE
LAMINAR FLOW IN OP.WARD

24. AIR FORCED-PREVENTION OF HYPOTHERMIA
EFFECTIVE PROCEDUREIN PERIPERATIVE PERIOD
REDUCTION OF HEAT LOSS FROM THE SKIN MOST PROMISSING APPROACH TO AVOID HYPOTHERMIC EPISODES
COVERING 15-20%BODY SURFACES TO MAKE HEAT BALANCE
INSSUFLATION OF WARM AIR

26. NORMOTHERMIA
THE MONITORING OF PATIENT TEMPERATURE IS RESPONSABILITY OF ALL SURGICAL TEAM MEMBERS AND NOT JUST THE ANESTHESIA PROVIDER, THE SURGEON, PERIOPERATIVE PERSONNEL AND PERIANESTHESIA PERSONNEL