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Accidental hypothermia

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https://www.readbyqxmd.com/read/29017847/the-biomarkers-neuron-specific-enolase-and-s100b-measured-the-day-following-admission-for-severe-accidental-hypothermia-have-high-predictive-values-for-poor-outcome
#1
Sebastian Wiberg, Jesper Kjaergaard, Benedict Kjærgaard, Bjarne Møller, Bo Nørnberg, Anne Marie Sørensen, Christian Hassager, Michael Wanscher
AIM: The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30days in patients admitted with severe accidental hypothermia. METHODS: Consecutive patients with severe accidental hypothermia, defined as a core temperature <32°C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO)...
October 7, 2017: Resuscitation
https://www.readbyqxmd.com/read/28940249/protection-against-cold-a-survey-of-available-equipment-in-swedish-pre-hospital-services
#2
O Henriksson, U Björnstig, B-I Saveman, P J Lundgren
BACKGROUND: The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services. METHODS: A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28934599/rewarming-after-severe-accidental-hypothermia-using-the-esophageal-heat-transfer-device-a-case-report
#3
Katarina Katja Primožič, Franci Svenšek, Andrej Markota, Andreja Sinkovič
Patients with severe accidental hypothermia require active rewarming. External rewarming may not be successful in severe hypothermia, and use of invasive techniques is limited to regional centers and is associated with vascular access site and other complications. We present a patient with severe accidental hypothermia who was successfuly rewarmed using a novel esophageal heat transfer device. A 55-year-old male (175 cm, 71 kg) was admitted with the first recorded temperature 23.3°C. Rewarming using renal replacement therapy circuit was unsuccessful because of severe hypotension...
September 21, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28931363/a-guideline-based-policy-to-decrease-intensive-care-unit-admission-rates-for-accidental-hypothermia
#4
Herman R Sequeira, Hesham E Mohamed, Neal Hakimi, Dorothy B Wakefield, Jonathan Fine
RATIONALE: Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut. METHODS: A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28766264/acetaminophen-paracetamol-induces-hypothermia-during-acute-cold-stress
#5
Josh Foster, Alexis R Mauger, Andrew Govus, David Hewson, Lee Taylor
BACKGROUND: Acetaminophen is an over-the-counter drug used to treat pain and fever, but it has also been shown to reduce core temperature (T c) in the absence of fever. However, this side effect is not well examined in humans, and it is unknown if the hypothermic response to acetaminophen is exacerbated with cold exposure. OBJECTIVE: To address this question, we mapped the thermoregulatory responses to acetaminophen and placebo administration during exposure to acute cold (10 °C) and thermal neutrality (25 °C)...
November 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28716150/swedish-norwegian-co-operation-in-the-treatment-of-three-hypothermia-victims-a-case-report
#6
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/28713580/severe-hypothermia-in-transported-pullets-case-study-of-its-occurrence-diagnosis-and-treatment-using-active-external-rewarming-technique
#7
Ndazo S Minka, Joseph O Ayo
Sixty pullets, aged 17 weeks, were presented when presumed to be 'dead' after being exposed to wet-cold weather transportation. The birds appeared unconscious and their feathers were soaking wet, and with a body rigid and cold to touch. The aim of the study was to resuscitate the hypothermic pullets. Blood samples were obtained and core body temperature recorded before and after rewarming. The birds were resuscitated using active external rewarming technique. Blood samples revealed significant (P < 0...
May 2017: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/28689048/the-impact-of-hypothermia-on-serum-potassium-concentration-a-systematic-review
#8
REVIEW
Sarah Buse, Marc Blancher, Damien Viglino, Mathieu Pasquier, Maxime Maignan, Pierre Bouzat, Thorsten Annecke, Guillaume Debaty
BACKGROUND: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. METHODS: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28643322/difficulties-in-funding-of-va-ecmo-therapy-for-patients-with-severe-accidental-hypothermia
#9
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksandra Czerw, Paweł Podsiadło, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Mirosław Ziętkiewicz, Krzysztof Kusza, Łukasz J Krzych, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28585067/modelling-accidental-hypothermia-effects-on-a-human-body-under-different-pathophysiological-conditions
#10
Alberto Coccarelli, Etienne Boileau, Dimitris Parthimos, Perumal Nithiarasu
Accidental exposure to cold water environment is one of the most challenging situations in which hypothermia occurs. In the present work, we aim to characterise the energy balance of a human body subjected to such extreme environmental conditions. This study is carried out using a recently developed computational model and by setting boundary conditions needed to simulate the effect of cold surrounding environment. A major finding is the capacity of the body core regions to maintain their temperature high for a substantial amount of time, even under the most extreme environmental conditions...
June 5, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28550896/pediatric-near-drowning-events-do-they-warrant-trauma-team-activation
#11
Pranit N Chotai, Lisa Manning, Benjamin Eithun, Joshua C Ross, James W Eubanks, Chad Hamner, Ankush Gosain
BACKGROUND: The purpose of this study was to determine the incidence of traumatic injuries, factors associated with mortality, and need for pediatric trauma surgery involvement for drowning and near-drowning events in children. MATERIALS AND METHODS: An institutional review board-approved, retrospective chart review was performed at three American College of Surgeons-verified Pediatric Trauma Centers (2011-2014). Patients with International Classification of Diseases, Ninth Revision, codes or E-codes for fatal-nonfatal drowning, fall into water, accidental drowning, or submersion were included...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28529728/measurements-of-rates-of-cooling-of-a-manikin-insulated-with-different-mountain-rescue-casualty-bags
#12
Christopher Press, Christopher Duffy, Jonathan Williams, Ben Cooper, Neil Chapman
BACKGROUND: Accidental hypothermia is common in those who sustain injuries in remote environments. This is unpleasant and associated with adverse effects on subsequent patient outcomes. To minimise further heat loss, a range of insulating systems are available to mountain rescue teams although the most effective and cost-efficient have yet to be determined. METHODS: Under ambient, still, dry, air conditions, a thermal manikin was filled with water at a temperature of 42 °C and then placed into a given insulation system...
