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Ann Thorac Surg 1987;43:428-431
© 1987 The Society of Thoracic Surgeons


Articles

Suppression of Shivering Decreases Oxygen Consumption and Improves Hemodynamic Stability during Postoperative Rewarming

J.B. Zwischenberger, M.D., M.M. Kirsh, M.D.*, R.E. Dechert, R.R.T., D.K. Arnold, B.S., R.H. Bartlett, M.D.

Departments of Thoracic and General Surgery, University of Michigan Hospitals, Ann Arbor, MI

Accepted for publication August 1, 1986.

* Address reprint requests to Dr. Kirsh, Section of Thoracic Surgery, University of Michigan Hospitals, 1500 E Medical Ctr Dr, Box 0344, Ann Arbor, MI 48109

Thirty-three patients undergoing elective myocardial revascularization were prospectively randomized into two study groups (Group S and Group P) to permit evaluation of the effects of shivering on oxygen consumption per minute (VO 2), carbon dioxide production per minute (VCO 2), and hemodynamic performance. Group S was allowed to shiver during the postoperative rewarming period, and Group P received hourly injections of pancuronium bromide and Metubine (metocurine) sulfate with sedation to block the shivering response. Group S demonstrated significantly higher increases in VO 2 and VCO 2, lower systolic blood pressure and mixed venous oxygen saturation, and a greater use of inotropic support than the patients in Group P. Suppression of the shivering response minimized increases in VO 2 and VCO 2, improved hemodynamic stability, and resulted in a decreased need for inotropic support.




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