Although shivering generally is an important adaptive response to cold, it "may not be the optimal method of rewarming in the postoperative period," reported anesthesiologist Jorge L. Rodriguez, MD, at the recent American College of Surgeons meeting in Chicago.
This is particularly true with respect to patients with preexisting cardiopulmonary disease who have been chilled during any type of major surgery, he said. In these patients, the least physiologically debilitating approach to rewarming may be complete obliteration of normal shivering.
Rodriguez reported on a study of 16 such patients who underwent major surgery at Columbia Presbyterian Hospital, New York City, and were subsequently admitted to the Surgical Intensive Care Unit, where they were maintained on mechanical ventilatory support for 24 hours. All of the patients were hypothermic, with esophageal temperatures of less than 35.8 °C, after having major body cavities exposed to a cool operating room and being unable to