keyword
https://read.qxmd.com/read/18717110/hypercapnia-effect-on-core-cooling-and-shivering-threshold-during-snow-burial
#21
JOURNAL ARTICLE
Colin K Grissom, John C McAlpine, Chris H Harmston, Martin I Radwin, Gordon G Giesbrecht, Mary Beth Scholand, J Scott Morgan
INTRODUCTION: Hypercapnia during avalanche burial may increase core temperature cooling rate by decreasing the temperature threshold for shivering or by increasing respiratory heat loss. METHODS: We studied the effect of hypercapnia on rectal core temperature (T(re)) cooling rate, respiratory heat loss, heat production, and the T(re) shivering threshold during snow burial (mean snow temperature -3.2 + 2.7 degrees C) in 11 subjects. In a 60-min hypercapnic burial subjects breathed a 5% carbon dioxide and 21% oxygen inhaled gas mixture and in a separate 60-min normocapnic burial subjects breathed ambient air...
August 2008: Aviation, Space, and Environmental Medicine
https://read.qxmd.com/read/17936003/effect-of-forced-air-heaters-on-perfusion-and-temperature-distribution-during-and-after-open-heart-surgery
#22
RANDOMIZED CONTROLLED TRIAL
Natascha M W Severens, Wouter D van Marken Lichtenbelt, Gerard M J van Leeuwen, Arjan J H Frijns, Anton A van Steenhoven, Bas A J M de Mol, Harry B van Wezel, Dirk J Veldman
OBJECTIVES: After cardiopulmonary bypass, patients often show redistribution hypothermia, also called afterdrop. Forced-air blankets help to reduce afterdrop. This study explores the effect of forced-air blankets on temperature distribution and peripheral perfusion. The blood perfusion data is used to explain the observed temperature effects and the reduction of the afterdrop. METHODS: Fifteen patients were enrolled in a randomised study. In the test group (n=8), forced-air warmers were used...
December 2007: European Journal of Cardio-thoracic Surgery
https://read.qxmd.com/read/17762076/a-model-to-predict-patient-temperature-during-cardiac-surgery
#23
JOURNAL ARTICLE
N M W Severens, W D van Marken Lichtenbelt, A J H Frijns, A A Van Steenhoven, B A J M de Mol, D I Sessler
A core temperature drop after cardiac surgery slows down the patient's recuperation process. In order to minimize the amount of the so-called afterdrop, more knowledge is needed about the impaired thermoregulatory system during anesthesia and the effect of different protocols on temperature distribution. Therefore, a computer model has been developed that describes heat transfer during cardiac surgery. The model consists of three parts: (1) a passive part, which gives a simplified description of the human geometry and the passive heat transfer processes, (2) an active part that takes into account the thermoregulatory system as a function of the amount of anesthesia and (3) submodels, through which it is possible to adjust the boundary conditions...
September 7, 2007: Physics in Medicine and Biology
https://read.qxmd.com/read/17355703/pre-hospital-torso-warming-modalities-for-severe-hypothermia-a-comparative-study-using-a-human-model
#24
JOURNAL ARTICLE
Michele V Hultzer, Xiaojiang Xu, Claudia Marrao, Gerald Bristow, Alex Chochinov, Gordon G Giesbrecht
OBJECTIVE: To compare 5 active torso-warming modalities in a human model of severe hypothermia with shivering heat production inhibited by intravenous meperidine. METHODS: Six subjects were cooled on 6 different occasions each, in 8 degrees C water, for 30 minutes or to a core temperature of 35 degrees C. Spontaneous warming was the first torso-warming modality to be tested for every subject, and results served both as a comparative control and for determination of the meperidine dose for subsequent trials...
November 2005: CJEM
https://read.qxmd.com/read/16676650/cranial-neck-and-inhalation-rewarming-failed-to-improve-recovery-from-mild-hypothermia
#25
JOURNAL ARTICLE
Heather E Wright, Stephen S Cheung
INTRODUCTION: Rewarming from hypothermia in a field setting is a challenge due to the typical lack of significant power or heat source, making the targeted application of available heat critical. The highly vascular area of the head and neck may allow heat to be rapidly transferred to the core via blood circulation. At the same time, the warming of only a small skin surface may minimize the rapid rise in skin temperature proposed to attenuate shivering and endogenous heat production. Therefore, we investigated the efficacy of targeting the head and neck for rewarming from mild hypothermia...
