Active core rewarming avoids bioelectrical impedance changes in postanesthetic patients

BMC Anesthesiology

Research Article

Alma Rebeca Gutiérrez-Cruz¹  Bernardo Soto-Rivera¹  Daniel Martinez-Fong²  Ernesto Suaste-Gómez³  Juan Antonio González-Barrios⁴  Bertha Alicia León-Chávez⁵ 

[1] Departamento de Anestesia, Hospital Regional "Primero de Octubre", Av. IPN, No. 1669, C.P. 07760, Mexico, D. F., Mexico;Departamento de Fisiología, Biofísica y Neurociencias, CINVESTAV, Av. IPN No. 2508, C.P. 06760, México, D.F., Mexico;Departamento de Ingeniera Eléctrica, CINVESTAV, Av. IPN No. 2508, C.P. 06760, México, D.F., Mexico;Laboratorio de Medicina Genómica, Hospital Regional "Primero de Octubre", Av. IPN, No. 1669, C.P. 07760, Mexico, D. F., Mexico;Área de Bioquímica y Biología Molecular, Facultad de Ciencias Qumícas, BUAP, 14 sur y Av. San Claudio, 72570, Puebla, Pue., Mexico;

关键词: Laparoscopic Cholecystectomy;    Core Temperature;    Mean Arterial Blood Pressure;    Bioelectrical Impedance;    Active Core;   

DOI  :  10.1186/1471-2253-11-2

 received in 2010-06-22, accepted in 2011-02-16,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPostoperative hypothermia is a common cause of complications in patients who underwent laparoscopic cholecystectomy. Hypothermia is known to elicit electrophysiological, biochemical, and cellular alterations thus leading to changes in the active and passive membrane properties. These changes might influence the bioelectrical impedance (BI). Our aim was to determine whether the BI depends on the core temperature.MethodsWe studied 60 patients (52 female and 8 male) age 40 to 80 years with an ASA I-II classification that had undergone laparoscopic cholecystectomy under balanced inhalation anesthesia. The experimental group (n = 30) received active core rewarming during the transanesthetic and postanesthesic periods. The control group (n = 30) received passive external rewarming. The BI was recorded by using a 4-contact electrode system to collect dual sets of measurements in the deltoid muscle. The body temperature, hemodynamic variables, respiratory rate, blood-gas levels, biochemical parameters, and shivering were also measured. The Mann-Whitney unpaired t-test was used to determine the differences in shivering between each group at each measurement period. Measurements of body temperature, hemodynamics variables, respiratory rate, and BI were analyzed using the two-way repeated-measures ANOVA.ResultsThe gradual decrease in the body temperature was followed by the BI increase over time. The highest BI values (95 ± 11 Ω) appeared when the lowest values of the temperature (35.5 ± 0.5°C) were reached. The active core rewarming kept the body temperature within the physiological range (over 36.5°C). This effect was accompanied by low stable values (68 ± 3 Ω) of BI. A significant decrease over time in the hemodynamic values, respiratory rate, and shivering was seen in the active core-rewarming group when compared with the controls. The temporal course of shivering was different from those of body temperatue and BI. The control patients showed a significant increase in the serum-potassium levels, which were not seen in the active-core rewarming group.ConclusionsThe BI analysis changed as a function of the changes of core temperature and independently of the shivering. In addition, our results support the beneficial use of active core rewarming to prevent accidental hypothermia.

【 授权许可】

Unknown   
© Gutiérrez-Cruz et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.