Outline the consequences of mild hypothermia in a patient following major surgery.
This is another very important, and not an infrequently seen, aspect of almost daily intensive care
practice which was poorly understood by candidates. For a good answer candidates were
expected to outline pharmacological (eg alteration in drug behaviour), physiological (eg shivering,
vasoconstriction, impaired coagulation, etc) consequences. Additional points such as poor wound
healing, discomfort also attracted a small number of marks. Candidates would have benefited by
illustrating their answers with examples, eg prolonged recovery from anaesthesia and duration of
References: Hemmings, Foundation of Anaesthesia: Basic and Clinical Science pg 815
Endocrine and metabolic consequences
Acid-base changes: alkalosis and hypocapnea
Central nervous system effects
Wong, K. C. "Physiology and pharmacology of hypothermia." Western Journal of Medicine 138.2 (1983): 227.
Polderman, Kees H. "Application of therapeutic hypothermia in the intensive care unit." Intensive care medicine 30.5 (2004): 757-769.
Polderman, Kees H. "Mechanisms of action, physiological effects, and complications of hypothermia." Critical care medicine 37.7 (2009): S186-S202.