April 2006: Aviation, Space, and Environmental Medicine
https://read.qxmd.com/read/16538942/problems-and-complications-with-cold-water-rescue
#26
JOURNAL ARTICLE
Gordon G Giesbrecht, John S Hayward
A case description is presented of a 9-member rowing team whose scull swamped on a small lake in Victoria, Canada, because of a sudden winter storm, which immersed them in 4 degrees C water for 50 minutes until a small rescue boat found them in darkness. Another 13 minutes of cold exposure in 6.7 degrees C air occurred during boat transport to waiting ambulance paramedics. Two rowers died, one from severe hypothermia and the other from drowning as a consequence of cold incapacitation and hypothermia. The 2 coldest rowers, who were transported 8 km to a major hospital, arrived with rectal temperatures of 23...
2006: Wilderness & Environmental Medicine
https://read.qxmd.com/read/16266300/end-point-temperature-of-rewarming-after-hypothermic-cardiopulmonary-bypass-in-pediatric-patients
#27
RANDOMIZED CONTROLLED TRIAL
Won Gon Kim, Ji Hyuck Yang
In an attempt to find an adequate end-point rewarming temperature after hypothermic cardiopulmonary bypass (CPB), 50 pediatric patients who underwent cardiac surgery were randomly assigned for the end-point rectal rewarming temperature at either 35.5 (Group 1) or 37.0 degrees C (Group 2). The patients' rectal temperature, with heart rate and blood pressure, was measured 0.5, 1.0, 4.0, 8.0, and 16.0 h after the arrival in the intensive care unit. For all patients, nonpulsatile perfusion with a roller pump and a membrane or bubble oxygenator was used for oxygenation...
November 2005: Artificial Organs
https://read.qxmd.com/read/11603234/comparison-of-oxygenated-perfluorocarbon-and-humidified-oxygen-for-rewarming-hypothermic-miniswine
#28
COMPARATIVE STUDY
S W Tobias, C B Matthew, D A Dubose, M P Hamlet
This study examines a method to rapidly rewarm the core using total liquid ventilation with warmed, oxygenated perfluorocarbon. Yucatan miniswine were splenectomized and surgically implanted with telemetry devices to transmit electrocardiographic response, arterial pressure, and core temperature. Hypothermia (core temperature = 25.9 +/- 1.3 degrees C) was induced by placing cold-water circulating blankets over the animals. Control animals (N = 7) were rewarmed using warm (37.8 degrees C), humidified oxygen...
October 2001: Military Medicine
https://read.qxmd.com/read/11107727/-treatment-of-accidental-hypothermia
#29
REVIEW
D H Olsen, I H Gøthgen
New knowledge about accidental hypothermia acquired in recent years may simplify treatment and aid the evaluation of prognosis. Evidence of death or severe collapse due to the feared afterdrop has not been published. Afterdrop is a phenomenon of conductive heat loss. Evaluation of rewarming techniques shows that results from forced air rewarming techniques are equivalent to or better than results from invasive rewarming methods, except for rewarming with cardiopulmonary bypass. In hypothermia the most important differential diagnosis is death...
November 1, 2000: Läkartidningen
https://read.qxmd.com/read/11052428/a-prospective-comparison-of-three-heat-preservation-methods-for-patients-undergoing-hypothermic-cardiopulmonary-bypass
#30
RANDOMIZED CONTROLLED TRIAL
S Ginsberg, A Solina, D Papp, T Krause, E Pantin, G Scott, Y Chuzhin, R Cody, A Israel
OBJECTIVE: To prospectively compare 3 methods of body heat preservation in patients undergoing surgery requiring the use of hypothermic cardiopulmonary bypass (CPB). DESIGN: Prospective, randomized, and nonblinded. SETTING: University teaching hospital. PARTICIPANTS: Adult cardiac surgery patients (n = 101). INTERVENTIONS: Subjects were randomly assigned to 1 of 3 treatment groups: Group 1 (n = 33) used a fluid-filled warming blanket, group 2 (n = 31) used a heated and humidified breathing circuit, and group 3 (n = 37) used intravenous fluid warmers for the administration of all fluids...
