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Accidental hypothermia

Abhinav Totapally, Michael Leoncio, Fernando Beltramo, Keith Meyer, Andre Raszynski, Balagangadhar R Totapally
BACKGROUND: The purpose of this study was to explore the epidemiology and outcomes of hospitalized children with a diagnosis of accidental hypothermia. METHODS: The 2012 Kids' Inpatient Database, detailing discharge diagnoses in children admitted to US hospitals, was analyzed using ICD-9-DM codes to filter out relevant patients. Children ages 1 month to 17 years were included in the analysis. Demographic and outcome variables in the hypothermia group were compared with the rest of the patients...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Anna Jarosz, Sylweriusz Kosiński, Tomasz Darocha, Peter Paal, Robert Gałązkowski, Hubert Hymczak, Rafał Drwiła
OBJECTIVES: When establishing the Severe Hypothermia Treatment Centre, certain problems and pitfalls regarding the qualification for extracorporeal rewarming were encountered. The authors shared their experience and opened a discussion with other centers that deal with severe, accidental hypothermia. DESIGN: Retrospective analysis of medical records of all patients examined by the hypothermia coordinator. SETTING: Patients consulted and treated by the Severe Hypothermia Treatment Centre...
May 13, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Dominika Batycka-Stachnik, Agnieszka Piwoda, Tomasz Darocha, Malgorzata Spiewak, Sylweriusz Kosinski, Anna Jarosz, Hubert Hymczak, Tomasz Sanak, Robert Galazkowski, Jacek Piatek, Janusz Konstanty-Kalandyk, Rafal Drwila
: The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN: Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Øyvind Sverre Svendsen, Ketil Grong, Knut Sverre Andersen, Paul Husby
BACKGROUND: Accidental hypothermia with arrested circulation remains a condition associated with high mortality. In our institution, extracorporeal circulation (ECC) rewarming has been the cornerstone in treating such patients since 1987. We here explore characteristics and outcomes of this treatment, to identify significant merits and challenges from 3 decades of experience in ECC rewarming. METHODS: Sixty-nine patients rewarmed by ECC during the period from December 1987 to December 2015 were analyzed...
September 27, 2016: Annals of Thoracic Surgery
Mohammed Akil Dilawar Gani, Balraj Singh Jagdev, Asgher Champsi, Uday Dandekar
This case report describes the successful treatment of severe accidental hypothermia with cardiopulmonary bypass (CPB). A known intravenous drug misuser aged 22 years was found to be unresponsive at his home (winter evening) with a Glasgow coma scale of 3/15. In the ambulance, the patient went into cardiac arrest, cardiopulmonary resuscitation being started. On arrival to the emergency department, he had a core body temperature of 27°C which was refractory to conservative management. He underwent femoro-femoral CPB, which was successful in rewarming the patient slowly...
2016: BMJ Case Reports
Jari Pirnes, Tero Ala-Kokko
Accidental hypothermia has a low incidence, but is associated with a high mortality rate. Knowledge about concomitant factors, complications, and length of hospital stay is limited. A retrospective cohort study on patients with accidental hypothermia admitted to Oulu University Hospital in Finland, over a 5-year period. Patients were categorized as short-stay patients (7 days or less) and long-stay patients (more than 7 days) according to their length of stay in hospital. From a total of 105 patients, 67 patients were included in the analyses...
September 27, 2016: Internal and Emergency Medicine
Peter Paal, Les Gordon, Giacomo Strapazzon, Monika Brodmann Maeder, Gabriel Putzer, Beat Walpoth, Michael Wanscher, Doug Brown, Michael Holzer, Gregor Broessner, Hermann Brugger
BACKGROUND: This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest. METHODS: The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce this narrative review. RESULTS: The hospital use of minimally-invasive rewarming for non-arrested, otherwise healthy, patients with primary hypothermia and stable vital signs has the potential to substantially decrease morbidity and mortality for these patients...
September 15, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Matthias Weuster, Alexander Brück, Sebastian Lippross, Leif Menzdorf, Stefanie Fitschen-Oestern, Peter Behrendt, Timo Iden, Jan Höcker, Rolf Lefering, Andreas Seekamp, Tim Klüter
BACKGROUND: Accidental hypothermia (AH) endangers the patient after polytrauma. Past studies have emphasized this entity as a major risk factor. The aim of this study was to describe the epidemiology of AH in major trauma considering the preclinical and clinical course. Predictors should be elucidated. METHODS: This is a retrospective investigation from the TraumaRegister DGU. Patients were documented in the period between 2002 and 2012. The study compared multiple-injured patients with or without hypothermic temperatures...
November 2016: Journal of Trauma and Acute Care Surgery
Patrick M Honore, Rita Jacobs, Inne Hendrickx, Joris Troubleyn, Elisabeth De Waele, Herbert D Spapen
No abstract text is available yet for this article.
July 2016: Journal of Emergencies, Trauma, and Shock
Matthew T Niehaus, Rita M Pechulis, James K Wu, Steven Frei, John J Hong, Rovinder S Sandhu, Marna Rayl Greenberg
Accidental hypothermia can lead to untoward cardiac manifestations and arrest. This report presents a case series of severe accidental hypothermia with cardiac complications in three emergency patients who were treated with extracorporeal membrane oxygenation (ECMO) and survived after re-warming. The aim of this discussion was to encourage more clinicians to consider ECMO as a re-warming therapy for severe hypothermia with circulatory collapse and to prompt discussion about decreasing the barriers to its use...
