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Normothermia

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https://www.readbyqxmd.com/read/28514320/preoperative-warming-versus-no-preoperative-warming-for-maintenance-of-normothermia-in-women-receiving-intrathecal-morphine-for-cesarean-delivery-a-single-blinded-randomized-controlled-trial
#1
Judy Munday, Sonya Osborne, Patsy Yates, David Sturgess, Lee Jones, Edward Gosden
BACKGROUND: Rates of hypothermia for women undergoing spinal anesthesia for cesarean delivery are high and prevention is desirable. This trial compared the effectiveness of preoperative warming versus usual care among women receiving intrathecal morphine, which is thought to exacerbate perioperative heat loss. METHODS: A prospective, single-blinded, randomized controlled trial compared 20 minutes of forced air warming (plus intravenous fluid warming) versus no active preoperative warming (plus intravenous fluid warming) in 50 healthy American Society of Anesthesiologists graded II women receiving intrathecal morphine as part of spinal anesthesia for elective cesarean delivery...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28504050/how-long-is-sufficient-for-optimal-neuroprotection-with-cerebral-cooling-after-ischemia-in-fetal-sheep
#2
Joanne O Davidson, Vittoria Draghi, Sean Whitham, Simerdeep K Dhillon, Guido Wassink, Laura Bennet, Alistair J Gunn
The optimal duration of mild "therapeutic" hypothermia for neonates with hypoxic-ischemic encephalopathy is surprisingly unclear. This study assessed the relative efficacy of cooling for 48 h versus 72 h. Fetal sheep (0.85 gestation) received sham ischemia (n = 9) or 30 min global cerebral ischemia followed by normothermia (n = 8) or delayed hypothermia from 3 h to 48 h (n = 8) or 72 h (n = 8). Ischemia was associated with profound loss of electroencephalogram (EEG) power, neurons in the cortex and hippocampus, and oligodendrocytes and myelin basic protein expression in the white matter, with increased Iba-1-positive microglia and proliferation...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28498095/risk-factors-for-development-of-postoperative-cerebellar-mutism-syndrome-in-children-after-medulloblastoma-surgery
#3
San Y C V Pols, Marie Lise C van Veelen, Femke K Aarsen, Antonia Gonzalez Candel, Coriene E Catsman-Berrevoets
OBJECTIVE Postoperative cerebellar mutism syndrome (pCMS) occurs in 7%-50% of children after cerebellar tumor surgery. Typical features include a latent onset of 1-2 days after surgery, transient mutism, emotional lability, and a wide variety of motor and neurobehavioral abnormalities. Sequelae of this syndrome usually persist long term. The principal causal factor is bilateral surgical damage (regardless of tumor location) to any component of the proximal efferent cerebellar pathway, which leads to temporary dysfunction of cerebral cortical regions as a result of diaschisis...
May 12, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28497797/suppression-of-cognitive-function-in-hyperthermia-from-the-viewpoint-of-executive-and-inhibitive-cognitive-processing
#4
Manabu Shibasaki, Mari Namba, Misaki Oshiro, Ryusuke Kakigi, Hiroki Nakata
Climate change has had a widespread impact on humans and natural systems. Heat stroke is a life-threatening condition in severe environments. The execution or inhibition of decision making is critical for survival in a hot environment. We hypothesized that, even with mild heat stress, not only executive processing, but also inhibitory processing may be impaired, and investigated the effectiveness of body cooling approaches on these processes using the Go/No-go task with electroencephalographic event-related potentials...
March 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28487302/prophylactic-use-of-eculizumab-during-surgery-in-chronic-cold-agglutinin-disease
#5
Eirik Tjønnfjord, Øystein A Vengen, Sigbjørn Berentsen, Geir Erland Tjønnfjord
Primary chronic cold agglutinin disease (CAD) is an autoimmune haemolytic anaemia in which a specific bone marrow lymphoproliferative disorder causes production of cold agglutinins (CA). Binding of CA to erythrocyte surface antigens results in a predominantly extravascular haemolysis that is entirely complement dependent. Because of complement activation, exacerbations are common during febrile infections, trauma or major surgery. Involvement of the terminal complement pathway with C5-mediated intravascular haemolysis is probably not prominent in stable disease but is supposed to be of importance in exacerbations following acute phase reaction...