October 2000: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/11043627/hypothermia-and-afterdrop-following-open-water-swimming-the-alcatraz-san-francisco-swim-study
#31
JOURNAL ARTICLE
T J Nuckton, D M Claman, D Goldreich, F C Wendt, J G Nuckton
To determine whether or not participants in open water swim events experience hypothermia and afterdrop, rectal temperature was measured for up to 45 minutes in 11 subjects following the New Year's Day Alcatraz Swim. This event was held in open water (11.7 degrees C [53.0 degrees F]) in the San Francisco Bay, and participants did not wear wetsuits or other protective clothing. Biophysical parameters, including surfacelvolume ratio, body mass index, and percent body fat were measured before the swim, and statistical analysis was done to determine predictors of temperature decrease and afterdrop duration...
October 2000: American Journal of Emergency Medicine
https://read.qxmd.com/read/10994374/-treatment-of-accidental-hypothermia
#32
REVIEW
D H Olsen, I H Gøthgen
New knowledge about accidental hypothermia acquired in recent years may simplify treatment and aid the evaluation of prognosis. Evidence of death or severe collapse due to the feared afterdrop has not been published. Afterdrop is a phenomenon of conductive heat loss. Evaluation of rewarming techniques shows that results from forced air rewarming techniques are equivalent to or better than results from invasive rewarming methods, except for rewarming with cardiopulmonary bypass. In hypothermia the most important differential diagnosis is death...
September 4, 2000: Ugeskrift for Laeger
https://read.qxmd.com/read/10736119/resistive-heating-is-more-effective-than-metallic-foil-insulation-in-an-experimental-model-of-accidental-hypothermia-a-randomized-controlled-trial
#33
RANDOMIZED CONTROLLED TRIAL
R Greif, A Rajek, S Laciny, H Bastanmehr, D I Sessler
STUDY OBJECTIVE: We study a resistive-heating blanket in a volunteer model of severe accidental hypothermia to evaluate differences in rates of rewarming, core temperature afterdrop, and body heat content and distribution during active and passive rewarming. METHODS: Eight volunteers participated in a crossover design on 2 days. The volunteers were anesthetized and cooled to 33 degrees C (91.4 degrees F); anesthesia was subsequently discontinued, and shivering was prevented with meperidine...
April 2000: Annals of Emergency Medicine
https://read.qxmd.com/read/10691247/perioperative-heat-balance
#34
REVIEW
D I Sessler
Hypothermia during general anesthesia develops with a characteristic three-phase pattern. The initial rapid reduction in core temperature after induction of anesthesia results from an internal redistribution of body heat. Redistribution results because anesthetics inhibit the tonic vasoconstriction that normally maintains a large core-to-peripheral temperature gradient. Core temperature then decreases linearly at a rate determined by the difference between heat loss and production. However, when surgical patients become sufficiently hypothermic, they again trigger thermoregulatory vasoconstriction, which restricts core-to-peripheral flow of heat...
February 2000: Anesthesiology
https://read.qxmd.com/read/10691232/efficacy-of-two-methods-for-reducing-postbypass-afterdrop
#35
RANDOMIZED CONTROLLED TRIAL
A Rajek, R Lenhardt, D I Sessler, G Brunner, M Haisjackl, J Kastner, G Laufer
BACKGROUND: Afterdrop, defined as the precipitous reduction in core temperature after cardiopulmonary bypass, results from redistribution of body heat to inadequately warmed peripheral tissues. The authors tested two methods of ameliorating afterdrop: (1) forced-air warming of peripheral tissues and (2) nitroprusside-induced vasodilation. METHODS: Patients were cooled during cardiopulmonary bypass to approximately 32 degrees C and subsequently rewarmed to a nasopharyngeal temperature near 37 degrees C and a rectal temperature near 36 degrees C...
