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Patient Temperature Management

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https://www.readbyqxmd.com/read/27923432/awakenings-patient-and-hospital-staff-perceptions-of-nighttime-disruptions-and-their-effect-on-patient-sleep
#1
Mila N Grossman, Samantha L Anderson, Aelaf Worku, William Marsack, Nimit Desai, Ambrosio Tuvilleja, Jacqueline Ramos, Mary Ann Francisco, Cynthia Lafond, Jay S Balachandran, Babak Mokhlesi, Jeanne M Farnan, David O Meltzer, Vineet M Arora
STUDY OBJECTIVES: Although important to recovery, sleeping in the hospital is difficult because of disruptions. Understanding how patients, hospital physicians, and nurses perceive sleep disruptions and identifying which disruptions are associated with objective sleep loss can help target improvement initiatives. METHODS: Patients and hospital staff completed the Potential Hospital Sleep Disruptions and Noises Questionnaire (PHSDNQ). Cutoff points were defined based on means, and responses were dichotomized...
November 28, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27907958/critical-care-management-after-cardiac-arrest
#2
Hans Friberg, Tobias Cronberg
Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907859/near-infrared-mediated-quantum-dots-and-paclitaxel-co-loaded-nanostructured-lipid-carriers-for-cancer-theragnostic
#3
Livesey David Olerile, Yongjun Liu, Bo Zhang, Tianqi Wang, Shengjun Mu, Jing Zhang, Lesego Selotlegeng, Na Zhang
Timing is an important factor in cancer management. Theragnostic systems have benefit of improving patients' life-quality by expediting therapeutic decisions. The objective of this study was to explore the potential of co-loaded [quantum dots (CdTe/CdS/ZnS) and paclitaxel] NLC (nanostructured lipid carriers) as a parenteral multifunctional delivery system. The co-loaded NLC was prepared by emulsion-evaporation and low temperature-solidification method utilising glyceryl monostearate, oleic acid, and soya phosphatidylcholine as lipid matrix...
November 24, 2016: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/27906641/time-to-cooling-is-associated-with-resuscitation-outcomes
#4
Robert B Schock, Andreas Janata, W Frank Peacock, Nathan S Deal, Sarathi Kalra, Fritz Sterz
Our purpose was to analyze evidence related to timing of cooling from studies of targeted temperature management (TTM) after return of spontaneous circulation (ROSC) after cardiac arrest and to recommend directions for future therapy optimization. We conducted a preliminary review of studies of both animals and patients treated with post-ROSC TTM and hypothesized that a more rapid cooling strategy in the absence of volume-adding cold infusions would provide improved outcomes in comparison with slower cooling...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27905297/altered-thermoregulatory-responses-in-heart-failure-patients-exercising-in-the-heat
#5
Bryce N Balmain, Ollie Jay, Surendran Sabapathy, Danielle Royston, Glenn M Stewart, Rohan Jayasinghe, Norman R Morris
Heart failure (HF) patients appear to exhibit impaired thermoregulatory capacity during passive heating, as evidenced by diminished vascular conductance. Although some preliminary studies have described the thermoregulatory response to passive heating in HF, responses during exercise in the heat remain to be described. Therefore, the aim of this study was to compare thermoregulatory responses in HF and controls (CON) during exercise in the heat. Ten HF (NYHA classes I-II) and eight CON were included. Core temperature (Tc), skin temperature (Tsk), and cutaneous vascular conductance (CVC) were assessed at rest and during 1 h of exercise at 60% of maximal oxygen uptake...
November 2016: Physiological Reports
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#6
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27899087/paradoxical-physiological-responses-to-propranolol-in-a-rett-syndrome-patient-a-case-report
#7
P J Santosh, L Bell, K Lievesley, J Singh, F Fiori
BACKGROUND: Rett Syndrome (RTT), caused by a loss-of-function in the epigenetic modulator: X-linked methyl-CpG binding protein 2 (MeCP2), is a pervasive neurological disorder characterized by compromised brain functions, anxiety, severe mental retardation, language and learning disabilities, repetitive stereotyped hand movements and developmental regression. An imbalance in the sympathetic and the parasympathetic nervous system (dysautonomia) and the resulting autonomic storms is a frequent occurrence in patients with RTT...
November 29, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27894327/a-statistical-analysis-protocol-for-the-time-differentiated-target-temperature-management-after-out-of-hospital-cardiac-arrest-tth48-clinical-trial
#8
Hans Kirkegaard, Asger Roer Pedersen, Ville Pettilä, Jakob Hjort, Bodil Steen Rasmussen, Inge de Haas, Jørgen Feldbæk Nielsen, Susanne Ilkjær, Anne Kaltoft, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Alf Inge Larsen, Valdo Toome, Urmet Arus, Fabio Silvio Taccone, Christian Storm, Timo Laitio, Markus B Skrifvars, Eldar Søreide
BACKGROUND: The TTH48 trial aims to determine whether prolonged duration (48 hours) of targeted temperature management (TTM) at 33 (±1) °C results in better neurological outcomes compared to standard duration (24 hours) after six months in comatose out-of-hospital cardiac arrest (OHCA) patients. METHODS: TTH48 is an investigator-initiated, multicentre, assessor-blinded, randomised, controlled superiority trial of 24 and 48 hours of TTM at 33 (±1) ° C performed in 355 comatose OHCA patients aged 18 to 80 years who were admitted to ten intensive care units (ICUs) in six Northern European countries...
