AP IIII- hypothermia

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Normal Core temp is ___ and elderly have a set-point ___ degree ______.
- 37
- 0.5
- lower
the main control center for temp is the _________. threshold for thermoregulatory response ___________ with both general and regional anesthesia.
- hypothalmus
- increases
Hymopthermia:
Mild-
Mod-
Severe-
- 34-36 C
- 30-34
- <30
DHCA is what temp?

18 C
Cerebral temp is measured in the ___________.

Nasopharynx
Afferent thermal sensing:
Cold receptor signals travel along __ ____ ______.
Warm receptor signals travel along __ ____.
- A delta fibers
- C fibers
What areas provide about 20% autonomic input for thermoreg?
- Skin surface
- deep abdominal/thoracic tissue
- hypothalmus
- other brain areas
Responses to heat:

vasodilation, sweating, temp gradient toward peripheral tissue
Response to cold:
- vasoconstriction
- temp gradient toward core
- shivering
Most effective way to change temp:

BEHAVIOR!
Sweating can dissipate ___ times the BMR in a ______________________.
- 10
- dry windy area
how much does shivering increase BMR?

2-3x
what is nonshivering thermogenesis in infants?

"brown fat" metabolism increases temp. kids lose and regain heat more quickly than adults
Name the types of heat transfer in order of greatest to least.
- Radiation- electromagnetic radiation (BSA)
- Convection- heat from body to surrounding air/fluid
- Conduction-
- Evaporation-
How much heat is lost in the first hour of surgery?

1- 1.5 C
What are the phases of cooling?
- 1- redistribution - core to periphery
- 2- linear phase- heat loss exceeds BMR
- 3- plateau when heat loss equals production
Threshold for shivering with anesthesia?
Nitrous-narcotic:
propofol-nitrous:
- 34.5 C
- 33 C
Elderly cool _______ and _____ slower.
- faster
- slower
High risk for hypothermia:
- old
- short
- low pre-op SBP
Regional anesthesia fx on temp:

peripheral nerve block prevents sweating, vasoconstriction, shivering.

central control inhibited, core temp allowed to cool further

*** high level of block and old age more likely to produce hypothermia than any other cause
What are the consequences of hypothermia?
MCMPCBPSW
- Mortality in trauma
- Cardiac problems
- Metabolism of drugs decr
- Plt fx decr
- Clotting decr
- Blood loss incr
- Prolonged PACU
- shivering and O2 consumption incr
- Wound infection
shivering is more likely with ______ ____________.

faster warming
a delcine of 1 - 3 provides _______ _______ __________. more profound hypothermia provides decrease in ____ that creates prolonged ________ to _______ __________.
- cerebral ischemia protection
- BMR
- tolerance
- ischemic insult
When to use deliberate hypothermia:
- CBP
- ARDS
- decrease mac .5%
- uniform cooling needed
a temp of greater than _____ will cause brain injury and less than ____ will be ______________.
- 37
- 35
- neuroprotective
What is used an indicator of cerebral temp/

nasopharyngeal

Author

bgroll

224653

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AP IIII- hypothermia

Description

summer ap test #2, hypothermia

Updated

2013-06-22T15:43:46Z

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