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Patient Temperature Management

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https://www.readbyqxmd.com/read/28731840/clinical-effect-of-rebound-hyperthermia-after-cooling-postcardiac-arrest-a-meta-analysis
#1
Parth Makker, Yumiko Kanei, Deepkia Misra
Rebound hyperthermia (RH) is frequently seen after completion of targeted temperature management (TTM) in comatose survivors of cardiac arrest. However, its clinical significance is not well understood. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this meta-analysis is to examine the impact of RH after completion of TTM in patients postcardiac arrest. We reviewed six studies that evaluated the incidence of RH (T > 38°C) with documentation of outcome based on the presence of hyperthermia...
July 21, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28731634/measuring-the-quality-of-hospital-food-services-development-and-reliability-of-a-meal-quality-audit-tool
#2
Merrilyn Banks, Mary Hannan-Jones, Lynda Ross, Ann Buckley, Jennifer Ellick, Adrienne Young
AIM: To develop and test the reliability of a Meal Quality Audit Tool (MQAT) to audit the quality of hospital meals to assist food service managers and dietitians in identifying areas for improvement. METHODS: The MQAT was developed using expert opinion and was modified over time with extensive use and feedback. A phased approach was used to assess content validity and test reliability: (i) trial with 60 dietetic students, (ii) trial with 12 food service dietitians in practice and (iii) interrater reliability study...
April 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#3
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28718257/risk-factors-for-heat-related-deaths-during-the-june-2015-heat-wave-in-karachi-pakistan
#4
Syed Ghazanfar Saleem, Tehreem Ansari, Ashraf Shamshad Ali, Sara Fatima, Mariam Hassan Rizvi, Muhammad Abdul Samad
BACKGROUND: Mortality as a consequence of heat related illness is a public health concern. Emergency department (ED) experiences increased patients' flow and decreased survival as a consequence of heat stroke during the episodes of heat wave. The present study was conducted to identify the risk factors for mortality among victims of heat wave (17th - 23rd June), 2015 evaluated in the Emergency Department of The Indus Hospital (TIH), Karachi. METHODS: In this cross-sectional study data was retrospectively collected...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28716150/swedish-norwegian-co-operation-in-the-treatment-of-three-hypothermia-victims-a-case-report
#5
Anders Wetting Carlsen, Nils K Skjaervold, Nils Johan Berg, Øystein Karlsen, Eli Gunnarson, Alexander Wahba
BACKGROUND: Accidental hypothermia with cardiac arrest represents a challenge for pre-hospital rescuers as well as in-hospital staff. For pre-hospital personnel, the main focus is to get the patient to the correct destination without unnecessary delay. For in-hospital personnel early information is vital to assess the possibility for resuscitation with extracorporeal re-warming. The challenge is augmented when rescuers must cross national borders to reach and/or deliver the patients. We present a case where three adolescent boys suffered severe hypothermia after a canoeing accident in Sweden...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28713631/percutaneous-cervical-laser-diskectomy-thermoannuloplasty-and-thermonucleoplasty-comparable-results-without-surgery
#6
EDITORIAL
Nancy E Epstein
BACKGROUND: Utilizing the literature, the results of three different minimally invasive surgery (MIS) anterior cervical percutaneous operations for neck/mild radicular pain and magnetic resonance (MR)-documented "contained" (not extruded/sequestrated) discs were evaluated. Results were compared with patients treated nonsurgically for comparable/greater neurological compromise, and even more severe cervical disc disease. METHODS: There were three MIS percutaneous anterior cervical discectomy procedures...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28713043/auditory-discrimination-improvement-predicts-awakening-of-postanoxic-comatose-patients-treated-with-targeted-temperature-management-at-36%C3%A2-c
#7
Christian Pfeiffer, Nathalie Ata Nguepno Nguissi, Magali Chytiris, Phanie Bidlingmeyer, Matthias Haenggi, Rebekka Kurmann, Frédéric Zubler, Mauro Oddo, Andrea O Rossetti, Marzia De Lucia
BACKGROUND: Outcome prognostication in postanoxic comatose patients is more accurate in predicting poor than good recovery. Using electroencephalography recordings in patients treated with targeted temperature management at 33°C (TTM 33), we have previously shown that improvement in auditory discrimination over the first days of coma predicted awakening. Given the increased application of a 36°C temperature target (TTM 36), here we aimed at validating the predictive value of auditory discrimination in the TTM 36 setting...
