Kinderanästhesie – Perioperatives Wärmemanagement bei Kindern

Zusammenfassung

Sinkt die Körpertemperatur des Patienten während einer Operation zu stark ab, kann dies zu Komplikationen führen und das Outcome des Patienten beeinträchtigen. Da gerade Kinder sehr schnell auskühlen, müssen diese besonders gut gegen eine Hypothermie geschützt werden – von der Vorbereitung zur Anästhesie bis zum Aufwachen nach dem Eingriff. Die perioperative Temperaturmessung ist zum Vermeiden einer unbeabsichtigten Hypothermie unabdingbar, und der Aufwand zum Wärmeerhalt muss umso größer sein, je jünger und unreifer Säuglinge sind. Intraoperativ eignen sich dazu Inkubatoren. Bei Kleinkindern sind konvektive Systeme am weitesten verbreitet und auch effektiv in Kombination mit Flüssigkeitswärmung. Postoperatives „shivering“ sollte man behandeln, z.B. mit Pethidin oder Clonidin.

Abstract

Perioperative temperature monitoring is a pre-requisite for successful prevention of inadvertent hypothermia in children. To achive this goal, besides of prewarming, active warming measures have to be intensified the younger and immature infants are. Intraoperatively incubators can be used. Forced-air warming in combination with fluid warming has been proven effective in children. Postoperative shivering should be treated, e.g. with pethidin or clonidine.

Schlüsselwörter:

Hypothermie - shivering - Temperaturmessung - Vorwärmen - Wärmeerhalt

Keywords:

children - perioperative - temperature monitoring - prewarming - active warming - shivering

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