PDF(Pubmed)
Abstract：
UNASSIGNED: Intraoperative hypothermia is a common but severe condition that is defined as a core body temperature below 36 °C. Accidental hypothermia can produce coagulopathy, immunosuppression and peripheral hypoperfusion that can ultimately lead to life-threatening ventricular arrhythmias and vital organ injury, and it is significantly associated with perioperative complications and mortality.
UNASSIGNED: We report the case of an 82-year-old man who presented with persistent ventricular tachycardia intraoperatively due to accidental hypothermia. The patient was diagnosed with benign prostatic hypertrophy and scheduled for transurethral resection of the prostate. Laboratory tests showed moderate anemia, and echocardiography indicated mild tricuspid and mitral regurgitation. The patient received general anesthesia with endotracheal intubation. Four hours after the start of surgery, the patient developed sudden ventricular tachycardia with severe hypotension. Arterial blood gas sampling indicated that there was no disturbance of electrolytes, acid-base balance or excessive bleeding. The rectal temperature was measured immediately, and the core temperature was 32 °C. The patient received antiarrhythmic therapy and rewarming measures. No additional ventricular arrhythmias appeared after the core temperature rose to 35 °C and the blood pressure returned to normal. The patient was transferred to the intensive care unit after surgery for further observation and was moved to the general ward the next day. He was discharged 4 days later without significant organ damage.
UNASSIGNED: Intraoperative hypothermia may increase ventricular arrhythmia risk, especially in elderly patients. Surgeons and anesthesiologists should pay more attention to preventing and reversing accidental hypothermia, necessitating aggressive efforts to maintain normothermia during surgery.
UNASSIGNED: We report the case of an 82-year-old man who presented with persistent ventricular tachycardia intraoperatively due to accidental hypothermia. The patient was diagnosed with benign prostatic hypertrophy and scheduled for transurethral resection of the prostate. Laboratory tests showed moderate anemia, and echocardiography indicated mild tricuspid and mitral regurgitation. The patient received general anesthesia with endotracheal intubation. Four hours after the start of surgery, the patient developed sudden ventricular tachycardia with severe hypotension. Arterial blood gas sampling indicated that there was no disturbance of electrolytes, acid-base balance or excessive bleeding. The rectal temperature was measured immediately, and the core temperature was 32 °C. The patient received antiarrhythmic therapy and rewarming measures. No additional ventricular arrhythmias appeared after the core temperature rose to 35 °C and the blood pressure returned to normal. The patient was transferred to the intensive care unit after surgery for further observation and was moved to the general ward the next day. He was discharged 4 days later without significant organ damage.
UNASSIGNED: Intraoperative hypothermia may increase ventricular arrhythmia risk, especially in elderly patients. Surgeons and anesthesiologists should pay more attention to preventing and reversing accidental hypothermia, necessitating aggressive efforts to maintain normothermia during surgery.
摘要：
■术中低温是一种常见但严重的疾病，定义为核心体温低于36°C。意外的低体温会产生凝血功能障碍，免疫抑制和外周灌注不足，最终可能导致危及生命的室性心律失常和重要器官损伤，并且与围手术期并发症和死亡率显著相关。
■我们报告了一例82岁男子，由于意外的低体温，在术中出现持续性室性心动过速。该患者被诊断为良性前列腺肥大，并计划进行经尿道前列腺切除术。实验室检查显示中度贫血,超声心动图提示轻度三尖瓣和二尖瓣反流。患者接受气管内插管全身麻醉。手术开始四小时后,患者出现突发性室性心动过速伴严重低血压。动脉血气采样显示没有电解质紊乱,酸碱平衡或过度出血。立即测量直肠温度，核心温度为32℃。患者接受了抗心律失常治疗和复温措施。核心温度升至35°C且血压恢复正常后，未出现其他室性心律失常。手术后患者被转移到重症监护病房进行进一步观察，并于第二天转移到普通病房。他在4天后出院，没有明显的器官损伤。
■术中低温可能会增加室性心律失常的风险，尤其是老年患者。外科医生和麻醉师应该更加注意预防和逆转意外的低体温，在手术过程中需要积极的努力来维持正常体温。
■我们报告了一例82岁男子，由于意外的低体温，在术中出现持续性室性心动过速。该患者被诊断为良性前列腺肥大，并计划进行经尿道前列腺切除术。实验室检查显示中度贫血,超声心动图提示轻度三尖瓣和二尖瓣反流。患者接受气管内插管全身麻醉。手术开始四小时后,患者出现突发性室性心动过速伴严重低血压。动脉血气采样显示没有电解质紊乱,酸碱平衡或过度出血。立即测量直肠温度，核心温度为32℃。患者接受了抗心律失常治疗和复温措施。核心温度升至35°C且血压恢复正常后，未出现其他室性心律失常。手术后患者被转移到重症监护病房进行进一步观察，并于第二天转移到普通病房。他在4天后出院，没有明显的器官损伤。
■术中低温可能会增加室性心律失常的风险，尤其是老年患者。外科医生和麻醉师应该更加注意预防和逆转意外的低体温，在手术过程中需要积极的努力来维持正常体温。
