International anesthesiology clinics
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Thermoregulatory responses in infants and children are now fairly well understood. The phenomenon of heat loss in children during surgery is widely acknowledged. Hypothermia is most likely to occur during long surgical procedures in an air-conditioned operating room, particularly when respiration is controlled. ⋯ Perioperative hypothermia results from decreased metabolic heat production, increased environmental heat loss, redistribution of heat within the body, and anesthesia-induced inhibition of thermoregulation. Radiation and convection from the skin surface combine with evaporation from tissues inside surgical incisions to decrease mean body temperature. Perioperative hypothermia can be limited by prewarming the skin surface before induction of anesthesia, warming the operating room, humidifying the airway, and warming intravenous fluids.
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The association between perioperative myocardial ischemia and infarction has clearly been established. In patients undergoing CABG, myocardial ischemia that occurs during the intraoperative period has the strongest correlation with perioperative MI. ⋯ Much of the descriptive phase of this research is complete. It is important next to determine the etiology of perioperative myocardial ischemia and to design treatment regimens that will tell us whether MI is merely associated with perioperative ischemia or is also the cause of cardiac morbidity.