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Deep hypothermia

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https://www.readbyqxmd.com/read/28930905/effectiveness-of-early-warming-with-self-warming-blankets-on-postoperative-hypothermia-in-total-hip-and-knee-arthroplasty
#1
Baris B Koc, Martijn G M Schotanus, Jean-Paul A P A C Kollenburg, Maurice J A Janssen, Fabian Tijssen, Edwin J P Jansen
BACKGROUND: Hypothermia is an important complication in joint arthroplasty. Commonly, forced air warming (FAW) devices are used intraoperatively to maintain body temperature in patients undergoing surgery. However, it is believed that these convective warming systems could increase the risk of deep surgical site infections due to disruption of unidirectional downward laminar airflow. Conductive warming devices have no noticeable effect on ventilation airflow. Nevertheless, the effectiveness of the self-warming (SW) blanket, a novel conductive warming device, on postoperative hypothermia in elective joint arthroplasty is unknown...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28844545/the-risk-of-neurological-dysfunctions-after-deep-hypothermic-circulatory-arrest-with-retrograde-cerebral-perfusion
#2
Giuseppe Gatti, Bernardo Benussi, Placido Currò, Gabriella Forti, Elisabetta Rauber, Alessandro Minati, Marco Gabrielli, Umberto Tognolli, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue. METHODS: For 344 (59.5%) of 578 consecutive patients (mean age, 66.9 ± 10.9 years) who underwent cardiovascular surgery under DHCA at the present authors' institution (1999-2015), RCP was the sole technique of cerebral protection that was adopted in addition to deep hypothermia...
August 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28836154/randomized-controlled-trial-of-moderate-hypothermia-versus-deep-hypothermia-anesthesia-on-brain-injury-during-stanford-a-aortic-dissection-surgery
#3
Xufang Sun, Hua Yang, Xinyu Li, Yue Wang, Chuncheng Zhang, Zhimin Song, Zhenxiang Pan
This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n = 40, nasopharyngeal temperature 25 °C, and rectal temperature 28 °C) and deep hypothermia group (DH, n = 42, nasopharyngeal temperature 20 °C, and rectal temperature 25 °C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used...
August 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28795615/international-survey-on-the-perioperative-management-of-pulmonary-endarterectomy-the-perfusion-perspective
#4
Roger D P Stanzel, Johannes Gehron, Matthias Wolff, Natalie Striegl, Peter Roth, Rolf-Hasso Boedeker, Christine Scheibelhut, Johannes Herrmann, Ingeborg Welters, Eckhard Mayer, Matthias Scheffler
INTRODUCTION: Pulmonary endarterectomy (PEA) is the most effective treatment available for chronic thromboembolic pulmonary hypertension (CTEPH). Patient selection, surgical technique and perioperative management have improved patient outcomes, which are traditionally linked to surgical and center experience. However, optimal perfusion care has not been well defined. The goal of the international survey was to better characterize the contemporary perfusion management of PEA and highlight similarities and controversies...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28776203/adaptive-temperature-regulation-in-the-little-bird-in-winter-predictions-from-a-stochastic-dynamic-programming-model
#5
Anders Brodin, Jan-Åke Nilsson, Andreas Nord
Several species of small birds are resident in boreal forests where environmental temperatures can be -20 to -30 °C, or even lower, in winter. As winter days are short, and food is scarce, winter survival is a challenge for small endothermic animals. A bird of this size will have to gain almost 10% of its lean body mass in fat every day to sustain overnight metabolism. Birds such as parids (titmice and chickadees) can use facultative hypothermia, a process in which body temperature is actively down-regulated to a specific level, to reduce heat loss and thus save energy...
August 3, 2017: Oecologia
https://www.readbyqxmd.com/read/28719038/static-cerebrovascular-pressure-autoregulation-remains-intact-during-deep-hypothermia
#6
Dheeraj Goswami, Katherine McLeod, Samantha Leonard, Kathleen Kibler, Ronald Blaine Easley, Charles D Fraser, Dean Andropoulos, Ken Brady
BACKGROUND: Clinical studies measuring cerebral blood flow in infants during deep hypothermia have demonstrated diminished cerebrovascular pressure autoregulation. The coexistence of hypotension in these cohorts confounds the conclusion that deep hypothermia impairs cerebrovascular pressure autoregulation. AIM: We sought to compare the lower limit of autoregulation and the static rate of autoregulation between normothermic and hypothermic piglets. METHODS: Twenty anesthetized neonatal piglets (5-7 days old; 10 normothermic and 10 hypothermic to 20°C) had continuous measurements of cortical red cell flux using laser Doppler flowmetry, while hemorrhagic hypotension was induced without cardiopulmonary bypass...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28709662/neonatal-aortic-arch-reconstruction-with-direct-splanchnic-perfusion-avoids-deep-hypothermia
#7
Muhammad Aanish Raees, Clinton D Morgan, Venessa L Pinto, Ashly C Westrick, Chevis N Shannon, Karla G Christian, Bret A Mettler, David P Bichell
BACKGROUND: Neonatal aortic arch reconstruction, typically performed with deep hypothermia and selective cerebral perfusion, leaves splanchnic organ protection dependent on hypothermia alone. A simplified method of direct in-field descending aortic perfusion during neonatal arch reconstruction permits the avoidance of deep hypothermia. We hypothesize that direct splanchnic perfusion at mild hypothermia provides improved or equivalent safety compared with deep hypothermia and may contribute to postoperative extracardiac organ recovery...