November 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27894313/identifying-the-barriers-and-enablers-for-a-triage-treatment-and-transfer-clinical-intervention-to-manage-acute-stroke-patients-in-the-emergency-department-a-systematic-review-using-the-theoretical-domains-framework-tdf
#9
REVIEW
Louise E Craig, Elizabeth McInnes, Natalie Taylor, Rohan Grimley, Dominique A Cadilhac, Julie Considine, Sandy Middleton
BACKGROUND: Clinical guidelines recommend that assessment and management of patients with stroke commences early including in emergency departments (ED). To inform the development of an implementation intervention targeted in ED, we conducted a systematic review of qualitative and quantitative studies to identify relevant barriers and enablers to six key clinical behaviours in acute stroke care: appropriate triage, thrombolysis administration, monitoring and management of temperature, blood glucose levels, and of swallowing difficulties and transfer of stroke patients in ED...
November 28, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27887653/intravascular-versus-surface-cooling-for-targeted-temperature-management-after-out-of-hospital-cardiac-arrest-an-analysis-of-the-ttm-trial-data
#10
Guy W Glover, Richard M Thomas, George Vamvakas, Nawaf Al-Subaie, Jules Cranshaw, Andrew Walden, Matthew P Wise, Marlies Ostermann, Emma Thomas-Jones, Tobias Cronberg, David Erlinge, Yvan Gasche, Christian Hassager, Janneke Horn, Jesper Kjaergaard, Michael Kuiper, Tommaso Pellis, Pascal Stammet, Michael Wanscher, Jørn Wetterslev, Hans Friberg, Niklas Nielsen
BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest and may be achieved using a variety of cooling devices. This study was conducted to explore the performance and outcomes for intravascular versus surface devices for targeted temperature management after out-of-hospital cardiac arrest. METHOD: A retrospective analysis of data from the Targeted Temperature Management trial. N = 934. A total of 240 patients (26%) managed with intravascular versus 694 (74%) with surface devices...
November 26, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27886052/a-melting-curve-based-multiplex-rt-qpcr-assay-for-simultaneous-detection-of-four-human-coronaviruses
#11
Zhenzhou Wan, Ya'nan Zhang, Zhixiang He, Jia Liu, Ke Lan, Yihong Hu, Chiyu Zhang
Human coronaviruses HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1 are common respiratory viruses associated with acute respiratory infection. They have a global distribution. Rapid and accurate diagnosis of HCoV infection is important for the management and treatment of hospitalized patients with HCoV infection. Here, we developed a melting curve-based multiplex RT-qPCR assay for simultaneous detection of the four HCoVs. In the assay, SYTO 9 was used to replace SYBR Green I as the fluorescent dye, and GC-modified primers were designed to improve the melting temperature (Tm) of the specific amplicon...
November 23, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27886022/fracture-risk-of-vertebral-bodies-after-cryosurgery-using-a-miniature-cryoprobe-a-biomechanical-in-vitro-analysis-on-human-bones
#12
K Zarghooni, L Westermann, R Sobottke, M Röllinghoff, J Bredow, J Siewe, Peer Eysel, M J Scheyerer
INTRODUCTION: Due to spinal instability and compressive neurologic deficits surgical management is sometimes necessary in patients with metastatic spinal lesions. However, in some cases open surgery is not possible and minimally invasive procedures, like cryoablation, are needed. The aim of the current study was to investigate whether a miniature cryoprobe provides adequate tissue cooling in vertebrae and to evaluate the direct impact of cryosurgery on vertebral body stability. MATERIALS AND METHODS: Twelve thoracic vertebral bodies were harvested from fresh cadavers...
November 18, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/27884576/extracorporeal-life-support-for-refractory-cardiac-arrest-from-accidental-hypothermia-a-10-year-experience-in-edinburgh
#13
Maziar Khorsandi, Scott Dougherty, Neil Young, Dean Kerslake, Vincenzo Giordano, Robert Lendrum, William Walker, Vipin Zamvar, Ivan Yim, Renzo Pessotto
BACKGROUND: Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management of such patients remains elusive. OBJECTIVE: In this single-center study, we looked at the outcomes of all adult patients undergoing salvage ECLS for cardiac arrest caused by accidental hypothermia over a 10-year period from June 2006 to June 2016...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27881620/catching-fakes-new-markers-of-urine-sample-validity-and-invalidity
#14
Melissa M Goggin, Cheng-Min Tann, Anna Miller, An Nguyen, Gregory C Janis
Urine drug testing is common for workplace drug testing, prescription management, emergency medicine and the criminal justice system. Unsurprisingly, with the significant consequences based upon the results of urine drug testing, a donor in need of concealing the contents of their sample is highly motivated to cheat the process. Procedures and safeguards ensuring sample validity are well known, and include measuring sample temperature at the time of collection, and laboratory measurements of creatinine, specific gravity and pH...