2017: Extreme Physiology & Medicine
https://www.readbyqxmd.com/read/28516343/therapeutic-dormancy-to-delay-postsurgical-glioma-recurrence-the-past-present-and-promise-of-focal-hypothermia
#13
REVIEW
Didier Wion
Surgery precedes both radiotherapy and chemotherapy as the first-line therapy for glioma. However, despite multimodal treatment, most glioma patients die from local recurrence in the resection margin. Glioma surgery is inherently lesional, and the response of brain tissue to surgery includes hemostasis, angiogenesis, reactive gliosis and inflammation. Unfortunately, these processes are also associated with tumorigenic side-effects. An increasing amount of evidence indicates that the response to a surgery-related brain injury is hijacked by residual glioma cells and participates in the local regeneration of tumor tissues at the resection margin...
July 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28513855/technical-note-system-for-evaluating-local-hypothermia-as-a-radioprotector-of-the-rectum-in-a-small-animal-model
#14
Brian A Hrycushko, Chenchen Bing, Cecil Futch, Michelle Wodzak, Strahinja Stojadinovic, Paul M Medin, Rajiv Chopra
PURPOSE: The protective effects of induced or even accidental hypothermia on the human body are widespread with several medical uses currently under active research. In vitro experiments using human cell lines have shown hypothermia provides a radioprotective effect that becomes more pronounced at large, single-fraction doses common to stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) treatments. This work describes the development of a system to evaluate local hypothermia for a radioprotective effect of the rat rectum during a large dose of radiation relevant to prostate SBRT...
August 2017: Medical Physics
https://www.readbyqxmd.com/read/28506506/endovascular-rewarming-in-the-emergency-department-for-moderate-to-severe-accidental-hypothermia
#15
Lauren R Klein, Joshua Huelster, Umama Adil, Megan Rischall, Douglas D Brunette, Robert R Kempainen, Matthew E Prekker
BACKGROUND: Endovascular temperature control catheters can be utilized for emergent rewarming in accidental hypothermia. The purpose of this study was to compare patients with moderate to severe hypothermia rewarmed with an endovascular temperature control catheter versus usual care at our institution. METHODS: We conducted a retrospective, observational cohort study of patients with moderate to severe accidental hypothermia (core body temperature less than 32°C) in the Emergency Department of an urban, tertiary care medical center...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28483389/battlefield-trauma-induced-hypothermia-transitioning-the-preferred-method-of-casualty-rewarming
#16
REVIEW
Brad L Bennett, John B Holcomb
For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28466294/-cardiac-support-and-replacement-systems
#17
REVIEW
T Graf, H Thiele
In recent years, the widespread use of partial mechanical cardiac support and even temporary complete replacement of cardiac function has been established in many intensive care units in the treatment of refractory cardiogenic shock. There is a difference between partial left-ventricular assist devices (LVAD) and the possibility of complete heart (and lung) replacement by extra corporeal life support (ECLS). Despite the use of mechanical support devices, the mortality of cardiogenic shock remains high. The consideration of using percutaneous LVAD and ECLS in cardiogenic shock should be considered in refractory cardiogenic shock patients in addition to support by catecholamines and after early revascularization in acute coronary syndromes...
June 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28464863/clinical-course-and-prognostic-factors-of-patients-in-severe-accidental-hypothermia-with-circulatory-instability-rewarmed-with-veno-arterial-ecmo-an-observational-case-series-study
#18
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksander Zeliaś, Mirosław Ziętkiewicz, Paweł Podsiadło, Tomasz Sanak, Kinga Sałapa, Jacek Piątek, Janusz Konstany-Kalandyk, Robert Gałązkowski, Paweł Krawczyk, Łukasz Krzych, Rafał Drwiła
BACKGROUND: Recently, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become the rewarming treatment of choice in hypothermic cardiac arrest. The detailed indications for extracorporeal rewarming in non-arrested, severely hypothermic patients with circulatory instability have not been established yet. The primary purpose of the study was a preliminary analysis of all aspects of the treatment process, as well as initial identification of mortality risk factors within the group of severely hypothermic patients, treated with arteriovenous extracorporeal membrane oxygenation (VA-ECMO)...
May 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28447143/-severe-accidental-hypothermia-treatment-using-an-intravascular-temperature-management-catheter
#19
S Allgäuer, F Pieper, H Mahrholdt
Different techniques have been reported for the treatment of severe accidental hypothermia. In this case, we successfully used an intravascular catheter temperature management system which has been developed to induce reversible therapeutic hypothermia in patients following resuscitation. In our patient, the initial core temperature was 26.7 °C, and the temperature management system allowed for successful rewarming without complications with a maximum rate of about 1 °C/h.
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28411927/out-of-hospital-evaluation-and-treatment-of-accidental-hypothermia
#20
REVIEW
Ken Zafren
Accidental hypothermia is an unintentional drop in core temperature to 35°C or below. Core temperature is best measured by esophageal probe. If core temperature cannot be measured, the degree should be estimated using clinical signs. Treatment is to protect from further heat loss, minimize afterdrop, and prevent cardiovascular collapse during rescue and resuscitation. The patient should be handled gently, kept horizontal, insulated, and actively rewarmed. Active rewarming is also beneficial in mild hypothermia but passive rewarming usually suffices...
May 2017: Emergency Medicine Clinics of North America
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