[Physical methods used to control body temperature].

The physical methods to control body temperature, either to induce hypothermia, or to increase body temperature, can be of two types: physical methods of external heating or cooling and invasive methods that require complex procedures and technology. There are many strategies for the induction of hypothermia, all based on three of the four basic mechanisms of heat transfer, evaporation, convection and conduction. In the hospital environment the external cooling methods or surface (blankets of cold air or water circulation, plates of hydrogel Artic Sun, methods of cooling helmet) are the most widely used for the induction of therapeutic hypothermia. The most non-invasive devices used are blades of hydrogel, which use water conduction high speed between the layers of pads. But there are quicker methods to induce hypothermia; i.e., invasive methods of internal cooling: infusion of intravenous crystalloid; endovascular catheters located in a central vein through which flows saline pumped by a closed circuit; By-pass cardio-pulmonary with extracorporeal circulation; and By-pass percutaneous venous system for continuous hemofiltration. The average physical external heating is based on the patient's ability to produce and retain heat or in the application of heat to the body surface of the patient (hot spring baths with hot water, air blankets, blankets of water). But when the answer to these methods are not sufficient or hypothermia is moderate or severe, other methods of internal heat are suggested: inhalation of oxygen or warm to 40-45 degrees C and wet by facial mask or endotracheal tube; intravenous (IV) infusion with hot solutions; Irrigation of body cavities with warm saline solution to 40-42 degrees C; peritoneal dialysis, haemodialysis and hemofiltration; Continuous reheating arterio-venous or venous-venous; extracorporeal circulation with cardiopulmonary bypass. In this article each of the methods listed above will be described for the induction of hypothermia and overheating.