July 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28709953/association-of-hemodynamic-variables-with-in-hospital-mortality-and-favorable-neurological-outcomes-in-post-cardiac-arrest-care-with-targeted-temperature-management
#8
Chien-Hua Huang, Min-Shan Tsai, Hooi Nee Ong, Weiting Chen, Chih-Hung Wang, Wei-Tien Chang, Tzung-Dau Wang, Shyr-Chyr Chen, Matthew Huei-Ming Ma, Wen-Jone Chen
PURPOSE: Although hemodynamic instability is expected during the post-cardiac arrest period, the implications of hemodynamic parameters for outcomes remain unclear. Each phase of targeted temperature management (TTM) affects hemodynamic responses differently. This study aims to investigate the association of hemodynamic parameters with outcomes in patients receiving TTM after cardiac arrest. METHODS: The study prospectively enrolled patients who were treated with TTM (33°C for 24h) after cardiac arrest...
July 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/28708678/dysglycemia-glycemic-variability-and-outcome-after-cardiac-arrest-and-temperature-management-at-33%C3%A2-c-and-36%C3%A2-c
#9
Ola Borgquist, Matt P Wise, Niklas Nielsen, Nawaf Al-Subaie, Julius Cranshaw, Tobias Cronberg, Guy Glover, Christian Hassager, Jesper Kjaergaard, Michael Kuiper, Ondrej Smid, Andrew Walden, Hans Friberg
OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28708472/rectal-instillation-of-cold-fluids-for-targeted-temperature-management-after-cardiac-arrest-a-case-report
#10
Andrej Markota, Jure Fluher, Andreja Sinkovič
The optimal method of temperature management after cardiac arrest remains unknown. Methods that are most effective are usually invasive and expensive. Noninvasive methods are not as effective and obstruct access to the patient. Temperature management via rectal cooling offers some potential advantages in survivors of cardiac arrest, namely, relatively large volumes of temperature-controlled fluids can be instilled, access to the patient is not obstructed, and fluid overload can be ameliorated by removal of a fraction of instilled fluid...
July 14, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28706860/targeted-temperature-management-in-neurological-intensive-care-unit
#11
REVIEW
Sombat Muengtaweepongsa, Winchana Srivilaithon
Targeted temperature management (TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy (HIE). In addition, TTM is also useful for treatment of elevated intracranial pressure (ICP). HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit (ICU). The most common cause of HIE is cardiac arrest. Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest. Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies...
June 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28700964/clinical-and-laboratory-predictors-of-infectious-complications-in-patients-after-out-of-hospital-cardiac-arrest
#12
Josef Kroupa, Jiri Knot, Jaroslav Ulman, Frantisek Bednar, Alena Dohnalova, Zuzana Motovska
PURPOSE: Identification of clinical and laboratory predictors related to Infectious Complications (ICs) in patients after Out-of-Hospital Cardiac Arrest (OHCA). METHODS: Patients, aged >18, after an OHCA between 9/2013 and 11/2015, surviving >24h, were studied. RESULTS: Study group consisted of 42 patients (mean age 63.4years, 88.1% men). Forty percent of patients had IC; lower respiratory tract infections were most common (87.5% of cases)...
July 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28698133/randomized-controlled-trial-of-internal-and-external-targeted-temperature-management-methods-in-post-cardiac-arrest-patients
#13
Xinqi Look, Huihua Li, Mingwei Ng, Eric Tien Siang Lim, Sohil Pothiawala, Kenneth Boon Kiat Tan, Duu Wen Sewa, Nur Shahidah, Pin Pin Pek, Marcus Eng Hock Ong
BACKGROUND: Targeted temperature management post-cardiac arrest is currently implemented using various methods, broadly categorized as internal and external. This study aimed to evaluate survival-to-hospital discharge and neurological outcomes (Glasgow-Pittsburgh Score) of post-cardiac arrest patients undergoing internal cooling verses external cooling. METHODOLOGY: A randomized controlled trial of post-resuscitation cardiac arrest patients was conducted from October 2008-September 2014...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28693536/hypothermia-induced-alteration-of-repolarization-impact-on-acute-and-long-term-outcome-a-prospective-cohort-study
#14
Sophie von Ulmenstein, Christian Storm, Thomas G K Breuer, Sebastian Lask, Philipp Attanasio, Andreas Mügge, Alexander Wutzler
BACKGROUND: The effects of target temperature management (TTM) on the heart aren't thoroughly studied yet. Several studies showed the prolongation of various ECG parameters including Tpeak-Tend-time under TTM. Our study's goal is to evaluate the acute and long-term outcome of these prolongations. METHODS: In this study we included patients with successful resuscitation after cardiac arrest who were admitted to the Charité Virchow Klinikum Berlin or the Heart and Vascular Centre of the Ruhr University Bochum between February 2006 and July 2013 (Berlin) or May 2014 to November 2015 (Bochum)...