November 22, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27879074/s1-guidelines-on-the-diagnosis-and-treatment-of-scabies-short-version
#15
Cord Sunderkötter, Hermann Feldmeier, Regina Fölster-Holst, Bertram Geisel, Sabine Klinke-Rehbein, Alexander Nast, Sandra Philipp, Bernhardt Sachs, Julia Stingl, Johanna Stoevesandt, Henning Hamm
The goals of this German guideline are the improvement of diagnosis and therapy of scabies, the implementation of a coordinated action in outbreaks of scabies, and the control of this infestation in large migration or refugee flows.Sarcoptes scabiei var. hominis is transmitted by direct skin-to-skin contact of sufficient duration. The infectivity of female mites when removed from patients does not exceed 48 hours at room temperature (21°C) and relative humidity of 40-80%. The risk of infection rises proportionally to the number of mites on the skin and is particularly high in crusted scabies...
November 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27877067/similar-long-term-survival-of-consecutive-in-hospital-and-out-of-hospital-cardiac-arrest-patients-treated-with-targeted-temperature-management
#16
Magaly Engsig, Helle Søholm, Fredrik Folke, Peter J Gadegaard, Julie Therese Wiis, Rune Molin, Thomas Mohr, Frederik N Engsig
OBJECTIVE: The long-term survival of in-hospital cardiac arrest (IHCA) patients treated with targeted temperature management (TTM) is poorly described. The aim of this study was to compare the outcomes of consecutive IHCA with out-of-hospital cardiac arrest (OHCA) patients treated with TTM. DESIGN SETTING AND PATIENTS: Retrospectively collected data on all consecutive adult patients treated with TTM at a university tertiary heart center between 2005 and 2011 were analyzed...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27875660/successful-use-of-targeted-temperature-management-after-repair-of-myocardial-rupture-from-blunt-chest-trauma-a-case-report
#17
Wook-Jin Choi, Yun Seok Kim, Jung Seok Hong, Jeong Won Kim
Targeted temperature management (TTM) improves survival and neurological outcome after nontraumatic cardiac arrest. However, TTM is not used widely after traumatic cardiac arrest because of concerns that it might exacerbate bleeding. We report the use of postarrest TTM after repair of blunt myocardial rupture. A 48-year-old man was admitted after being rescued from a major traffic accident by the local emergency service. Focused sonography showed pericardial fluid without cardiac tamponade. Computed tomography showed a large hematoma in the anterior mediastinum associated with hemopericardium...
November 22, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27871588/novel-resuscitation-devices-facilitate-complete-neurologic-recovery-after-prolonged-cardiac-arrest-in-postanesthesia-care-unit
#18
Elif C Cingi, Luke A McMahon, Richard C Prielipp
Cardiac arrest in the perioperative period is associated with significant morbidity and mortality. Novel resuscitation devices may afford patients improved survival and limit neurologic injury. We report a case of cardiac arrest in the postanesthesia care unit that required an extensive period of cardiopulmonary resuscitation assisted by the ResQPOD impedance threshold device to optimize coronary perfusion and a LUCAS chest compression system to maintain optimal cardiopulmonary resuscitation while transporting the patient to the cardiac catheterization laboratory...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27866109/magnitude-of-temperature-elevation-is-associated-with-neurologic-and-survival-outcomes-in-resuscitated-cardiac-arrest-patients-with-postrewarming-pyrexia
#19
Anne V Grossestreuer, David F Gaieski, Michael W Donnino, Douglas J Wiebe, Benjamin S Abella
PURPOSE: Avoidance of pyrexia is recommended in resuscitation guidelines, including after treatment with targeted temperature management (TTM). Which aspects of postresuscitation pyrexia are harmful and modifiable have not been conclusively determined. MATERIALS AND METHODS: This retrospective multicenter registry study collected serial temperatures during 72 hours postrewarming to assess the relationship between 3 aspects of pyrexia (maximum temperature, pyrexia duration, timing of first pyrexia) and neurologic outcome (primary) and survival (secondary) at hospital discharge...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27860555/time-to-awakening-is-often-delayed-in-patients-who-receive-targeted-temperature-management-after-cardiac-arrest
#20
Katie Zanyk-McLean, Kelly N Sawyer, Ryan Paternoster, Rebekah Shievitz, William Devlin, Robert Swor
Post cardiac arrest, neuroprognostication remains a complex and clinically challenging issue for critical care providers. For this reason, our primary objective in this study was to determine the frequency of survival and favorable neurological outcomes in post-cardiac arrest patients with delayed time to awakening. To assess whether early withdrawal of care may adversely impact survival, we also sought to describe the time to withdrawal of care of non-surviving patients. We performed a retrospective study of patients resuscitated after cardiac arrest in two large academic community hospitals...
November 18, 2016: Therapeutic Hypothermia and Temperature Management
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