July 11, 2017: Annals of Thoracic Surgery
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/28687308/deep-hypothermia-therapy-attenuates-lps-induced-microglia-neuroinflammation-via-the-stat3-pathway
#9
G Tong, A Krauss, J Mochner, S Wollersheim, P Soltani, F Berger, K R L Schmitt
Deep hypothermia therapy (HT) is a standard method for neuroprotection during complex pediatric cardiac surgery involving extracorporeal circulation and deep hypothermic cardiac arrest. The procedure, however, can provoke systemic inflammatory response syndrome (SIRS), one of the most severe side effects associated with pediatric cardiac surgery. To date, the cellular inflammatory mechanisms induced by deep HT remain to be elucidated. Therefore, we investigated the effects of deep HT (17°C) and rewarming on the inflammatory response in lipopolysaccharide (LPS) stimulated BV-2 murine microglia...
September 1, 2017: Neuroscience
https://www.readbyqxmd.com/read/28623417/a-validated-clinical-mri-injury-scoring-system-in-neonatal-hypoxic-ischemic-encephalopathy
#10
Shamik B Trivedi, Zachary A Vesoulis, Rakesh Rao, Steve M Liao, Joshua S Shimony, Robert C McKinstry, Amit M Mathur
BACKGROUND: Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. OBJECTIVES: To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18-24 months. MATERIALS AND METHODS: MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated...
June 16, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28622752/microvascular-fluid-exchange-during-cpb-with-deep-hypothermia-circulatory-arrest-or-low-flow
#11
Bjørg Elvevoll, Paul Husby, Venny L Kvalheim, Lodve Stangeland, Arve Mongstad, Øyvind S Svendsen
OBJECTIVE: Use of deep hypothermic low-flow (DHLF) cardiopulmonary bypass (CPB) has been associated with higher fluid loading than the use of deep hypothermia circulatory arrest (DHCA). We evaluated whether these perfusion strategies influenced fluid extravasation rates and edema generation differently per-operatively. MATERIALS AND METHODS: Twelve anesthetized pigs, randomly allocated to DHLF (n = 6) or DHCA (n = 6), underwent 2.5 hours CPB with cooling to 20°C for 30 minutes (min), followed by 30 min arrested circulation (DHCA) or 30 min low-flow circulation (DHLF) before 90 min rewarming to normothermia...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28608861/neonatal-pinealectomy-in-rats-a-simple-micro-suction-technique
#12
Bohdan Pawlicki, Brandon Michael Henry, Krzysztof A Tomaszewski, Mariusz Gajda, Iwona Brzozowska, Jerzy A Walocha, Anna Skowron-Cendrzak
To determine the role of the pineal gland and its secretory product melatonin on various aspects of the functioning of the organism, the gland can be easily surgically removed in rats within 18 hours after birth. We performed pinealectomy in rats in a state of deep hypothermia under an operating microscope, using a micro-suction device of our own construction. The rats were induced into a state of suspended animation by placing them in the freezing compartment at minus 20 Celsius degrees. The cessation of respiration and heart beat lasted for about 15 minutes...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/28595819/risk-factors-and-prediction-model-for-inpatient-surgical-site-infection-after-major-abdominal-surgery
#13
Aslam Ejaz, Carl Schmidt, Fabian M Johnston, Steve M Frank, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSIs) are a common source of postoperative morbidity and a marker of surgical quality. The ability to predict the incidence of SSIs is limited and most models have poor predictive value. We sought to identify risk factors associated with SSIs and develop a prediction model for SSIs after major abdominal surgery. METHODS: A total of 1744 patients undergoing pancreatic, hepatobiliary, and colorectal resections between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital were identified...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28574047/risk-of-development-of-neurological-complications-in-prosthetic-repair-of-the-aortic-ascending-portion-and-arch
#14
A S Klinkova, O V Kamenskaia, A M Cherniavskiĭ, V V Lomivorotov
The study comprised a total of 68 patients (presenting) with chronic dissection of the aortic ascending portion and arch, undergoing surgery and subjected to measuring at various stages of the operation the level of cerebral oxygenation (rSO2) of the right and left hemispheres by means of bilateral transcranial spectroscopy. The aim of the study was to examine the risk for the development of neurological complications in patients with chronic dissection of the aortic ascending portion and arch in various methods of cerebral protection during aortic prosthetic reconstruction...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28526092/transapical-aortic-perfusion-using-a-deep-hypothermic-procedure-to-prevent-dissecting-lung-injury-during-re-do-thoracoabdominal-aortic-aneurysm-surgery
#15
Yuya Kise, Yukio Kuniyoshi, Mizuki Ando, Hitoshi Inafuku, Takaaki Nagano, Satoshi Yamashiro
BACKGROUND: Avoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery. CASE PRESENTATION: A 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28495952/deep-and-profound-hypothermia-in-haemorrhagic-shock-friend-or-foe-a-systematic-review
#16
REVIEW
Samuel E Moffatt, S J B Mitchell, J L Walke
INTRODUCTION: Survival in exsanguinating cardiac arrest patients is poor, as is neurological outcome in survivors. Hypothermia has traditionally been seen as harmful to trauma patients and associated with increased mortality; however, there has been speculation that cooling to very low temperatures (≤20°C) could be used to treat haemorrhagic trauma patients by the induction of a suspended animation period through extreme cooling, which improves survival and preserves neurological function...
