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

Hypothermia, a core body temperature of less than 95 degrees F (35 degrees C), is a common intraoperative complication among adult patients and may occur in obstetric patients. Obstetric patients are predisposed to hypothermia because of vasodilation from pregnancy, administration of anesthetics and pharmacologic agents, and inherent blood loss with rapid fluid replacement during delivery. Morbidity associated with hypothermia occurs from complications such as hypotension, cardiac arrhythmias, increased oxygen consumption or respiratory depression, and disseminated intravascular coagulation. Interventions include preventive measures such as maintaining reasonable ambient room temperatures, avoiding infusion of cold solutions, and promptly assessing postoperative temperature, as well as corrective measures--rewarming the patient, placing the patient on dry surfaces, minimizing additional heat loss, and providing external heat sources.
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PMID:Maternal hypothermia: implications for obstetric nurses. 820 55

The peak incidence of DIC in the pediatric age group is in the neonatal period. The newborn infant is particularly susceptible to DIC because of several handicaps, such as physiological hypofunction of anticoagulant and fibrinolytic systems, an underdeveloped capacity in the reticuloendothelial system and a tendency to develop acidosis, hypothermia, hypoxia and shock. Although some criteria have been reported for the diagnosis of DIC in adults, based on clinical and laboratory findings, these are not necessarily applicable to the diagnosis of DIC in newborn infants. This is because a large blood sample is required, a long period of time is necessary for assay and difference in several coagulation and fibrinolysis factors exist between newborn infants and adults. We therefore established a criteria for the diagnosis of DIC in newborn infants, based on data obtained from newborn infants with DIC. Diagnostic procedures of many molecular markers of hemostasis have been developed from this. Some of them, such as FDP-D dimer are valuable for the diagnosis in children but others are not necessarily useful because of the susceptibility to the venipuncture technique. Our criteria for the diagnosis of DIC in newborn infants must be modified in the diagnosis of DIC in very low birth weight infants.
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PMID:[New approach to the diagnosis of disseminated intravascular coagulation in childhood]. 843 30

The lower temperatures utilized during profound hypothermic circulatory arrest (PHCA) surgery may exacerbate the hypothermia associated platelet and clotting factor dysfunction observed in conventional cardiopulmonary bypass (CPB) procedures. Hypothermia has been shown to impair the activity of the enzymes involved in the platelet activation pathways and to reduce the enzymatic activity of clotting factors upon coagulation activation. The resulting retardation of the generation of fibrin/platelet clot compounded by the presence of heparin may contribute significantly to a bleeding tendency. Excessive fibrinolytic activity may disrupt surgical wound thrombi and exacerbate haemorrhage. There is good evidence that the fibrinolytic activity, mediated predominantly by tissue plasminogen activator (tPA), is a secondary response to thrombin generated by coagulation activation, which is ongoing during CPB despite full heparinization. The effects of hypothermia on the fibrinolytic response remain to be clarified and the extent to which the lower temperatures and blood stasis associated with PHCA moderate this response is unknown. Despite impairment of coagulation activation by hypothermia there appears to be a shift in the hemostatic balance towards thrombosis presumably as a consequence of endothelial cell injury by both hypothermia and stasis induced ischemia. There is evidence that widespread microvascular thrombus deposition may occur as a consequence of stasis in patients undergoing PHCA and that this might result in vascular occlusion and end organ damage. Although it is not uncommon to find laboratory evidence of disseminated intravascular coagulation (DIC) in patients presenting with aortic aneurysm rupture or dissection, the incidence of clinically overt DIC resulting in bleeding is low. The underlying hemostatic disturbance however may contribute to the surgery-associated bleeding diathesis.
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PMID:Hematological consequences of profound hypothermic circulatory arrest and aortic dissection. 927 46

Although reliable hemostasis screening in the newborn is difficult to obtain, the information gained from such testing is essential in differentiating the inherited from the acquired bleeding disorder. Sick infants are at risk for developing hemorrhage or thrombosis in response to a variety of diseases or injuries. Screening tests must be interpreted using appropriate normal ranges for term or preterm infants. Neonates are particularly susceptible to DIC because of their underdeveloped reticuloendothelial system and their tendency to develop acidosis, hypothermia, hypoxia, and shock. Bleeding is commonly the results of intravascular coagulation or decreased synthesis of clotting factors by the liver. Criteria based on clinical and laboratory findings have been determined in adults; however, these criteria are not necessarily applicable to neonates. A study reviewing 74 cases of newborns with suspected DIC reported that the most reliable diagnostic tests are the platelet count, D-dimer or FDP, PT, PTT, and fibrinogen. Whatever the test, the nurse's accurate assessment of the neonate, careful collection of blood, and reporting of abnormal results remain paramount in obtaining timely, appropriate care.
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PMID:DIC screening in the newborn. 936 97

