Document Detail


Baroreflex modulation of peripheral vasoconstriction during progressive hypothermia in anesthetized humans.
MedLine Citation:
PMID:  11004013     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mild hypothermia is a major concomitant of surgery under general anesthesia. We examined the hypothesis that baroreceptor loading/unloading modifies thermoregulatory peripheral vasoconstriction and, consequently, body core temperature in subjects undergoing lower abdominal surgery with general anesthesia. Thirty-six patients were divided into four groups: control group (C), applied positive end-expiratory pressure (PEEP; 10 cmH(2)O) group (P), applied leg-up position group (L), and a group of leg-up position patients with PEEP starting 90 min after induction of anesthesia (L + P). The esophageal temperature (T(es)) and the forearm-fingertip temperature gradient, as an index of peripheral vasoconstriction, were monitored for 3 h after induction of anesthesia. Mean arterial pressure and pulse pressure did not change during the study in any group. The change in right atrial transmural pressure from the baseline value was 0.3 +/- 0.1 mmHg in C, -3.0 +/- 0.5 mmHg in P, and 2.3 +/- 0.4 mmHg in L (P < 0.01). The change in T(es) at the end of the study was -1.7 +/- 0.1 (35.1 +/- 0.1) degrees C in C, -1.1 +/- 0.1 (35.7 +/- 0.1) degrees C in P, and -2.7 +/- 0.1 (34.1 +/- 0.1) degrees C in L, showing significant differences (P < 0.01). The T(es) threshold for thermal peripheral vasoconstriction was 35.6 +/- 0.1 degrees C in C, 36.2 +/- 0.2 degrees C in P, and 34.8 +/- 0.2 degrees C in L (P < 0.01). Excessive T(es) decrease in the leg-up-position operation was attenuated by applying PEEP (L + P group; P < 0.05). Our data indicate that baroreceptor loading augments and unloading prevents perioperative hypothermia in anesthetized and paralyzed subjects by reducing and increasing the body temperature threshold for peripheral vasoconstriction, respectively.
Authors:
Y Nakajima; T Mizobe; A Takamata; Y Tanaka
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of physiology. Regulatory, integrative and comparative physiology     Volume:  279     ISSN:  0363-6119     ISO Abbreviation:  Am. J. Physiol. Regul. Integr. Comp. Physiol.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-11-07     Completed Date:  2000-11-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100901230     Medline TA:  Am J Physiol Regul Integr Comp Physiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  R1430-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602 - 8566, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General*
Baroreflex / physiology*
Blood Pressure
Body Temperature / physiology
Body Temperature Regulation / physiology*
Esophagus / physiology
Female
Fingers / blood supply
Forearm / blood supply
Heart Rate
Humans
Hypothermia, Induced*
Male
Middle Aged
Positive-Pressure Respiration
Posture
Pulse
Skin Temperature / physiology
Surgical Procedures, Operative
Vasoconstriction / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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