Rapid core-to-peripheral tissue heat transfer during cutaneous cooling

Anesthesia and Analgesia
O PlattnerD Clough

Abstract

Perioperative thermal manipulations are usually directed at the skin surface because methods of directly warming the core are invasive or ineffective. However, inadequate heat flow between peripheral and core compartments will decrease the rate at which core temperature changes. We therefore determined whether core hypothermia is delayed after initiation of surface cooling. Six volunteers were anesthetized with propofol and midazolam, and maintained under three layers of passive insulation for 2.5-4 h. Subsequently, the skin surface was cooled using forced air, 1000 L/min, at 10 degrees C. Isoflurane was added as necessary to maintain arteriovenous shunt vasodilation. Overall heat balance was determined from the difference between cutaneous heat loss (thermal flux transducers) and metabolic heat production (oxygen consumption). Average arm and leg (peripheral) tissue temperatures were determined from 19 intramuscular needle thermocouples, 10 skin temperatures, and "deep" foot temperature. Overall body heat content decreased approximately 234 kcal during 2.5 h of active cooling. Core temperature, which was nearly constant before active cooling, decreased approximately 1.3 degrees C/h. There was no delay between initiation of act...Continue Reading

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Citations

Feb 6, 2010·European Journal of Applied Physiology·Motoi YamaneKaoru Kitagawa
Apr 12, 2003·Nursing in Critical Care·Theresa Price, Sarah McGloin
Oct 29, 2004·Critical Care Medicine·Terry L Vanden HoekLance B Becker
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Aug 12, 2009·The Medical Clinics of North America·Kevin M SchusterStanley H Rosenbaum
Jul 20, 2010·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Joana M FreyJan A van der Linden
Nov 28, 2009·Anesthesiology Clinics·Kevin M SchusterStanley H Rosenbaum
Jan 17, 2015·International Surgery·Tarik J Wasfie, Kimberly R Barber
Aug 4, 2012·World Journal of Critical Care Medicine·Jesse J Corry
Aug 17, 2001·Anesthesiology·D I Sessler

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