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The Annals of Thoracic Surgery, Vol 43, 428-431, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

Suppression of shivering decreases oxygen consumption and improves hemodynamic stability during postoperative rewarming

JB Zwischenberger, MM Kirsh, RE Dechert, DK Arnold and RH Bartlett

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 (VO2), carbon dioxide production per minute (VCO2), 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 VO2 and VCO2, 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 VO2 and VCO2, improved hemodynamic stability, and resulted in a decreased need for inotropic support.


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