Outcomes Research Consortium, Department of Anesthesiology, Cleveland Clinic, Cleveland, OH, United States of America.
J Clin Anesth. 2024 Sep;96:111496. doi: 10.1016/j.jclinane.2024.111496. Epub 2024 May 10.
Three linked clinical observations prompted our current understanding of perioperative heat balance. The first was the extraordinarily rapid decrease in core temperature after induction of general anesthesia which led to an understanding of redistribution hypothermia. The second was the linear reduction in core temperature during the subsequent 2-3 h which led to an understanding of anesthetic effects on metabolic heat production and factors that influence cutaneous heat loss. And the third was the observation that core temperature reaches a plateau at about 34.5 °C which led to the understanding that thermoregulatory vasoconstriction re-emerges when patients become sufficiently hypothermic, and that arteri-venous shunt constriction constrains metabolic heat to the core thermal compartment.
三个相关的临床观察结果促使我们对围手术期热量平衡有了目前的认识。第一个是全身麻醉诱导后核心体温的异常快速下降，这导致了对再分布性低体温的认识。第二个是随后 2-3 小时内核心体温的线性下降，这导致了对麻醉对代谢产热的影响以及影响皮肤散热的因素的认识。第三个是观察到核心温度达到约 34.5°C 的平台期，这导致了对以下认识：当患者变得足够低体温时，体温调节性血管收缩重新出现，动静脉短路收缩将代谢热限制在核心热腔室中。