May 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28481829/a-population-pharmacokinetic-analysis-to-study-the-effect-of-therapeutic-hypothermia-on-vancomycin-disposition-in-children-resuscitated-from-cardiac-arrest
#6
Nicole R Zane, Michael D Reedy, Marc R Gastonguay, Adam S Himebauch, Evan Z Ramsey, Alexis A Topjian, Athena F Zuppa
OBJECTIVES: Limited data exist on the effects of therapeutic hypothermia on renal function and pharmacokinetics in pediatric patients after cardiac arrest. The objective was to describe the differences in vancomycin disposition in pediatric patients following cardiac arrest treated with either therapeutic hypothermia or normothermia using population pharmacokinetic modeling. DESIGN: Single-center, retrospective cohort study. SETTING: A tertiary care hospital pediatric and cardiac ICU...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28471439/relationships-between-cerebral-autoregulation-and-markers-of-kidney-and-liver-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#7
J K Lee, J Perin, C Parkinson, M O'Connor, M M Gilmore, M Reyes, J Armstrong, J M Jennings, F J Northington, R Chavez-Valdez
OBJECTIVE: We studied whether cerebral blood pressure autoregulation and kidney and liver injuries are associated in neonatal encephalopathy (NE). STUDY DESIGN: We monitored autoregulation of 75 newborns who received hypothermia for NE in the neonatal intensive care unit to identify the mean arterial blood pressure with optimized autoregulation (MAPOPT). Autoregulation parameters and creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were analyzed using adjusted regression models...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28470638/-management-of-massive-intraoperative-blood-loss-using-a-case-study
#8
Andreas Pape, Angelo Ippolito, Joanna Warszawska, Florian Raimann, Kai Zacharowski
Massive intraoperative bleeding is a major and potentially life-threatening complication during surgical procedures. The lethal triade of hemorrhagic shock with metabolic acidosis, hypothermia and coagulopathy enhances bleeding tendency. Avoiding this vitious circle requires a well-structured and standardized procedure. Primary goals include the maintenance of adequate tissue oxygenation, restauration of proper coagulatory function, normothermia and homeostasis of acid-base and electrolyte balance. In the present article, these therapeutic goals and their pathophysiological background are illustrated with a clinical case example...
April 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28467526/centers-for-disease-control-and-prevention-guideline-for-the-prevention-of-surgical-site-infection-2017
#9
Sandra I Berríos-Torres, Craig A Umscheid, Dale W Bratzler, Brian Leas, Erin C Stone, Rachel R Kelz, Caroline E Reinke, Sherry Morgan, Joseph S Solomkin, John E Mazuski, E Patchen Dellinger, Kamal M F Itani, Elie F Berbari, John Segreti, Javad Parvizi, Joan Blanchard, George Allen, Jan A J W Kluytmans, Rodney Donlan, William P Schecter
Importance: The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. Objective: To provide new and updated evidence-based recommendations for the prevention of SSI...
May 3, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28464863/clinical-course-and-prognostic-factors-of-patients-in-severe-accidental-hypothermia-with-circulatory-instability-rewarmed-with-veno-arterial-ecmo-an-observational-case-series-study
#10
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksander Zeliaś, Mirosław Ziętkiewicz, Paweł Podsiadło, Tomasz Sanak, Kinga Sałapa, Jacek Piątek, Janusz Konstany-Kalandyk, Robert Gałązkowski, Paweł Krawczyk, Łukasz Krzych, Rafał Drwiła
BACKGROUND: Recently, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become the rewarming treatment of choice in hypothermic cardiac arrest. The detailed indications for extracorporeal rewarming in non-arrested, severely hypothermic patients with circulatory instability have not been established yet. The primary purpose of the study was a preliminary analysis of all aspects of the treatment process, as well as initial identification of mortality risk factors within the group of severely hypothermic patients, treated with arteriovenous extracorporeal membrane oxygenation (VA-ECMO)...
