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Patient Temperature Management

J Düring, J Dankiewicz, T Cronberg, C Hassager, J Hovdenes, J Kjaergaard, M Kuiper, N Nielsen, T Pellis, P Stammet, J Vulto, M Wanscher, M Wise, A Åneman, H Friberg
BACKGROUND: Admission lactate and lactate clearance are implemented for risk stratification in sepsis and trauma. In out-of-hospital cardiac arrest, results regarding outcome and lactate are conflicting. METHODS: This is a post-hoc analysis of the Target Temperature Management trial in which 950 unconscious patents after out-of-hospital cardiac arrest were randomized to a temperature intervention of 33°C or 36°C. Serial lactate samples during the first 36 hours were collected...
June 21, 2018: Acta Anaesthesiologica Scandinavica
Hyae-Jin Kim, Hyeon-Jeong Lee, Eunsoo Kim, Jihwan Yun
RATIONALE: Intrapleural hyperthermic chemotherapy (IPHC) is the preferred method to locally treat lung cancer with pleural seeding. Anesthetic management during IPHC is a very challenging task for the anesthesiologist because of the hemodynamic instability associated with the procedure; however, there is no report on anesthetic considerations during the IPHC procedure. PATIENT CONCERNS: Three patients who diagnosed lung cancer with pleural invasion scheduled for IPHC were reported in this case series...
June 2018: Medicine (Baltimore)
Brandon D D'Aloiso, Sarah S Rupchak, Kaitlin J Gettle, Claudio Lima, Robert D Rush
Waldenström's Macroglobulinemia (WM) is a rare lymphoma caused by the overproduction of immunoglobulin M (IgM). The elevated level of IgM causes serum hyperviscosity, cold agglutinins, and cryoglobulinemia. Anemia is also present because of impaired production of erythrocytes. For these reasons, placing a patient with WM on cardiopulmonary bypass (CPB) requires careful preparation. In this case, the patient was a 73-year-old male with known Waldenström's disease who required coronary artery bypass graft surgery...
June 2018: Journal of Extra-corporeal Technology
Marcel Levi
The delicate biochemistry of coagulation and anticoagulation is greatly affected by deviations from the optimal temperature required for the interactions between various coagulation enzymes, cellular receptors, and intracellular mechanisms. Hyperthermia will lead to a prothrombotic state and, if sufficiently severe such as in heatstroke, a consumption coagulopathy, which will clinically manifest with the simultaneous appearance of intravascular thrombotic obstruction and an increased bleeding tendency. Hypothermia slows down the coagulation process, but as this seems to be adequately balanced by impairment of anticoagulant and fibrinolytic processes, its clinical effects are modest; however, hypothermia may be modestly linked to a somewhat higher risk of localized thrombosis...
June 19, 2018: Seminars in Thrombosis and Hemostasis
Raymond Farah, Rola Khamisy-Farah, Nicola Makhoul
BACKGROUND: Accurate diagnosis of community acquired pneumonia (CAP) is crucial to its proper management and to combating antibiotic resistance. Levels of C-reactive protein (CRP) have been shown to distinguish pneumonia from other pathological conditions and can be used to control the severity of infection during admission. OBJECTIVES: To investigate an association between consecutive measurements of CRP and the severity of CAP in hospitalized patients. METHODS: A total of 500 patients with CAP were admitted to the hospital...
June 2018: Israel Medical Association Journal: IMAJ
Serge Molliex, Sylvie Passot, Jerome Morel, Emmanuel Futier, Jean Yves Lefrant, Jean Michel Constantin, Yannick Le Manach, Bruno Pereira
INTRODUCTION: in elderly patients, goal directed haemodynamic therapy (GDHT), depth of anaesthesia monitoring and lung-protective ventilation have been shown to improve postoperative outcomes. The aim of this study was to evaluate current practices concerning strategies of anaesthesia optimisation in patients aged ≥ 75 years. PATIENTS AND METHODS: a multicentre observational study was performed from February to May 2015 in 23 French academic centres. On 30 consecutive days in each centre, patients ≥ 75 years with at least one major co-morbidity undergoing elective or emergency procedures (femoral-neck fractures surgery, intraperitoneal abdominal surgery or vascular surgery) were included...
June 11, 2018: Anaesthesia, Critical Care & Pain Medicine
Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Yong Hun Jung, Yong Soo Cho, In Soo Cho, Chun Song Yun, Jin Woong Kim, Jung Soo Park, Yong Il Min
AIM OF THE STUDY: Brain swelling after cardiac arrest may affect the ventricles. We aimed to investigate the prognostic performance of ventricular characteristics on brain computed tomography (CT) in cardiac arrest survivors who underwent targeted temperature management (TTM). METHODS: This retrospective cohort study included adult comatose cardiac arrest survivors who underwent brain CT scan within 24 hours after resuscitation and underwent TTM from 2014 to 2016...
