Peri-operative Hyperthermia - Guidelines for Crises in Anaesthesia

If prolonged or ≥ 39 C this is a clinical emergency: permanent organ dysfunction and death can result.

Treatment depends on the aetiology. Distinguish early between:

 • Excessive heating (most common)

 • Inadequate dissipation of metabolic heat

 • Excessive heat production

 • Actively maintained fever



CAUSES OF HYPERTHERMIA

COMMON

 • Excessive insulation, high ambient temperature, external warming devices, especially infants and children (most common)

 • Surgical devices, e.g. HIFU, diathermy, radiotherapy

 • Prolonged epidural anaesthesia

 • Sepsis (→ 3-14) e.g. during manipulation of a urological device

 • Blood transfusion

 • Allergic reaction / anaphylaxis (→ 3-1)

Drug induced:

 • Neuroleptic malignant syndrome (e.g. haloperidol and other antipsychotics)

 • Malignant hyperthermia crisis (late sign) (→ 3-8)

 • Serotonin syndrome (cocaine, amphetamine, phencyclidine, MDMA)

 • Anticholinergic syndrome (tricyclic antidepressants, antipsychotics, antihistamines)

 • Sympathomimetic syndrome (cocaine, MDMA, amphetamines)

Toxic:

 • Radiologic contrast neurotoxicity

 • Alcohol withdrawal

Endocrine:

 • Thyrotoxicosis

 • Phaeochromocytoma

Neurologic:

 • Meningitis

 • Intracranial blood

 • Hypoxic encephalopathy

 • Traumatic brain injury



By Association of Anaesthetists @ https://twitter.com/AAGBI

Quick Reference Handbook - Guidelines for crises in anaesthesia 



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