Journal of cardiothoracic anesthesia
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J Cardiothorac Anesth · Feb 1987
Randomized Controlled Trial Clinical TrialShivering following cardiac surgery: hemodynamic changes and reversal.
The effects of shivering on hemodynamics and systemic oxygenation, as well as the effectiveness of therapeutic interventions in decreasing shivering and increasing mixed venous oxygen saturation, were studied. Thirty adult patients undergoing cardiopulmonary bypass with systemic hypothermia were observed for 1 1/2 to 5 hours postoperatively for signs of shivering associated with a simultaneous decrease in oxygen transport. Systemic and pulmonary hemodynamic measurements were made, blood temperature and mixed venous oxygen saturation were monitored via the pulmonary arterial catheter, and oxygen consumption and delivery were calculated. ⋯ The end-point for successful treatment was a return of SvO2 to within 5% to 10% of its value upon arrival in the ICU or a cessation of shivering that did not recur within 45 minutes. Twenty of the thirty patients shivered sufficiently to decrease SvO2 by more than one third of its initial value, thus requiring pharmacologic therapy. As shivering increased from a score of 0.8 +/- 1.1 to 3.4 +/- 0.9, SvO2 decreased from 74 +/- 6% to 57 +/- 12%.(ABSTRACT TRUNCATED AT 250 WORDS)