Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During 1969-77, 20 episodes of severe hypothermia occurred in 19 diabetic patients in Nottingham. Thirteen were associated with ketotic hyperosmolar coma, two with lactic acidosis, and one with hypoglycaemia, while in four there was no loss of diabetic control. Ketoacidosis accounted for 11.8% of all admissions for severe accidental hypothermia and was a commoner cause than hypothyroidism (8%). Patients with ketoacidosis were younger and developed hypothermia as often during the summer as during the winter. The metabolic disturbance was characteristic, with severe acidosis (mean pH 7.04), a high blood glucose concentration (mean 56.6 mmol/l; 1020 mg/100 ml), and high plasma osmolality (mean 379.7 mmol (mosmol)/kg). Eight of the 13 episodes proved fatal. Hypothermia may aggravate ketoacidosis and complicate treatment and should be sought in all patients with severe diabetic coma.
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PMID:Hypothermia: a complication of diabetic ketoacidosis. 10 2

In a previous study occlusion of a middle cerebral artery (MCA) followed by 48 h of hypothermia (29 degrees) was lethal in 5 of 5 monkeys as compared to only 3 of 9 normothermic animals. The present study extended these observations in monkeys and cats with or without MCA occlusion. In monkeys MCA occlusion plus 48 h of hypothermia was consistently lethal. Without MCA occlusion of 2 of 3 monkeys survived, but were comatose the first 12 h post-hypothermia. In normothermic cats, MCA occlusion was lethal in only one of 5 animals whereas hypothermia was lethal in 20 of 21 cats with or without MCA occlusion. The detrimental effects of hypothermia were not favorably influenced either by hemodilution or by deliberate alterations in PaCO2. The effect of 48 h of hypothermia and rewarming on cerebral blood flow (CBF) and cerebral metabolites was evaluated in 6 normal monkeys. CBF was reduced 60 to 70 percent at 29 degrees C and returned to only a maximum of 50 percent of control with re-warming. Prior to re-warming distribution of CBF was inhomogeneous. Cerebral metabolites were borderline normal prior to re-warming but energy stores decreased while lactate increased with re-warming.
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PMID:Deterimental effect of prolonged hypothermia in cats and monkeys with and without regional cerebral ischemia. 11 94

Among comas of toxic origin, in children, alcoholic coma due to accidental poisoning is uncommon compared with comas due to drugs or household products. It is however important to make an early diagnosis, for this is a severe from of poisoning, liable to cause irreversible cerebral lesions if not treated very quickly. It almost always causes a flask coma, without localising signs, hypothermia and hypoglycemia, but hypoglycemic comas are not always of alcoholic origin, and only measurement of blood alcohol gives a definite diagnosis.
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PMID:[Alcoholic coma by accidental poisoning in children]. 21 27

The various stages and therapeutic modalities in the management of children with moderate and severe head injuries is reviewed. Emphasis on aggressive management upon arrival to the emergency room, and continuing until brain swelling has definitely resolved, is stressed. Management includes prompt endotracheal intubation and hyperventilation, arterial and venous lines and bladder catheter insertion. Computed tomography to assess underlying pathology, intracranial pressure monitoring for appropriate therapy should follow. In this way mannitol, other diuretics, hypothermia and barbiturate coma can be decided on, and the response assessed. The role of high dose steroids is discussed.
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PMID:Analysis of therapeutic modalities for head-injured children. 45 3

