Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942006000100012
Brazilian Journal of Anesthesiology
Review Article

Hipotermia no período peri-operatório

Perioperative hypothermia

Camila B. Biazzotto; Márcio Brudniewski; André P. Schmidt; José Otávio Costa Auler Júnior

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Resumo

JUSTIFICATIVA E OBJETIVOS: A hipotermia ocorre freqüentemente durante o período peri-operatório, sendo, porém, raramente diagnosticada e tratada. A hipotermia pode ser benéfica ou prejudicial ao paciente dependendo da situação e do procedimento específicos. Este artigo teve como objetivo realizar uma revisão da literatura sobre as indicações e complicações da hipotermia, assim como seu diagnóstico, prevenção e tratamento. CONTEÚDO: São apresentadas as principais causas e complicações da hipotermia peri-operatória, bem como os seus benefícios. CONCLUSÕES: A hipotermia pode ocorrer durante o ato anestésico-cirúrgico devido à inibição direta da termorregulação pelos anestésicos, à diminuição do metabolismo e à perda de calor para o ambiente frio das salas cirúrgicas, mesmo com a utilização de aquecimento ativo. Quando ocorre de forma inadvertida, pode estar associada a numerosas complicações, mas, quando bem indicada, pode proteger órgãos vitais, como o sistema nervoso central e o miocárdio. A manutenção da normotermia reduz os efeitos indesejáveis da hipotermia, sendo a prevenção através do aquecimento, o método mais efetivo. Estratégias de aquecimento ativo ou passivo devem ser empregadas e os tremores musculares devem ser adequadamente tratados, prevenindo desconforto e o aumento da demanda metabólica.

Palavras-chave

COMPLICAÇÕES, FISIOLOGIA, Temperatura, HIPOTERMIA, HIPOTERMIA

Abstract

BACKGROUND AND OBJECTIVES: Perioperative hypothermia is a common event, however seldom diagnosed and treated. Hypothermia may be beneficial or noxious for the patient depending on specific situations and procedures. This paper is a literature review of hypothermia indications and complications, as well as its diagnosis, prevention and treatment. CONTENTS: Major perioperative causes and complications of hypothermia are presented, in addition to its benefits. CONCLUSIONS: Perioperative hypothermia may be due to direct anesthetic inhibition of thermoregulation, decreased metabolism and loss of heat to the cold environment of operating rooms, even with active warming. When it is inadvertent, it may be associated to several complications, but when adequately indicated, it may protect vital organs such as central nervous system and heart. Normothermia decreases undesirable hypothermia effects, being warming the most effective preventive method. Active or passive warming approaches should be adopted and muscle shivering should be adequately treated to prevent discomfort and increased metabolic demand.

Keywords

COMPLICATIONS, HYPOTHERMIA, HYPOTHERMIA, PHYSIOLOGY, Temperature

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