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Nicholas B Frisch, Andrew M Pepper, Edward Rooney, Craig Silverton
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes...
October 25, 2016: Orthopedics
Hedwig Schroeck, Angela K Lyden, Wendy L Benedict, Satya Krishna Ramachandran
Background. Despite increasing adoption of active warming methods over the recent years, little is known about the effectiveness of these interventions on the occurrence of abnormal postoperative temperatures in sick infants. Methods. Preoperative and postoperative temperature readings, patient characteristics, and procedural factors of critically ill infants at a single institution were retrieved retrospectively from June 2006 until May 2014. The primary endpoints were the incidence and trend of postoperative hypothermia and hyperthermia on arrival at the intensive care units...
2016: Anesthesiology Research and Practice
Daniel W Birch, Jerry T Dang, Noah J Switzer, Namdar Manouchehri, Xinzhe Shi, Ghassan Hadi, Shahzeer Karmali
BACKGROUND: Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible. Past studies on heated insufflation have shown inconclusive results with regards to maintenance of core temperature and reduction of postoperative pain and recovery times...
October 19, 2016: Cochrane Database of Systematic Reviews
Ahmer M Hameed, Henry C Pleass, Germaine Wong, Wayne J Hawthorne
BACKGROUND: The two main options for renal allograft preservation are static cold storage (CS) and machine perfusion (MP). There has been considerably increased interest in MP preservation of kidneys, however conflicting evidence regarding its efficacy and associated costs have impacted its scale of clinical uptake. Additionally, there is no clear consensus regarding oxygenation, and hypo- or normothermia, in conjunction with MP, and its mechanisms of action are also debated. The primary aims of this article were to elucidate the benefits of MP preservation with and without oxygenation, and/or under normothermic conditions, when compared with CS prior to deceased donor kidney transplantation...
October 2016: Medicine (Baltimore)
Dirk Wackernagel, Sami Obaya, Per Nydert
Drug fever caused by dalteparin-sodium (DS), a low-molecular-weight derivative of heparin, is neither listed in the official drug information and nor published as a case report until today. A preterm infant, born at 26 weeks of gestation, developed fever 2 days after starting a treatment with DS for an intracardial thrombus. The fever reverses soon after changing the treatment to unfractionated heparin and reappeared after reintroduction of DS. Once again, after discontinuing DS, the infant regained normothermia...
October 13, 2016: BMJ Case Reports
Kathleen Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To explore the safety and efficacy of targeted temperature management amongst infants with out-of-hospital cardiac arrest due to an apparent life threatening event (ALTE) recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest Out-of-Hospital trial. METHODS: Fifty-four infants (48h to <1year of age) with ALTE who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation were included...
October 11, 2016: Resuscitation
David S Park, Akshay Shekhar, Christopher Marra, Xianming Lin, Carolina Vasquez, Sergio Solinas, Kevin Kelley, Gregory Morley, Mitchell Goldfarb, Glenn I Fishman
Fever is a highly conserved systemic response to infection dating back over 600 million years. Although conferring a survival benefit, fever can negatively impact the function of excitable tissues, such as the heart, producing cardiac arrhythmias. Here we show that mice lacking fibroblast growth factor homologous factor 2 (FHF2) have normal cardiac rhythm at baseline, but increasing core body temperature by as little as 3 °C causes coved-type ST elevations and progressive conduction failure that is fully reversible upon return to normothermia...
October 4, 2016: Nature Communications
Tadeu A Fantaneanu, Benjamin Tolchin, Vincent Alvarez, Raymond Friolet, Kathleen Avery, Benjamin M Scirica, Molly O'Brien, Galen V Henderson, Jong Woo Lee
OBJECTIVE: Electroencephalogram (EEG) background reactivity is a reliable outcome predictor in cardiac arrest patients post therapeutic hypothermia. However, there is no consensus on modality testing and prior studies reveal only fair to moderate agreement rates. The aim of this study was to explore different stimulus modalities and report interrater agreements. METHODS: We studied a multicenter, prospectively collected cohort of cardiac arrest patients who underwent therapeutic hypothermia between September 2014 and December 2015...
September 10, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Emma L Kurnat-Thoma, Mary M Roberts, Eleanor B Corcoran
Preventing unplanned perioperative hypothermia is crucial. Thermal reflective blankets may reduce heat loss, promote normothermia, increase patient comfort, and decrease cotton blanket expenses. Our purpose was to determine whether a thermal reflective blanket plus one warmed cotton blanket provides better temperature control and thermal comfort than warmed cotton blankets only. We compared two groups of perioperative patients who received a thermal reflective blanket plus one warmed cotton blanket (n = 110) or warmed cotton blankets only (n = 114) for temperature control and comfort, and we evaluated outcomes in the preoperative holding area, the OR, and the postanesthesia care unit...
October 2016: AORN Journal
Charles E Edmiston, David J Leaper
BACKGROUND: Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure...
September 27, 2016: Surgical Infections
Jennifer K Lee, Bing Wang, Michael Reyes, Jillian S Armstrong, Ewa Kulikowicz, Polan T Santos, Jeong-Hoo Lee, Raymond C Koehler, Lee J Martin
Therapeutic hypothermia provides incomplete neuroprotection after hypoxia-ischemia (HI)-induced brain injury in neonates. We previously showed that cortical neuron and white matter apoptosis are promoted by hypothermia and early rewarming in a piglet model of HI. The unfolded protein response (UPR) may be one of the potential mediators of this cell death. Here, neonatal piglets underwent HI or sham surgery followed by 29 h of normothermia, 2 h of normothermia + 27 h of hypothermia or 18 h of hypothermia + rewarming...