A death case following a suicidal overdose of flurazepam (Dalmadorm) is reported. The body was found after 3 month near a highway. The course of the intoxication is in question as benzodiazepines are believed to be relatively save drugs. The death might have occured rapidly because of the acute toxic actions of the drug overdose as well as after a protracted course involving additional complications like inflammatory alteration of the myocard or hypothermia during a coma. Flurazepam and its major metabolites were analysed in blood and urine. The toxic levels of flurazepam (0.51 mg/l), N1-desalkylflurazepam (0.14 mg/1) and N1-hydroxyethylflurazepam (9.0 mg/1) in the blood amounted to 20--50 times higher than therapeutic levels, with flurazepam and metabolites being in only slight altered relation to each other. The overdose is considered to have been above 2.4 g (80 tablets). The resorption of the drug was complete. The analytical findings in blood and urine as well as in the GI-tract are in satisfactory agreement. The analytical data of flurazepam and its metabolites are discussed in detail, taking metabolic and pharmacokinetic parameters, autopsy findings and case circumstances into consideration. A final decision about the course of the intoxication is not possible. This case shows however the fatal consequences of a flurazepam overdose although alcohol or other drugs were not involved.
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PMID:[A fatal monointoxication by flurazepam (Dalmadorm). Problems of the toxicological interpretation (author's transl)]. 53 64

A preterm infant with accidental triclofos sodium poisoning is described. He developed deep coma, severe hypothermia, mild by hypotension and lack of the primitive and deep tendon reflexes. During recovery, the primitive reflexes were the last to appear. The natural course of triclofos poisoning, and its influence on the immature central nervous system of the preterm infant are discussed.
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PMID:Acute triclofos poisoning in a preterm infant. 57 69

In 1967-76 the annual number of admissions to a poisoning treatment centre rose from 964 to 2134. The proportion of admissions caused by taking barbiturate hypnotics and methaqualone fell considerably while that caused by taking benzodiazepines and tricyclic antidepressants increased. As a result the proportion of patients admitted unconscious fell from 23% to 15%. The declining contributions of barbiturates and methaqualone and increased importance of tricyclic antidepressants were significant in all grades of coma. The change in drugs taken, however, has not yet reduced the percentage of unconscious patients needing endotracheal intubation or assisted ventilation, and hypothermia remains as common. Only hypotension has become less frequent as antidepressants replace barbiturates as the main cause of drug-induced coma. The use of salicylates for self-poisoning is declining slowly, and paracetamol poisoning is now as common.
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PMID:Changing pattern of drugs used for self-poisoning. 62 Feb 15

Latency measurements between three potentials (waves I, III, and IV/V) of the human brainstem auditory response can allow early detection of certain posterior fossa lesions. The diagnostic use of these interwave latencies requires knowledge of what factors may prolong them in the absence of disease. Hypothermia appears to be one such factor--in 5 neurologically and audiometrically normal patients, mean esophageal temperatures as high as 34.5 degrees C resulted in prolongations of central auditory conduction time. Interwave latency prolongations that were abnormal relative to an age-matched normal population were seen at 32.1 degrees +/- 0.3 degrees C in patients with both spontaneous and induced hypothermia, and these abnormalities disappeared after rewarming to normothermia. Hypothermia often accompanies intoxication and coma and should therefore be considered when brainstem auditory response abnormalities are being interpreted in these two clinical conditions.
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PMID:Effects of hypothermia on the human brainstem auditory response. 66 80

Seventy-four patients were admitted after cardiac resuscitation to a general intensive care unit; 19, of whom 14 were neurologically normal, were utimately discharged from hospital. It is suggested that elderly patients, those who have had prolonged resuscitation, and patients with a combination of hypothermia, coma, dilated pupils, and apnoea have a very poor prognosis. It is doubtful whether such patients benefit from admission to an intensive care unit.
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PMID:Length of survival after cardiac resuscitation in an intensive care unit. 67 25

In three cases of severe hypophosphatemia profound coma was associated. Although the occurrence of hypophosphatemia appeared to coincide with a high rate of intravenous administration of glucose and water, two of the three patients had liver disease and the other had hypothermia. In two instances the neurologic status improved with intravenous phosphate therapy. These case reports emphasize the importance of early recognition and treatment of profound hypophosphatemia in critically ill patients.
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PMID:Hypophosphatemia associated with coma. 67 14


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