May 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28488623/endovascular-pulmonary-artery-inflatable-balloon-induced-hypotension-a-novel-technique-for-clipping-giant-intracranial-aneurysms
#17
V R Roopesh Kumar, Sudhakar B Subramaniam, A B Gopala Murugan, K R Suresh Bapu
Management of giant intracranial aneurysms presents unique challenges to the neurosurgical team. Various techniques such as adenosine-induced hypotension, rapid ventricular pacing, and inducing deep hypothermia are described in the literature to effect circulatory arrest for the successful obliteration of giant aneurysms. We describe a novel technique of induced hypotension for clipping a giant aneurysm by using an inflatable balloon across the main pulmonary artery with a successful outcome. This technique has not been described earlier in the literature...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28472154/hypothermia-induced-dystonia-and-abnormal-cerebellar-activity-in-a-mouse-model-with-a-single-disease-mutation-in-the-sodium-potassium-pump
#18
Toke Jost Isaksen, Lieke Kros, Natascia Vedovato, Thomas Hellesøe Holm, Ariel Vitenzon, David C Gadsby, Kamran Khodakhah, Karin Lykke-Hartmann
Mutations in the neuron-specific α3 isoform of the Na+/K+-ATPase are found in patients suffering from Rapid onset Dystonia Parkinsonism and Alternating Hemiplegia of Childhood, two closely related movement disorders. We show that mice harboring a heterozygous hot spot disease mutation, D801Y (α3+/D801Y), suffer abrupt hypothermia-induced dystonia identified by electromyographic recordings. Single-neuron in vivo recordings in awake α3+/D801Y mice revealed irregular firing of Purkinje cells and their synaptic targets, the deep cerebellar nuclei neurons, which was further exacerbated during dystonia and evolved into abnormal high-frequency burst-like firing...
May 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28460021/hypothermia-and-cerebral-protection-strategies-in-aortic-arch-surgery-a-comparative-effectiveness-analysis-from-the-sts-adult-cardiac-surgery-database
#19
Brian R Englum, Xia He, Brian C Gulack, Asvin M Ganapathi, Joseph P Mathew, J Matthew Brennan, T Brett Reece, W Brent Keeling, Bradley G Leshnower, Edward P Chen, Jeffrey P Jacobs, Vinod H Thourani, G Chad Hughes
OBJECTIVES: Hypothermic circulatory arrest is essential to aortic arch surgery, although consensus regarding optimal cerebral protection strategy remains lacking. We evaluated the current use and comparative effectiveness of hypothermia/cerebral perfusion (CP) strategies in aortic arch surgery. METHODS: Using the Society of Thoracic Surgeons Database, cases of aortic arch surgery with hypothermic circulatory arrest from 2011 to 2014 were categorized by hypothermia strategy-deep/profound (D/P; ≤20°C), low-moderate (L-M; 20...
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28457172/a-systematic-surgical-approach-to-hepatoblastoma-with-intracardiac-extension
#20
Sajid Sayed, Sudesh Prabhu, Jonathan Fawcett, Kelvin Choo, Nelson Alphonso
Hepatoblastoma is very uncommon in children, and intracardiac extension is rare. The SIOPEL-4 regime for metastatic hepatoblastoma has extended the surgical options with good results. We successfully treated a boy aged 2 years and 9 months with hepatoblastoma, using a multidisciplinary surgical strategy involving an extended left hepatectomy, left adrenalectomy, biopsy of the paraaortic and coeliac lymph nodes, and resection of the inferior vena caval-right atrial extension of the hepatoblastoma, under cardiopulmonary bypass and deep hypothermia...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
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