How three linked clinical observations led to an understanding

J Clin Anesth · Sep 2024

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How three linked clinical observations led to an understanding of perioperative heat balance: A personal reflection on the scientific process.

Three linked clinical observations prompted our current understanding of perioperative heat balance. The first was the extraordinarily rapid decrease in core temperature after induction of general anesthesia which led to an understanding of redistribution hypothermia. The second was the linear reduction in core temperature during the subsequent 2-3 h which led to an understanding of anesthetic effects on metabolic heat production and factors that influence cutaneous heat loss. And the third was the observation that core temperature reaches a plateau at about 34.5 °C which led to the understanding that thermoregulatory vasoconstriction re-emerges when patients become sufficiently hypothermic, and that arteri-venous shunt constriction constrains metabolic heat to the core thermal compartment.

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- Daniel I Sessler.
- Outcomes Research Consortium, Department of Anesthesiology, Cleveland Clinic, Cleveland, OH, United States of America. Electronic address: DS@OR.org.
- J Clin Anesth. 2024 Sep 1; 96: 111496111496.
AbstractThree linked clinical observations prompted our current understanding of perioperative heat balance. The first was the extraordinarily rapid decrease in core temperature after induction of general anesthesia which led to an understanding of redistribution hypothermia. The second was the linear reduction in core temperature during the subsequent 2-3 h which led to an understanding of anesthetic effects on metabolic heat production and factors that influence cutaneous heat loss. And the third was the observation that core temperature reaches a plateau at about 34.5 °C which led to the understanding that thermoregulatory vasoconstriction re-emerges when patients become sufficiently hypothermic, and that arteri-venous shunt constriction constrains metabolic heat to the core thermal compartment.Copyright © 2023. Published by Elsevier Inc.

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How three linked clinical observations led to an understanding of perioperative heat balance: A personal reflection on the scientific process.

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