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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peritoneal dialysis is rarely indicated for conditions other than end-stage renal failure. Patients with refractory congestive cardiac failure, who are awaiting cardiac transplantation or have potentially reversible cardiac disease, appear to benefit from CAPD. The prognosis of patients with fulminant hepatic failure or severe acute pancreatitis has not yet been shown to improve with the addition of peritoneal dialysis to standard supportive treatment. Isolated reports have suggested that patients with hypothermia, hyperthermia, dialysis-associated ascites and drug poisonings may be treated successfully with peritoneal dialysis. The above indications are encountered infrequently and renal failure remains the only major indication for commencing patients on peritoneal dialysis.
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PMID:Non-renal indications for peritoneal dialysis. 136 71

A patient who developed acute renal failure associated with severe hypothermia is reported. Warm peritoneal dialysis was initiated for core rewarming followed by intermittent hemodialysis till he entered the diuretic phase. The factors which led to acute renal failure in this patient included hypovolemia, hypotension, and acute pancreatitis.
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PMID:Acute renal failure in severe hypothermia. 146 13

An analysis of postmortem investigations between 1980 and 1985 revealed 43 patients with acute pancreatitis. In 13 (30.2%) of them, the diagnosis was first established at autopsy. In eight of the latter patients, the diagnosis could have been present on admission. The etiology was alcoholism in three patients, hypothermia in one, biliary tract disease in one, and unknown in three patients. In five patients, acute pancreatitis developed after gastric, pancreatic, or biliary tract surgery. Abdominal pain was present in only one patient. Amylase levels had been estimated in 11 patients, but the level was in the diagnostic range (greater than or equal to 3 times of upper normal level) in only four. Consequently, ultrasound examination was performed in only two of the latter four patients, but failed to show the pancreas because of intestinal gas. To diagnose acute pancreatitis at an earlier stage and to improve therapy and prognosis, we recommend that serum amylase levels be measured and ultrasound examination be performed. If the results are inconclusive, this should be followed by computed tomography for all abdominal emergency cases and for patients who have undergone cardiopulmonary or upper abdominal surgery, especially when the patients deteriorate or fail to improve postoperatively.
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PMID:Undetected fatal acute pancreatitis: why is the disease so frequently overlooked? 180 1

The article discusses the results of endovascular therapy (ET) in 92 patients with various forms of acute pancreatitis. ET was conducted without operative treatment, in preparation for operation, and in the postoperative period. Ten patients were subjected to direct hypothermia by intraarterial infusion of cooled solutions. Bi-arterial catheterization of the aortic branches was performed for higher efficacy of the management of acute pancreatitis and prevention of its complications. The inclusion of ET in the complex of therapeutic measures for acute pancreatitis led to a fall of pancreonecrosis lethality from 54% to 25%.
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PMID:[Intra-arterial therapy in the combination therapy of acute pancreatitis]. 270 64

Serial serum amylase and blood glucose levels were measured in 68 hypothermic (rectal temperature 35 degrees C or less) patients, including 15 who had hypothermic myxoedema (serum protein bound iodine 3.5 mug/100 ml or less). Raised amylase levels were found in 34 patients and probably reflected a mild acute pancreatitis. The high amylase levels correlated with low arterial PO(2) levels and significantly with high arterial PCO(2) levels and the base deficit but not with the severity or duration of the hypothermia. The acute pancreatitis does not explain why hypothermic patients with myxoedema have a poorer prognosis than those who are euthyroid. The pancreatitis occasionally contributed to the development, sometimes delayed, of diabetic ketoacidosis, blood glucose levels of over 120 mg/100 ml being found in 20 patients. There was a significant correlation between the raised serum amylase levels and the hyperglycaemia. Hypoglycaemia, sometimes profound, was found in 12 patients.
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PMID:Acute pancreatitis and diabetic ketoacidosis in accidental hypothermia and hypothermic myxoedema. 412 1

The clinical features in a series of 24 patients with hypothermia treated at Mulago Hospital, Kampala, are described. Hypothermia developed in all when the environmental temperature did not fall below 16 degrees. There was a preponderance of males; 14 of the 24 cases were over 50 years old. The most common predisposing factors were severe undernutrition or malnutrition with wasting and almost complete absence of subcutaneous fat, and anaemia present in over two thirds of the patients. Hypoglycaemia appeared to be the immediate precipitating factor in at least five patients. Acute pancreatitis was found in three of the four patients who died unexpectedly 2-7 days after recovery from hypothermia; focal pancreatitis and fat necrosis was also present in six other cases. It is concluded that hypothermia is not uncommon, and is a dangerous complication amongst patients with severe under- or malnutrition, and can occur even under "tropical" conditions, when the environmental temperature does not fall below 16 degrees.
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PMID:Hypothermia in the tropics. A review of 24 cases. 443 62

Observations in favour of the early application of the intragastric hypothermia for acute pancreatitis especially for edematic and hemorrhagic forms of the disease are presented.
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PMID:[Intragastric hypothermia in the treatment of acute pancreatitis]. 671 63

There is a recognised but poorly understood association between hypothermia and acute pancreatitis. A histological study of the pancreas was made in eight patients with accidental hypothermia who had evidence of pancreatitis at necropsy. From an analysis of the patterns of parenchymal necrosis in the pancreas it was thought that there were at least three possible mechanisms for the relation between hypothermia and pancreatitis. Firstly, that ischaemic pancreatitis may result from the "microcirculatory shock" of hypothermia. Secondly, that both hypothermia and pancreatitis may be secondary to alcohol abuse: and finally, that severe pancreatitis may be the primary disease and that hypothermia results from the patients' social circumstances.
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PMID:Morphological study of the relation between accidental hypothermia and acute pancreatitis. 714 33

A retrospective review of 41 patients with post-mortem evidence of acute pancreatitis revealed that 19 patients (46%) showed concomitant evidence of increased intracranial pressure (ICP). A prospective analysis of five patients with increased ICP demonstrated two patients with evidence of acute pancreatitis. The pathogenesis of acute pancreatitis in these patients appears to be dependent on the following risk factors: increased intracranial pressure, steroids, hypovolemia, morphine infusion and hypothermia. These factors increase vagal stimulation, predispose to pancreatic duct obstruction and enhance cellular hypoperfusion. Acute pancreatitis occurring in Reye's Syndrome is probably a consequence of increased ICP and the therapy instituted.
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PMID:Acute pancreatitis and increased intracranial pressure. 727 56

Acute pancreatitis was an unexpected complication during the course of intensive supportive management in five patients with Reye's syndrome. Four of the five patients died and one survived with transient neurologic deficits. Although corticosteroid therapy, fluid restriction, and hypothermia may have contributed to the development of this complication, acute pancreatitis may represent a severe manifestation of visceral metabolic dysfunction in Reye's syndrome.
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PMID:Acute pancreatitis in Reye's syndrome: a fatal complication during intensive supportive care. 735 11


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