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Monitor the shivering according to BSAS (Bedside Shivering Assessment Scale) and adjust sedation accordingly. Shivering should be prevented since it will defeat the hypothermia cooling. Hypothermia shifts the oxyhemoglobin curve to the left and there will probably a decrease in oxygen delivery. Vasoconstriction of peripheral vessels which may also affect a pulse oximeter reading. If CVP monitoring is accessible, CVP and ScvO2 can be utilized. Maintain an adequate MAP 80 - 100 mmHg or lower depending on etiology. Correcting electrolyte values should be considered. Check H&H values to see if low which is associated with malnutrition. Low Hb would also affect pulse oximeter reading.