Heat loss in exposed volunteers.

Hypothermia is a common complication of major surgery and trauma. We studied this problem using Heat Flux Transducers to directly measure heat exchange between seven exposed volunteers and the environment. Heat exchange by radiation and convection was measured from the anterior chest wall and by conduction, between the back and a thermal mattress (CSZ, Blanketrol II). We determined the coefficients for: radiation = 6.6; convection = 8.3 square root of v; combined radiation and convection = 9.7; conductance = 41, all expressed in W/m2.degrees C. The clinical significance of these results is that heat loss, by radiation and convection alone, is 10 W/m2.degrees C. However, heat production under anaesthesia is only 40 W/m2, so a temperature gradient of greater than 4 degrees C between the skin and environment will cause more heat to be lost than is produced. The thermal mattress can supply 41 W/m2.degrees C, effectively doubling heat production.