September 14, 2016: Developmental Neuroscience
Matthew Keane
Multiple organ failure is a significant complication in traumatic injury, and can be exacerbated by a failure to adequately monitor and control trauma patients' core body temperature in emergency departments (EDs). Nearly half of trauma patients are hypothermic on arrival at emergency departments, often due to factors beyond the control of emergency service responders and during on-scene resuscitation attempts. This article examines the physiology of the 'triad of death' -hypothermia, metabolic acidosis and coagulopathy - to highlight the importance of monitoring and maintaining normothermia, or normal body temperature, which is between 36°C and 37...
September 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Shoji Yokobori, Markus S Spurlock, Stephanie W Lee, Shyam Gajavelli, Ross M Bullock
Cerebral microdialysis (MD) is a fine laboratory technique which has been established for studying physiological, pharmacological, and pathological changes in the experimental studies of traumatic brain injury (TBI). This technique has also been well translated and widely applied to clinical bedside monitoring to provide pathophysiological analysis in severe TBI patients. The MD technique is thus well suited for straightforward translation from basic science to clinical application.In this chapter, we describe our evaluation of MD method in acute subdural hematoma (ASDH) rat model...
2016: Methods in Molecular Biology
N Rose, G P S Kwong, D S J Pang
OBJECTIVES: Use of clinical audits to assess and improve perioperative hypothermia management in client-owned dogs. METHODS: Two clinical audits were performed. In Audit 1 data were collected to determine the incidence and duration of perioperative hypothermia (defined as rectal temperatures <37·0°C). The results from Audit 1 were used to reach consensus on changes to be implemented to improve temperature management, including re-defining hypothermia as rectal temperature <37·5°C...
September 2016: Journal of Small Animal Practice
X L Jin, K Wang, L Liu, H Y Liu, F-Q Zhao, J X Liu
Nuclear factor (erythroid-derived 2)-like factor 2 (Nrf2) is a transcription factor that binds to the antioxidant response element (ARE) in the upstream promoter region of many antioxidative genes. The Nrf2-ARE signaling plays a key role in the cellular antioxidant-defense system, but whether Nrf2 activation has protective effects against heat shock (HS) stress in mammary epithelial cells (MEC) remains unclear. The objective of this study was to determine whether tert-butylhydroquinone (tBHQ), a well-known Nrf2 activator, could attenuate heat stress-induced cell damage in MAC-T cells of the bovine MEC line...
August 31, 2016: Journal of Dairy Science
Satoko Tomita Ide, Ryoji Ide, Jacopo P Mortola
In embryos, cooling and hypoxia cause a decrease in oxygen consumption ( [Formula: see text] ); we asked what was the relative contribution of heart rate (HR) and of the 'not-HR' factor (the product of stroke volume and arterial-venous O2 difference) to the drop in [Formula: see text] . Data of HR (with subcutaneous electrodes) and [Formula: see text] (by an open-flow methodology) were collected simultaneously on chicken embryos close to end-incubation. Over the last four days of incubation (E16-E20) differences in HR contributed about 30% of the differences in resting [Formula: see text] among embryos...
August 30, 2016: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
C J Moon, Y A Youn, S K Yum, I K Sung
OBJECTIVE: This study aimed to examine changes in cytokines according to therapeutic hypothermia (TH) for newborn hypoxic ischemic encephalopathy (HIE). STUDY DESIGN: We studied 20 neonates who were admitted with a diagnosis of HIE in the neonatal intensive care unit. Cytokine concentration assay was carried out for neonates (n=12) who received TH and neonates (n=8) who were not treated with hypothermia by collecting blood sample at 12, 48 and 120 h after birth...
September 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Ashok Tholpady, Arthur W Bracey, Kelty R Baker, Ross M Reul, Alice J Chen
Cold hemagglutinin disease with broad thermal amplitude and high titers presents challenges in treating cardiac-surgery patients. Careful planning is needed to prevent the activation of cold agglutinins and the agglutination of red blood cells as the patient's temperature drops during surgery. We describe our approach to mitigating cold agglutinin formation in a 77-year-old man with severe cold hemagglutinin disease who underwent off-pump coronary artery bypass surgery without the use of preoperative plasmapheresis...
August 2016: Texas Heart Institute Journal
Clarissa Tjoakarfa, Vikram David, Atlas Ko, Raphael Hau
BACKGROUND: The use of forced air warming devices in the operating room has been shown to cause disruption of laminar airflow and a potential for increase in surgical site contamination. In contrast, conductive warming devices such as reflective blankets do not disrupt airflow and therefore have no potential for this increase in surgical site infection. However, some studies have shown them to be inferior to forced air warming devices in maintaining normothermia. We tested the hypothesis that the use of reflective blankets is as effective as forced air warming devices in maintaining intraoperative normothermia after adequate prewarming...
July 21, 2016: Journal of Arthroplasty
Anas Ahmad Sabir, Kabiru Sada, Bashir O Yusuf, Idris Aliyu
Thyroid storm is a rare life-threatening emergency due to thyrotoxicosis. A 30-year-old female presented with restlessness, tachycardia and vomiting but with normothermia which is an unusual presentation. There is the need for clinicians to be aware of atypical clinical features that can make the diagnosis of thyroid storm difficult.
August 2016: Therapeutic Advances in Endocrinology and Metabolism
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