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3. Muscle contraction
-Exercise (20 x BMR)
-Shivering (5 x BMR)
HEAT LOSS
Blood vessels are distributed profusely
beneath the skin.
A high rate of skin blood flow causes heat
to be conducted from the core to the skin.
While decreasing blood flow decreases heat
conduction
Vasodilatation & vasoconstriction are
controlled by sympathetic N.S.
Skin circulation
Effect of changes in environmental temp. on
heat conductance from body core to skin
surface
HEAT LOSS
Preoptic Area
W Sweating
Set Vasodilation
Warm W
Receptors
point Vasoconstriction
W C Shivering
Cold
Receptors
Temperature regulation
Threshold for
sweating&vasodilatation:37ºC
Threshold for vasoconstriction: 36.8º C
Threshold for nonshivering
thermogenesis:36ºC
Threshold for shivering: 35.5º C
Normal thermoregulation
Afferent input: cold signal-Aδ fiber
warm signal-C fiber
Each contribute 20% of the total thermal input:
hypothalamus
other parts of brain
skin surface
spinal cord
deep abdominal and thoracic tissues
Normal thermoregulation
PYROGEN WBC
bacterial toxins, leukocytes,
viruses, pollen, + monocytes = Cytokines
proteins, dust (Endogenous pyrogen)
Prostaglandins Aspirin
Phase I: 38
36
Phase II :
Slow linear reduction 35
34
Phase III:
Thermal plateau 33
0 1 2 3 4 5 6
Patterns of intraoperative hypothermia
3. Thermal plateau
After 3-5 hrs,core temperature stops decreasing
It may simply reflect a steady state that
heat loss=heat production in well-warmed p`t
If a p`t is sufficiently hypothermic,plateau phase
means activation of vasoconstriction to reestablish
the normal core-to-peripheral temperature gradient
Temperature plateau due to vasoconstriction is not a
thermal steady state and body heat content
continues to decrease even though temperature
remains constant
Regional Anesthesia