May 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28462685/effect-of-heat-exposure-on-cognition-in-persons-with-tetraplegia
#11
John P Handrakis, Zhen Ni Guan, John W Nulty, Oriana Tascione, Dwindally Rosado-Rivera, Daniel White, Charlene Bang, Ann Spungen, William A Bauman
Individuals with cervical spinal cord injury (SCI) have impaired thermoregulatory mechanisms due to interruption of motor, sensory, and autonomic neuropathways. To determine the effects of heat exposure on core body temperature (Tcore) and cognitive performance in persons with tetraplegia, eight individuals with chronic tetraplegia (C3-C7, AIS A-B) and 9 able-bodied controls were acclimated to 27°C at baseline (BL) before being exposed to 35°C for up to 120 minutes (Heat Challenge). Rectal temperature (Tcore), distal skin temperatures (Tsk<sub>avg</sub>), sweat rate (QS<sub>avg</sub>), microvascular skin perfusion (LDF<sub>avg</sub>), and plasma norepinephrine (NE) were measured...
May 2, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28454611/inadvertent-perioperative-hypothermia-current-nursing-knowledge
#12
Karen K Giuliano, Jane Hendricks
Inadvertent perioperative hypothermia is estimated to affect 70% of surgical patients and is associated with adverse clinical outcomes, lengthened hospital stays, and increased costs. To better understand the current level of nursing knowledge on this subject since the release of the "Guideline for prevention of unplanned patient hypothermia," we conducted an e-mail survey of AORN members. The overall response rate was 6.5% (N = 324), and most responding nurses overestimated or underestimated the lower and upper limits for normothermia...
May 2017: AORN Journal
https://www.readbyqxmd.com/read/28452566/hypothermia-after-cranial-irradiation-protects-neural-progenitor-cells-in-the-subventricular-zone-but-not-in-the-hippocampus
#13
Magnus Sabel, Marie Kalm, Thomas Björk-Eriksson, Birgitta Lannering, Klas Blomgren
PURPOSE: To explore if hypothermia can reduce the harmful effects of ionizing radiation on the neurogenic regions of the brain in young rats. MATERIAL AND METHODS: Postnatal day 9 rats were randomized into two treatment groups, hypo- and normothermia, or a control group. Treatment groups were placed in chambers submerged in temperature-controlled water baths (30˚C and 36˚C) for 8 h, after receiving a single fraction of 8 Gy to the left hemisphere. Seven days post-irradiation, we measured the sizes of the subventricular zone (SVZ) and the granule cell layer (GCL) of the hippocampus, and counted the number of proliferating (phospho-histone H3+) cells and microglia (Iba1+ cells)...
April 28, 2017: International Journal of Radiation Biology
https://www.readbyqxmd.com/read/28437236/temperature-variation-after-rewarming-from-deep-hypothermic-circulatory-arrest-is-associated-with-survival-and-neurologic-outcome
#14
Alessio Rungatscher, Giovanni Battista Luciani, Daniele Linardi, Elisabetta Milani, Leonardo Gottin, Beat Walpoth, Giuseppe Faggian
Therapeutic hypothermia is recommended by international guidelines after cardio-circulatory arrest. However, the effects of different temperatures during the first 24 hours after deep hypothermic circulatory arrest (DHCA) for aortic arch surgery on survival and neurologic outcome are undefined. We hypothesize that temperature variation after aortic arch surgery is associated with survival and neurologic outcome. In the period 2010-2014, a total of 210 consecutive patients undergoing aortic arch surgery with DHCA were included...
March 1, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28407632/hypothermic-neuronal-rescue-from-infection-sensitised-hypoxic-ischaemic-brain-injury-is-pathogen-dependent
#15
Mari Falck, Damjan Osredkar, Elke Maes, Torun Flatebø, Thomas Ragnar Wood, Hemmen Sabir, Marianne Thoresen
Perinatal infection increases the vulnerability of the neonatal brain to hypoxic-ischaemic (HI) injury. Hypothermia treatment (HT) does not provide neuroprotection after pre-insult inflammatory sensitisation by lipopolysaccharide (LPS), a gram-negative bacterial wall constituent. However, early-onset sepsis in term babies is caused by gram-positive species in more than 90% of cases, and neuro-inflammatory responses triggered through the gram-negative route (Toll-like receptor 4, TLR-4) are different from those induced through the gram-positive route via TLR-2...