Primary infection with varicella-zoster virus usually is a mild, self-limiting childhood illness. However, certain rare but potentially life-threatening complications can be associated with the disease. Adults and immunosuppressed patients are at increased risk for these events. We report a case of a patient on chronic immunosuppressants with fulminant varicella infection complicated by rhabdomyolysis and disseminated intravascular coagulation. Mechanisms of muscle damage in viral diseases might be direct invasion of skeletal muscle and/or induction of harmful cytokines. Aggressive fluid therapy, alkalinization of urine and supportive measures correcting electrolyte imbalances, hypothermia and hypoxemia should result in preservation or complete restoration of renal function. Disseminated intravascular coagulation occurs in conjunction with various diseases and may range from mild laboratory abnormalities to fulminant lethal thrombosis and bleeding. Apart from elimination of the causative process therapeutic strategies are still highly disputed.
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PMID:Disseminated intravascular coagulation (DIC) and rhabdomyolysis in fulminant varicella infection--case report and review of the literature. 979 91

The pathophysiology and support of the massively transfused patient from the vantage of a blood banker is reviewed. Hypothermia, acidosis and shock must be reversed if blood component therapy is to be effective. Algorithms which employ ratios of various blood components have not proved themselves, nor are screening coagulation tests of value until they are remarkably abnormal. Thrombocytopenia, thrombocytopathy, and hypofibrinogenemia appear to be the parameters which predispose to continued bleeding and microvascular hemorrhage in these patients. A large part of the impaired hemostasis is due to a consumption coagulopathy rather than the anecdotal assumption that dilution of the hemostatic elements is to blame. Hypocalcemia, hypomagnesemia and hyperkalemia are rarely observed nor do they pose a problem for this group of individuals. The logistics of blood supply to the clinical areas are addressed by describing one system that has proved itself.
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PMID:Massive blood transfusion: the blood bank perspective. 1014 40

We report the case of a 43-year-old schizophrenic who sustained, after 12 days of treatment including olanzapine (20 mg.day-1), carbamazepine, levomepromazine and alprazolan, a severe shock with bradycardia (HR: 40 b.min-1), circulatory collapse (SAP: 60 mmHg), hypothermia (T: 27 degrees C), coma and disseminated intravascular coagulation. A significant improvement was obtained with high doses of intravenous glucagon, whereas the normalization of central temperature, atropine, adrenaline and volume loading had been inefficient. Olanzapine, alone of associated with other psychotropics, could cause severe circulatory collapse with hypothermia and coma responding to a treatment including glucagon.
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PMID:[Severe intoxication probably from olanzapine (Zyprexa). Beneficial effect of glucagon]. 1046 38

CT/MRI findings, laboratory examinations and prognoses of 42 patients with acute encephalopathy (AE) (Japan Coma Scale > or = 200) were reported. 1. Findings on CT/MRI were divided into the following 7 categories: Group 1 (normal), Group 2 (CT/MRI looked normal in acute phase, but brain atrophy developed and progressed slowly by weeks or months), Group 3 (CT/MRI looked normal within a few days after the onset of AE, but cortical laminar necrosis developed at 4-5 days after the onset), Group 4 (marked brain edema developed within 2 days after the onset of AE), Group 5 (AE with symmetric thalamic lesions), Group 6 (symmetric pallidum, lesions on MRI which appeared after brain edema disappeared), and Group 7 (the brain shrinked during acute phase, which normalized on the follow up CT/MRI). 2. Serum AST elevated in approximately 50% of the patients with AE. Sixty percent of them exhibited DIC, whose prognoses were poor. Cerebrospinal fluids (CSF) neopterin (NP) and/or interleukin (IL)-6 were elevated in all the 8 patients examined. In the two cases whose serum NP and IL-6 were measured at the same time, their values in the CSF were higher than those in the serum in one case, and almost the same in the other. In a patient with a condition mimicking hemorrhagic shock and encephalopathy, serum IL-6 concentration was very high (94,000 pg/ml). 3. Mild hypothermia (around 34 degrees C) combined with methylprednisolone pulse therapy was excellently effective on AE. A 6-year-old boy exhibited tonsillar herniation at admission recovered well to be able to run. 4. Differentiation between Reye syndrome and HSE, and the pathogenesis of AE were also discussed.
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PMID:[Infection-related acute encephalopathy: CT scan/MRI finding, laboratory examination and prognosis]. 1072 91

Hypovolemia, hypothermia, and hypotension are common postoperative findings that predispose the critically ill patient to secondary complications. This patient population is especially vulnerable to sepsis, hypoxia, and immune dysfunction. Careful monitoring is essential for early recognition of potentially life-threatening physiologic derangements. Early and aggressive intervention may help minimize systemic insult before it progresses to acute respiratory distress syndrome, acute renal failure, disseminated intravascular coagulation, or multiple organ failure.
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PMID:Postoperative management of the emergency surgery small animal patient. 1085 83

A peri-parturient fifteen-month-old female Maine Coon cat was presented with extreme weakness and depression, profound hypovolaemia and hypothermia. Severe hyperkalaemia, hyponatraemia and anaemia were detected. Disseminated intravascular coagulation was suspected due to marked prolongation of activated partial thromboplastin time. Uterine torsion was diagnosed at exploratory laparotomy. The cat made a full recovery following ovariohysterectomy and intensive supportive therapy.
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PMID:Successful treatment of uterine torsion in a cat with severe metabolic and haemostatic complications. 1171 4


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