June 11, 2018: Resuscitation
Kaitlin A Pruskowski, Julie A Rizzo, Beth A Shields, Rodney K Chan, Ian R Driscoll, Matthew P Rowan, Kevin K Chung
Maintaining body temperature is a unique challenge with burn care. We sought to describe core temperature goals in the operating room (OR) and the methods used to achieve and maintain these goals, along with current methods of warming in the intensive care unit (ICU), the perception of effect of increased ambient temperature on work performance, and concerns with contamination of sterile fields due to increased ambient temperature. A 24 question survey was disseminated to burn centers in the United States and Canada...
June 13, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Ian P Harrison, Fabrizio Spada
Wound management, in addition to presenting a significant burden to patients and their families, also contributes significantly to a country’s healthcare costs. Treatment strategies are numerous, but in most cases not ideal. Hydrogels, three-dimensional polymeric materials that can withstand a great degree of swelling without losing structural integrity, are drawing great attention for their use as topical wound management solutions in the form of films and as vehicles for drug delivery, due to their unique properties of high water content, biocompatibility, and flexibility...
June 14, 2018: Pharmaceutics
Daniel H Moreno, Daniel G Cacione, Jose Cc Baptista-Silva
BACKGROUND: An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair...
June 13, 2018: Cochrane Database of Systematic Reviews
Li-Wen Chen, Chao-Ku Teng, Yi-Shan Tsai, Jieh-Neng Wang, Yi-Fang Tu, Ching-Fen Shen, Ching-Chuan Liu
INTRODUCTION: Seasonal influenza-associated neurological complications had high mortality and morbidity rates in recent studies. We reported influenza-associated encephalitis/encephalopathy in children during 2014-2017 in Taiwan, focusing on neurological presentations, neuroimaging correlations, and critical care managements. MATERIALS/SUBJECTS: During January 1st 2014 to June 30th 2017, pediatric patients reported to the Taiwan Centers for Disease Control surveillance system for severe complicated influenza infections in the hospital were retrospectively reviewed...
June 8, 2018: Brain & Development
James Bras, Kelsey Uminski, Arjuna Ponnampalam
BACKGROUND: Cold agglutinin disease is characterized by acrocyanosis, hemolytic anemia, and occasionally, frank hemoglobinuria. Although cold agglutinins are commonly detected, they are rarely clinically significant due to subphysiologic temperatures at which agglutination occurs. Cardiovascular surgical procedures requiring hypothermia present a unique challenge for these patients, requiring modification of the conduct of cardiopulmonary bypass and cardioplegia. CASE REPORT: Herein we report a case of a patient with a prior history of symptomatic cold agglutinin disease and type A aortic dissection, presenting with dilation of his known diseased ascending aorta, requiring semi-urgent repair...
April 2018: Transfusion and Apheresis Science
Simon Foged Haugaard, Anni Nørgaard Jeppesen, Anne Troldborg, Hans Kirkegaard, Steffen Thiel, Anne-Mette Hvas
The lectin pathway (LP) of the complement system may initiate inflammatory reactions when body tissue is altered. We aimed to investigate levels of the LP proteins in out-of-hospital cardiac arrest patients, and to compare these with healthy individuals. Furthermore, we aimed to clarify whether duration of targeted temperature management influenced LP protein levels, and we further examined whether LP proteins were associated with 30-day mortality. We included 82 patients resuscitated from out-of-hospital cardiac arrest...
June 9, 2018: Scandinavian Journal of Immunology
Kelly N Sawyer, Michael Mooney, Gregory Norris, Thomas Devlin, Justin Lundbye, Pratik B Doshi, Jonathan Kyle Hewett, Alan T Kono, Jesse P Jorgensen, Brian J O'Neil
Targeted temperature management (TTM) is recommended postcardiac arrest. The cooling method with the highest safety and efficacy is unknown. The COOL-ARREST pilot trial aimed to evaluate the safety and efficacy of the most contemporary ZOLL Thermogard XP Intravascular Temperature Management (IVTM) system for providing mild TTM postcardiac arrest. This multicenter, prospective, single-arm, observational pilot trial enrolled patients at eight U.S. hospitals between July 28, 2014, and July 24, 2015. Adult (≥18 years old), out-of-hospital cardiac arrest subjects of presumed cardiac etiology who achieved return of spontaneous circulation (ROSC) were considered for inclusion...
