A 24-year-old man undergoes an uncomplicated appendectomy for acute appendicitis. Shortly after the end of surgery, in the recovery room, he develops violent shivering and becomes cyanotic.
Which of the following is most likely to have caused this condition?
A Depression of the reflex control of blood oxygen saturation
B Exaggeration of the reflex control of body temperature
C Low temperature in the recovery room
D Septicaemia related to the appendicitis
E Undiagnosed cyanotic heart disease
Answer And Discussion:
A Depression of the reflex control of blood oxygen saturation
The violent, cyanotic, shivering in the recovery room, as this man recovers from the effects of his anaesthetic suggests that, during the anaesthetic, the loss of body temperature homeostasis due to suppression of brain function allowed his core temperature to fall. With recovery of reflex control of core temperature, vigorous shivering is initiated. However, recovery of homeostatic control of arterial
blood oxygenation has lagged behind that of core temperature, due to residual suppression of ventilation, so oxygen intake is unable to keep up with the very large oxygen consumption associated with shivering. Thus, the shivering is normal in relation to restoring body temperature.
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