BIOMAT Database Logo BIOMAT Database Logo

Neither arm nor face warming reduces the shivering threshold in unanesthetized humans. 2003

Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Outcomes Research Institute, Department of Anesthesiology, University of Louisville, Louisville, KY, USA. agdoufas@louisville.edu

OBJECTIVE Hand warming and face warming, combined with inhalation of heated air, are reported to suppress shivering. However, hand or face temperature contributes only a few percent to control of shivering. Thus, it seems unlikely that manipulating hand or facial skin temperature alone would be sufficient to permit induction of therapeutic hypothermia. We tested the hypothesis that focal arm (forearm and hand) warming or lower facial warming, combined with inhalation of heated and humidified gas, only minimally reduces the shivering threshold (triggering core temperature). METHODS We studied 8 healthy male volunteers (18 to 40 years of age) on 3 days: (1) control (no warming), (2) arm warming with forced air at approximately 43 degrees C, and (3) face warming with 21 L/min of air at approximately 42 degrees C at a relative humidity of 100%. Fluid at approximately 4 degrees C was infused via a central venous catheter to decrease tympanic membrane temperature 1 degrees C/h to 2 degrees C/h; mean skin temperature was maintained at 31 degrees C. A sustained increase in oxygen consumption quantified the shivering threshold. RESULTS Shivering thresholds did not differ significantly between the control (36.7+/-0.1 degrees C), arm-warming (36.5+/-0.3 degrees C), or face-warming (36.5+/-0.3 degrees C; analysis of variance, P=0.34) day. The study was powered to have a 95% probability of detecting a difference of 0.5+/-0.5 degrees C (mean+/-SD) between control and either of the 2 treatments at alpha=0.05. CONCLUSIONS Focal arm or face warming did not substantially reduce the shivering threshold in unanesthetized volunteers. It thus seems unlikely that these nonpharmacological modalities will substantially facilitate induction of therapeutic hypothermia.

UI MeSH Term Description Entries
D007036 Hypothermia, Induced Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries. Induced Hypothermia,Mild Hypothermia, Induced,Moderate Hypothermia, Induced,Targeted Temperature Management,Therapeutic Hypothermia,Hypothermia, Therapeutic,Induced Mild Hypothermia,Induced Mild Hypothermias,Induced Moderate Hypothermia,Induced Moderate Hypothermias,Mild Hypothermias, Induced,Moderate Hypothermias, Induced,Targeted Temperature Managements
D008297 Male Males
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D012129 Respiratory Function Tests Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc. Lung Function Tests,Pulmonary Function Tests,Function Test, Pulmonary,Function Tests, Pulmonary,Pulmonary Function Test,Test, Pulmonary Function,Tests, Pulmonary Function,Function Test, Lung,Function Test, Respiratory,Function Tests, Lung,Function Tests, Respiratory,Lung Function Test,Respiratory Function Test,Test, Lung Function,Test, Respiratory Function,Tests, Lung Function,Tests, Respiratory Function
D001831 Body Temperature The measure of the level of heat of a human or animal. Organ Temperature,Body Temperatures,Organ Temperatures,Temperature, Body,Temperature, Organ,Temperatures, Body,Temperatures, Organ
D005145 Face The anterior portion of the head that includes the skin, muscles, and structures of the forehead, eyes, nose, mouth, cheeks, and jaw. Faces
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006358 Hot Temperature Presence of warmth or heat or a temperature notably higher than an accustomed norm. Heat,Hot Temperatures,Temperature, Hot,Temperatures, Hot
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

Related Publications

Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Nefopam, a nonsedative benzoxazocine analgesic, selectively reduces the shivering threshold in unanesthetized subjects.
January 2004, Anesthesiology,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Facial warming increases the threshold for shivering.
October 1999, Journal of neurosurgical anesthesiology,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Severe hypoglycemia reduces the shivering threshold in rabbits.
July 2019, BMC anesthesiology,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
[Neither martyrs nor good sisters in the face of death].
January 2009, Krankenpflege. Soins infirmiers,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Doxapram only slightly reduces the shivering threshold in healthy volunteers.
November 2005, Anesthesia and analgesia,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Proprioceptive information neither improves fixation stability nor reduces autokinesis.
January 1979, Vision research,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Dexmedetomidine and meperidine additively reduce the shivering threshold in humans.
May 2003, Stroke,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Lower-body warming mimics the normal epidural-induced reduction in the shivering threshold.
January 2008, Anesthesia and analgesia,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
Epidural fentanyl reduces the shivering threshold during epidural lidocaine anesthesia.
September 1998, Anesthesia and analgesia,
Anthony G Doufas, and Anupama Wadhwa, and Chun-Ming Lin, and Yunus M Shah, and Keith Hanni, and Daniel I Sessler
No insulating effect of obesity, neither in mice nor in humans.
November 2019, American journal of physiology. Endocrinology and metabolism,
Copied contents to your clipboard!