Effects of Mild perioperative hypothermia on cellular immune responses

Unintentional perioperative hypothermia is a common complication of anesthesia and surgery associated with adverse effects on several systems, including impaired wound healing and more frequent wound infections. Mild hypothermia affects various immune functions. In the current study, the authors sou...

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Bibliographic Details
Published in:	Anesthesiology (Philadelphia) Vol. 89; no. 5; pp. 1133 - 1140
Main Authors:	BEILIN, B, SHAVIT, Y, RAZUMOVSKY, J, WOLLOCH, Y, ZEIDEL, A, BESSLER, H
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott 01-11-1998
Subjects:	Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Antibody-Dependent Cell Cytotoxicity - physiology Biological and medical sciences Body Temperature - physiology Cell Division - drug effects Cell Division - physiology Female General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Humans Hydrocortisone - blood Hypothermia - immunology Immunity, Cellular - physiology Interleukin-1 - blood Interleukin-2 - blood Intraoperative Complications - immunology Killer Cells, Natural - immunology Male Medical sciences Middle Aged Mitogens - pharmacology Neutrophils - immunology Neutrophils - physiology Tumor Necrosis Factor-alpha - metabolism Human Cell proliferation Postoperative Cytokine Thermoregulation General anesthesia Cytotoxicity Intraoperative Cellular immunity Central temperature Hydrocortisone Natural killer cell Immunosuppression Complication Mitogen Hypothermia
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Summary:	Unintentional perioperative hypothermia is a common complication of anesthesia and surgery associated with adverse effects on several systems, including impaired wound healing and more frequent wound infections. Mild hypothermia affects various immune functions. In the current study, the authors sought to determine whether immune alterations in the perioperative period might be induced, at least in part, by impaired thermoregulation during this period. Sixty patients undergoing abdominal surgery were randomly assigned to two thermal care groups: routine care or forced-air warming. The patients' anesthetic care was standardized. Venous blood samples were collected 90 min before induction of anesthesia and immediately, 24 h, and 48 h after surgery. White cells were separated and frozen. Peripheral blood mononuclear cells were used to test cytokine production (interleukins [IL] -1beta, -2, and -6; tumor necrosis factor-alpha [TNF-alpha]), mitogens-induced proliferation, and natural killer NK cell cytotoxicity. Plasma cortisol levels were also determined. Patients in the normothermia group maintained normal body core temperature, whereas temperature decreased by approximately 1 degree C in the hypothermia group. Mitogenic responses were suppressed in cells from patients in the hypothermia but not in the normothermia group 24 and 48 h after surgery. Proinflammatory cytokine (IL-1beta, IL-6, TNF-alpha) production increased in both groups, although the production of IL-1beta was significantly higher in the normothermia group 24 h after surgery. Production of IL-2 was suppressed in the hypothermia but not in the normothermia group at 24 h. Mild perioperative hypothermia suppressed mitogen-induced activation of lymphocytes and reduced the production of certain cytokines, IL-1beta and IL-2, and in this way may contribute to the immune alterations observed in the perioperative period.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0003-3022 1528-1175
DOI:	10.1097/00000542-199811000-00013