February 2000: Anesthesiology
https://read.qxmd.com/read/10608605/immersion-of-distal-arms-and-legs-in-warm-water-ava-rewarming-effectively-rewarms-mildly-hypothermic-humans
#36
JOURNAL ARTICLE
L Vanggaard, D Eyolfson, X Xu, G Weseen, G G Giesbrecht
INTRODUCTION: Active rewarming of hypothermic victims for field use, and where transport to medical facilities is impossible, might be the only way to restore deep body temperature. In active rewarming in warm water, there has been a controversy concerning whether arms and legs should be immersed in the water or left out. Further, it has been suggested in the Royal Danish Navy treatment regime, that immersion of hands, forearms, feet, and lower legs alone might accomplish rapid rates of rewarming (AVA rewarming)...
November 1999: Aviation, Space, and Environmental Medicine
https://read.qxmd.com/read/10488932/forced-air-surface-rewarming-in-patients-with-severe-accidental-hypothermia
#37
COMPARATIVE STUDY
E Kornberger, B Schwarz, K H Lindner, P Mair
Methods of rewarming patients with severe accidental hypothermia remain controversial. This paper reports our experience with the use of forced air rewarming in patients with severe accidental hypothermia and a body core temperature below 30 degrees C. Fifteen hypothermic patients (body core temperature 24-30 degrees C) were successfully treated with forced air rewarming to a body core temperature above 35 degrees C (mean rewarming rate 1.7 degrees C/h, range from 0.7 to 3.4 degrees C/h). An afterdrop phenomenon was not observed in any of the patients...
July 1999: Resuscitation
https://read.qxmd.com/read/10458492/relation-with-preoperative-fructosamine-and-autonomic-nerve-function-and-blood-pressure-during-anesthesia-in-diabetics-a-retrospective-study
#38
JOURNAL ARTICLE
Y Goto, Y Sugiura, M Yanagimoto, Y Yasuda, H Suzuki, K Hasegawa
Many diabetics may have a high risk involving the cardiovascular system. In an attempt to predict the intraoperative risks of diabetics during anesthesia, we evaluated retrospectively the relationship among the biochemical assay or autonomic nerve function obtained as parts of the preoperative examination, and the blood pressure changes relating to the stimulation of intubation and extubation for anesthesia. In 40 diabetic surgical patients examined the biochemical assay (HbA1c, fructosamine level and blood glucose level) beforehand, the autonomic nerve function was quantified preoperatively by analysis of ECG R-R variability recorded in supine and subsequent standing position using an HRV analyzer, and some parameters of autonomic nerve function especially responsive sympathetic nerve activities were obtained...
January 1999: Tohoku Journal of Experimental Medicine
https://read.qxmd.com/read/10357322/tissue-heat-content-and-distribution-during-and-after-cardiopulmonary-bypass-at-17-degrees-c
#39
JOURNAL ARTICLE
A Rajek, R Lenhardt, D I Sessler, M Grabenwöger, J Kastner, P Mares, U Jantsch, E Gruber
UNLABELLED: We measured afterdrop and peripheral tissue temperature distribution in eight patients cooled to approximately 17 degrees C during cardiopulmonary bypass and subsequently rewarmed to 36.5 degrees C. A nasopharyngeal probe evaluated trunk and head temperature and heat content. Peripheral tissue temperature (arm and leg temperature) and heat content were estimated using fourth-order regressions and integration over volume from 30 tissue and skin temperatures. Peripheral tissue temperature decreased to 19...
June 1999: Anesthesia and Analgesia
https://read.qxmd.com/read/9813513/pharmacological-vasodilatation-improves-efficiency-of-rewarming-from-hypothermic-cardiopulmonary-bypass
#40
RANDOMIZED CONTROLLED TRIAL
C D Deakin, G W Petley, D Smith
An afterdrop in core temperature after hypothermic cardiopulmonary bypass (CPB) is related to inadequate peripheral rewarming. We proposed that pharmacological vasodilatation during rewarming on bypass would improve peripheral rewarming and reduce the degree of afterdrop. Fifty-nine of 120 patients were randomized to receive a sodium nitroprusside (SNP) infusion during the rewarming stage of hypothermic CPB. Mean systemic vascular resistance (SVR) during the rewarming phase of CPB was 1129 dyne s-1 cm-5 in the control group and 768 dyne s-1 m-5 in the SNP group (P < or = 0...
August 1998: British Journal of Anaesthesia
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