April 14, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28406486/promoting-teamwork-may-improve-infant-care-processes-during-delivery-room-management-florida-perinatal-quality-collaborative-s-approach
#16
M Balakrishnan, N Falk-Smith, L A Detman, B Miladinovic, W M Sappenfield, J S Curran, T L Ashmeade
BACKGROUND: LOCAL PROBLEM: Inadequate understanding of compliance with standardized evidence-based DR management. INTERVENTIONS: Promote inter-professional teamwork and a bundle of interventions focusing on resuscitation team roles, equipment check, and debriefing using QI methodology. Optimize delivery room (DR) management to achieve 10-min SPO2 targets, delayed-cord clamping (DCC), team role assignment and debriefings in >50% of deliveries, and achieve normothermia in >75% of infants...
April 13, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28397383/passive-heat-stress-reduces-circulating-endothelial-and-platelet-microparticles
#17
Anthony R Bain, Philip N Ainslie, Tyler D Bammert, Jamie G Hijmans, Mypinder Sekhom, Ryan L Hoiland, Daniela Flück, Joseph Donnelly, Christopher A DeSouza
Interest in circulating endothelial- (EMPs) and platelet- (PMPs) derived microparticles has increased due to their potential pathogenic role in vascular disease and as biomarkers for vascular health. Hyperthermia is commonly associated with a proinflammatory stress, but may also provide vascular protection when the temperature elevation is non-pathological. Circulating microparticles may contribute to the cellular adjustments and resultant vascular impacts of hyperthermia. Here, we determined whether circulating concentrations of arterial EMPs and PMPs are altered by passive heat stress (+2°C esophageal temperature)...
April 11, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28383534/the-effect-of-therapeutic-hypothermia-on-heart-rate-variability
#18
Z A Vesoulis, R Rao, S B Trivedi, A M Mathur
OBJECTIVE: Heart rate variability (HRV) reflects integrity of the autonomic nervous system. However, no study has investigated the impact of therapeutic hypothermia (TH) on HRV measures in infants with hypoxic-ischemic encephalopathy (HIE). In this study, we evaluate the influence of temperature on measures of HRV for a group of infants with favorable outcomes, as compared with a control group of infants with unfavorable outcomes. STUDY DESIGN: Term-born infants with moderate-severe HIE underwent standard TH treatment and prospective electroencephalography (EEG) and electrocardiogram (ECG) recording...
April 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28374415/biventricular-function-on-early-echocardiograms-in-neonatal-hypoxic-ischemic-encephalopathy
#19
Sanjeev Aggarwal, Girija Natarajan
AIM: To compare early (<24 hours) echocardiograms (ECHOs) in infants with perinatal hypoxic-ischemic encephalopathy (HIE) undergoing a)therapeutic hypothermia (TH) b) normothermia and c) normal controls. METHODS: This was a single center retrospective review of clinical early ECHOs of term infants with moderate or severe HIE and controls (with a normal ECHO <72 hours of age). Right (RVO) and left ventricular output (LVO), RV and LV myocardial performance index (MPI), systolic to diastolic duration ratio (S/D) and eccentricity indices (EI) in systole and diastole were compared using ANOVA...
April 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28364479/detection-of-intraoperative-myocardial-dysfunction-by-accelerometer-during-aortic-valve-replacement
#20
Ole-Johannes H N Grymyr, Jan O Beitnes, Jo Eidet, Stein Tølløfsrud, Arnt Fiane, Helge Skulstad, Erik Fosse, Per S Halvorsen
OBJECTIVES: Myocardial dysfunction may occur during weaning from cardiopulmonary bypass (CPB). Epicardial accelerometers have been shown to be useful in continuous monitoring of myocardial ischaemia during beating-heart surgery. We aimed to investigate whether an accelerometer can detect myocardial dysfunction during weaning from CPB. METHODS: In 23 patients undergoing isolated aortic valve replacement (AVR), a three-axis accelerometer was attached to the left ventricle and 3D velocity was calculated from the signals...
February 1, 2017: Interactive Cardiovascular and Thoracic Surgery
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