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 #Perioperative #Hyperthermia #Differential #Causes #Anesthesiology #Anesthesia #Checklist #Diagnosis #Management #Workup
