Intensive careHypothermia – it's more than a toyPestel, Gunther J; Kurz, AndreaAuthor Information Department of Anesthesiology, Bern University Hospital (Inselspital), University of Bern, Switzerland Correspondence to Gunther J. Pestel, MD, Department of Anesthesiology, Bern University Hospital (Inselspital), University of Bern, Switzerland Tel: +41 31 632 2483; fax: +41 31 632 0554; e-mail: [email protected] Current Opinion in Anaesthesiology: April 2005 - Volume 18 - Issue 2 - p 151-156 doi: 10.1097/01.aco.0000162833.25850.ec Buy Metrics Abstract Purpose of review Perioperative hypothermia triples the incidence of adverse myocardial outcomes in high-risk patients; it significantly increases blood loss and augments allogeneic transfusion requirements. Even mild hypothermia increases the incidence of surgical wound infection following colon resection and therefore the duration of hospitalization. Hypothermia adversely affects antibody- and cell-mediated immune defenses, as well as the oxygen availability in the peripheral wound tissues. Mild perioperative hypothermia changes the kinetics and action of various anesthetic and paralyzing agents, increases thermal discomfort, and is associated with delayed postanesthetic recovery. Recent findings On the other hand however, therapeutic hypothermia may be an interesting approach in various settings. Lowering core temperature to 32–34°C may reduce cell injury by suppressing excitotoxins and oxygen radicals, stabilizing cell membranes, and reducing the number of abnormal electrical depolarizations. Evidence in animals indicates that even mild hypothermia provides substantial protection against cerebral ischemia and myocardial infarction. Mild hypothermia has been shown to improve outcome after cardiac arrest in humans. Randomized trials are in progress to evaluate the potential benefits of mild hypothermia during aneurysm clipping and after stroke or acute myocardial infarction. Summary This article reviews recent publications in the field of accidental as well as therapeutic hypothermia, and tries to assess what evidence is available at the present time. © 2005 Lippincott Williams & Wilkins, Inc.