June 8, 2018: Therapeutic Hypothermia and Temperature Management
Francis Thien, Paul J Beggs, Danny Csutoros, Jai Darvall, Mark Hew, Janet M Davies, Philip G Bardin, Tony Bannister, Sara Barnes, Rinaldo Bellomo, Timothy Byrne, Andrew Casamento, Matthew Conron, Anthony Cross, Ashley Crosswell, Jo A Douglass, Matthew Durie, John Dyett, Elizabeth Ebert, Bircan Erbas, Craig French, Ben Gelbart, Andrew Gillman, Nur-Shirin Harun, Alfredo Huete, Louis Irving, Dharshi Karalapillai, David Ku, Philippe Lachapelle, David Langton, Joy Lee, Clare Looker, Christopher MacIsaac, Joseph McCaffrey, Christine F McDonald, Forbes McGain, Edward Newbigin, Robyn O'Hehir, David Pilcher, Shivonne Prasad, Kanishka Rangamuwa, Laurence Ruane, Vineet Sarode, Jeremy D Silver, Anne Marie Southcott, Ashwin Subramaniam, Cenk Suphioglu, Nugroho Harry Susanto, Michael F Sutherland, Gopal Taori, Philip Taylor, Paul Torre, Joseph Vetro, Geoffrey Wigmore, Alan C Young, Charles Guest
BACKGROUND: A multidisciplinary collaboration investigated the world's largest, most catastrophic epidemic thunderstorm asthma event that took place in Melbourne, Australia, on Nov 21, 2016, to inform mechanisms and preventive strategies. METHODS: Meteorological and airborne pollen data, satellite-derived vegetation index, ambulance callouts, emergency department presentations, and data on hospital admissions for Nov 21, 2016, as well as leading up to and following the event were collected between Nov 21, 2016, and March 31, 2017, and analysed...
June 2018: Lancet. Planetary Health
Salia Farrokh, Pouya Tahsili-Fahadan, Eva K Ritzl, John J Lewin, Marek A Mirski
BACKGROUND: The incidence of seizures in intensive care units ranges from 3.3% to 34%. It is therefore often necessary to initiate or continue anticonvulsant drugs in this setting. When a new anticonvulsant is initiated, drug factors, such as onset of action and side effects, and patient factors, such as age, renal, and hepatic function, should be taken into account. It is important to note that the altered physiology of critically ill patients as well as pharmacological and nonpharmacological interventions such as renal replacement therapy, extracorporeal membrane oxygenation, and target temperature management may lead to therapeutic failure or toxicity...
June 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
Yuka Nakatani, Takeo Nakayama, Kei Nishiyama, Yoshimitsu Takahashi
This data article contains raw data and supplementary analyzed data regarding to the article entitled "Effect of target temperature management at 32-34 °C in cardiac arrest patients considering assessment by regional cerebral oxygen saturation: A multicenter retrospective cohort study". We examined the effectiveness of target temperature management (TTM) at 32-34 °C considering degrees of patients' cerebral injury and cerebral circulation assessed by regional cerebral oxygen saturation (rSO2 )...
April 2018: Data in Brief
Neerja Bharti, Suryabrata Chattopadhyay, Navneet Singla, Indu Bala, Yatindra K Batra, Jaimanti Bakshi
BACKGROUND: The management of glossopharyngeal neuralgia due to oropharyngeal carcinoma is particularly difficult because of rich innervations of the area, erosive nature of neoplasm and dynamic pain evoked by the functional movements like swallowing and chewing. Few case reports have shown the efficacy of pulsed radiofrequency (PRF) treatment in primary and secondary glossopharyngeal neuralgia in non-cancer patients. However, the efficacy of PRF ablation of the glossopharyngeal nerve in oral cancer patients is not known...
May 2018: Pain Physician
Mahboobeh Zare Moayedi, Azam Aslani, Mostafa Fakhrahmad, Shahrokh Ezzatzadegan J
OBJECTIVES: This study was conducted to develop an android based patient decision aid (PDA) as a self-care instrument for patients after kidney transplant and its usability evaluation. METHODS: In this study, the systematic development process of Android-based self-care application for patients after kidney transplant based on Ottawa standard was included: scoping, assemble steering group, analysis of requirements, designing, develop of a prototype and system evaluation...
2018: Studies in Health Technology and Informatics
Yoonje Lee, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Byuk Sung Ko
OBJECTIVE: Carbon monoxide (CO) poisoning is known to increase thrombotic tendency, and the risk of deep vein thrombosis in individuals who have experienced CO poisoning is higher than in the general population. However, there are a few reports describing cases of pulmonary thromboembolisms (PTE) secondary to CO poisoning. DATA SOURCES: Retrospective data analysis. STUDY SELECTION: Seven hundred fifty bed tertiary university affiliated hospital...
May 29, 2018: American Journal of Emergency Medicine
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