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J Trauma ; 57(6): 1287-98, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15625462

RESUMO

BACKGROUND: Hypothermia is commonly observed in victims of trauma, and it is generally combined with shock caused by either hemorrhagic or nonhemorrhagic mechanisms. This study deals with phenomena related to nonhemorrhagic mechanisms. The objective is to document through experimental evidence the existence of a natural mechanism in rats that compensates for the inadequate tissue perfusion in the presence of shock by reducing body temperature (hypothermia). METHODS: Different types of trauma are analyzed (i.e., abdominal cavity and bowel exposure) and compared with other groups that suffered, additionally, femur fracture and partial hepatectomy. Further thermal alterations are also studied as consequences of vascular phenomena involving the elevation of intra-abdominal pressure and clamping of arteries and veins, such as the aorta and inferior vena cava. The loss of energy and temperature response of the animals is documented in time through charts with experimental uncertainties. RESULTS: It is concluded that exposure of the bowels is the main factor involved in the genesis of hypothermia, regardless of the associated trauma. Plastic film is shown to be the most effective way to avoid heat loss in bowel exposure. An optimal intra-abdominal pressure, Popt congruent with 12 mm Hg, is found such that heat flux loss is minimum in pneumoperitoneal procedures. CONCLUSION: Aortic and inferior vena cava clamping induces hypothermia at levels comparable to bowel exposure.


Assuntos
Hipotermia/etiologia , Hipotermia/fisiopatologia , Choque/fisiopatologia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Ferimentos e Lesões/fisiopatologia , Abdome/cirurgia , Análise de Variância , Animais , Regulação da Temperatura Corporal , Modelos Animais de Doenças , Fraturas do Fêmur/fisiopatologia , Hemostasia Cirúrgica/efeitos adversos , Laparotomia/efeitos adversos , Masculino , Pneumoperitônio/fisiopatologia , Ratos , Ratos Wistar , Índices de Gravidade do Trauma , Incerteza
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