October 2016: Prehospital and Disaster Medicine
Anna Jarosz, Tomasz Darocha, Sylweriusz Kosiński, Robert Gałązkowski, Piotr Mazur, Jacek Piątek, Janusz Konstanty-Kalandyk, Hubert Hymczak, Rafał Drwiła
We sought to organize a functional system of recognition and advanced treatment of hypothermic patients with extracorporeal rewarming as a treatment option. All patients with suspected hypothermia are consulted with the Hypothermia Coordinator (HC), whose role is to provide expertise on hypothermia recognition and treatment to all rescue and medical services. Patients with Swiss Staging System of Hypothermia (HT) class III and IV are subjected to extracorporeal rewarming. Patients with class I and II are managed in local hospitals, after the hypothermia coordinator provides instructions...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Alexis L Cates, Scott M Wheatley, Kenneth D Katz
A 22-month-old girl without any significant medical history accidentally consumed a small amount of a therapeutic compounding cream that contained camphor, gabapentin, clonidine, ketoprofen, and lidocaine. Upon presentation to the emergency department, the child exhibited immediate onset of altered mental status with wide fluctuation in her vital signs, which included intermittent apnea requiring bag-valve mask assistance and endotracheal intubation. Serum laboratory analysis measured a clonidine level of 2...
July 23, 2016: Pediatric Emergency Care
Michael Sgro, Douglas M Campbell, Neil Gandhi
The case presented advocates for prolonged resuscitation, and aggressive rewarming in neonates with severe hypothermia (core temperature <32.0°C). The importance of rewarming has not been extensively studied in current guidelines, whereas the importance of cardiopulmonary resuscitation is well established. This abandoned, severely hypothermic (found with temperature of 27.9°C) newborn had an excellent neurological outcome at two years of age with aggressive resuscitation and rewarming techniques initiated at the time of presentation...
May 2016: Paediatrics & Child Health
Guillaume Debaty, Maxime Maignan, Bertrand Perrin, Angélique Brouta, Dorra Guergour, Candice Trocme, Vincent Bach, Stéphane Tanguy, Raphaël Briot
BACKGROUND: This study aimed to assess cardiac and pulmonary pathophysiological responses during cooling and extracorporeal life support (ECLS) rewarming in a porcine model of deep hypothermic cardiac arrest (DHCA). In addition, we evaluated whether providing a lower flow rate of ECLS during the rewarming phase might attenuate cardiopulmonary injuries. METHODS: Twenty pigs were cannulated for ECLS, cooled until DHCA occurred and subjected to 30 min of cardiac arrest...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Tomasz Darocha, Sylweriusz Kosiński, Anna Jarosz, Dorota Sobczyk, Robert Gałązkowski, Jacek Piątek, Janusz Konstany-Kalandyk, Rafał Drwiła
BACKGROUND: The prognosis in hypothermic cardiac arrest is frequently good despite prolonged period of hypoperfusion and cardiopulmonary resuscitation. Apart from protective effect of hypothermia itself established protocols of treatment and novel rewarming techniques may influence on outcome. The purpose of the study was to assess the outcome of patients with hypothermic circulatory arrest treated by means of arterio-venous extracorporeal membrane oxygenation (ECMO) according to locally elaborated protocol in Severe Accidental Hypothermia Center in Cracow, Poland...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Raphael Briot, Marc Blancher
No abstract text is available yet for this article.
July 2016: Critical Care Medicine
Fanny Vardon, Ségolène Mrozek, Thomas Geeraerts, Olivier Fourcade
Hypothermia, along with acidosis and coagulopathy, is part of the lethal triad that worsen the prognosis of severe trauma patients. While accidental hypothermia is easy to identify by a simple measurement, it is no less pernicious if it is not detected or treated in the initial phase of patient care. It is a multifactorial process and is a factor of mortality in severe trauma cases. The consequences of hypothermia are many: it modifies myocardial contractions and may induce arrhythmias; it contributes to trauma-induced coagulopathy; from an immunological point of view, it diminishes inflammatory response and increases the chance of pneumonia in the patient; it inhibits the elimination of anaesthetic drugs and can complicate the calculation of dosing requirements; and it leads to an over-estimation of coagulation factor activities...
May 13, 2016: Anaesthesia, Critical Care & Pain Medicine
Shuang Li, Chen Qiu, Wenwen Shi, Yan Huang, Li Gui
OBJECTIVES: Accidental hypothermia (AH) is a potentially life-threatening condition that can lead to significant morbidity and life-long effects. Navy personnel are always at a greater risk of AH due to frequent outdoor work, wilderness exposure, prolonged immobility and exhaustion. The purpose of the survey was to assess Chinese Navy members' awareness of AH and to make recommendations with regard to better measures for improving it. METHODS: 111 Navy members completed a written questionnaire that was subsequently analyzed...
March 2016: International Journal of Environmental Research and Public Health
T Deslarzes, V Rousson, B Yersin, B Durrer, M Pasquier
BACKGROUND: Core body temperature is used to stage and guide the management of hypothermic patients, however obtaining accurate measurements of core temperature is challenging, especially in the pre-hospital context. The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia. The proposed temperature range for clinical stage 1 is <35-32 °C (95-90 °F), for stage 2, <32-28 °C (<90-82 °F) for stage 3, <28-24 °C (<82-75 °F), and for stage 4 below 24 °C (75 °F)...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Aneta D Petelska, Joanna Kotyńska, Monika Naumowicz, Zbigniew A Figaszewski
Equilibria between the membranes of erythrocytes as well as thrombocytes and solution ions in fatal accidental hypothermia were analyzed using a theoretical four-equilibria model. The model was developed to determinate parameters characterizing cell membrane-surrounding ion interactions: the total surface concentrations of both acidic and basic groups C A, C B, and association constants K AH, K BOH. Knowledge of these parameters was necessary to calculate the theoretical values of surface charge density. The model was validated by curve-fitting the experimental data points to simulated data generated by the model...
June 2016: Journal of Membrane Biology
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