The prevention of shivering during deep hypothermic circulatory arrest (DHCA) is effectively achieved through the use of neuromuscular blocking agents. Shivering is a natural physiological response to cold that results in muscle contractions to generate heat, which can be detrimental when the body is intentionally cooled during cardiac surgery. This involuntary muscle activity can increase metabolic demand and potentially lead to complications.
By administering neuromuscular blocking agents, muscle activity is inhibited, thus preventing shivering. This controlled approach allows for a more stable temperature management during DHCA, facilitating the targeted hypothermic state necessary for surgical procedures while minimizing the risks associated with increased metabolic activity.
While increasing ambient temperature, administering warm fluids, and applying external heating pads can help maintain body temperature in other contexts, they do not directly address shivering during the deep hypothermic state required for DHCA. Neuromuscular blockade is the most effective strategy to ensure the absence of muscular activity, thus allowing for safer and more effective cooling.