July 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#15
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28687281/head-computed-tomography-for-prognostication-of-poor-outcome-in-comatose-patients-after-cardiac-arrest-and-targeted-temperature-management
#16
Marion Moseby-Knappe, Tommaso Pellis, Irina Dragancea, Hans Friberg, Niklas Nielsen, Janneke Horn, Michael Kuiper, Andrea Roncarati, Roger Siemund, Johan Undén, Tobias Cronberg
INTRODUCTION: A multimodal approach to prognostication of outcome after cardiac arrest (CA) is recommended. Evidence for combinations of methods is low. In this post-hoc analysis we described findings on head computed tomography (CT) after CA. We also examined whether generalised oedema on CT alone or together with the biomarker Neuron-specific enolase (NSE) could predict poor outcome. METHODS: Patients participating in the Target Temperature Management after out-of-hospital-cardiac-arrest-trial underwent CT based on clinical indications...
July 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28687073/association-of-neuron-specific-enolase-values-with-outcomes-in-cardiac-arrest-survivors-is-dependent-on-the-time-of-sample-collection
#17
Dagmar Vondrakova, Andreas Kruger, Marek Janotka, Filip Malek, Vlasta Dudkova, Petr Neuzil, Petr Ostadal
BACKGROUND: Despite marked advances in intensive cardiology care, current options for outcome prediction in cardiac arrest survivors remain significantly limited. The aim of our study was, therefore, to compare the day-specific association of neuron-specific enolase (NSE) with outcomes in out-of-hospital cardiac arrest (OHCA) survivors treated with hypothermia. METHODS: Eligible patients were OHCA survivors treated with targeted temperature management at 33 °C for 24 h using an endovascular device...
July 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28682972/temperature-controlled-delivery-of-radiofrequency-energy-in-fecal-incontinence-a-randomized-sham-controlled-clinical-trial
#18
Arjan P Visscher, Tze J Lam, Maria M Meurs-Szojda, Richelle J F Felt-Bersma
BACKGROUND: Controlled delivery of radiofrequency energy has been suggested as treatment for fecal incontinence. OBJECTIVE: The aim of this study was to determine whether the clinical response to the radiofrequency energy procedure is superior to sham in patients with fecal incontinence. DESIGN: This was a randomized sham-controlled clinical trial from 2008 to 2015. SETTING: This study was conducted in an outpatient clinic...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28668700/comparison-of-brain-computed-tomography-and-diffusion-weighted-magnetic-resonance-imaging-to-predict-early-neurologic-outcome-before-target-temperature-management-comatose-cardiac-arrest-survivors
#19
Chi Heon Jeon, Jung Soo Park, Ji Han Lee, Hoon Kim, Sang Chul Kim, Kyung Hye Park, Kyung Sik Yi, Sun Moon Kim, Chun Song Youn, Young-Min Kim, Byung Kook Lee
AIM: We previously reported that diffusion-weighted magnetic resonance imaging (DW-MRI) could be used to predict neurologic outcomes before targeted temperature management (TTM) after return of spontaneous circulation (ROSC) from cardiac arrest (CA). We compared the efficacy of brain computed tomography (CT) and DW-MRI to predict neurologic outcome before TTM in comatose cardiac arrest survivors. METHODS: We performed a retrospective study of CA patients treated with TTM...
June 28, 2017: Resuscitation
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#20
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
June 30, 2017: American Journal of Forensic Medicine and Pathology
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