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

In very low birth weight infants, the occurrence of bilirubin-related brain damage has been repeatedly observed at low serum bilirubin concentrations in close association with altered pathophysiologic status (hypoxia, acidosis, hypothermia, and so on). This increased susceptibility is accompanied by increased severity and duration of unconjugated hyperbilirubinemia as compared with more mature infants. Clinical manifestations of kernicterus in very low birth weight infants are almost always nonspecific. No single biochemical or physiologic measurement is sufficient to predict the risk for development of the bilirubin-related brain damage in this group. Prevention of bilirubin-related brain damage in very low birth weight infants requires not only the maintenance of physiologic and biochemical milieu within normal limits, but also specific therapy to alleviate unconjugated hyperbilirubinemia. Although exchange transfusion has been the mainstay of therapy for unconjugated hyperbilirubinemia, the increased morbidity and mortality associated with exchange transfusion in these immature infants and the need to maintain very low serum bilirubin concentrations suggest that prophylactic phototherapy may be more beneficial for this group.
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PMID:Unconjugated hyperbilirubinemia in very low birth weight infants. 33 31

The reduction of both the severe CNS-disturbances (major CNS-handicaps) as a whole and the infantile cerebral palsies (ICP), epilepsies, and mental retardations (oligophrenias) especially, can be attributed to the comprehensively improved pre-, intra- and postnatal care since the 60/70-ies. The best indicator is the decreasing ICP, because 60% of this disturbance is caused perinatally. It is closely associated with cerebral hemorrhages. In several centers, in Sweden and in West-Australia, an isolated recrudescence of ICP was noted. This fact is probably caused by a very active management of respirator therapy in some perinatological centers. However, today there is an effective therapy of several potential causes of perinatal cerebral lesions, i.e. hypoglycemia, hypothermia, asphyxia, RDS, and hyperbilirubinemia. The therapy of these diseases is simultaneously a prevention of the possible consecutive cerebral lesion as well. In the past, only two causes for CNS-disturbances have scarcely been influenced: cerebral hemorrhage, and nosocomial infections. Conclusions for the strategy of the further perinatal care can be deduced from these analyses: prevention of the extremely preterm deliveries, improvement of the perinatal care, prevention of cerebral hemorrhages and nosocomial infections, and responsible ethical decision about the application of the respirator therapy in the individual case.
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PMID:[Neuropsychiatric disorders in very-low-birthweight newborn infants (VLBW-infants)--before and after the introduction of modern perinatal medicine. 3. Discussion of trends in quality of survival (CNS morbidity) and conclusions]. 267 94

In a prospective study, 93 patients were observed up to nine months after open-heart surgery using hypothermia, hemodilution and cold cardioplegia. In the first two weeks frequent determinations were made of serum aminotransferase, alkaline phosphatases (ALP), lactic dehydrogenase isoenzymes, gamma glutamyltransferase (GT), total and free bilirubin and bile acids. Plasma hemoglobin was measured at the end of the operation. After the first period, aminotransferases, alkaline phosphatases and bilirubin were determined monthly. On the first postoperative day almost all of the patients showed abnormal aspartate aminotransferase (ASAT) activity and ASAT/ALAT (alanine aminotransferase) greater than 1, and about 25% had hyperbilirubinemia. The findings suggested early postoperative leakage of enzymes not only from the myocardium, but also from the liver. After two weeks the patients presented another pattern of liver dysfunction, with abnormal ALAT in 50%, ASAT/ALAT less than 1, and abnormal ALP and GT in 28 and 45%, respectively. Eight patients were judged to have post-transfusion hepatitis of non-A, non-B type. Six of them had abnormal aminotransferases for more than six months.
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PMID:Hepatic dysfunction after open-heart surgery. 615 78

Besides oxygen administration and immaturity of the premature retinal vessels, there are other risk factors for retrolental fibroplasia: (1) respiratory distress syndrome; (2) multiple episodes of bradycardia apnoea; (3) exchange transfusions; (4) hyaline membrane disease; (5) anemia of prematurity; (6) hyperbilirubinemia; (7) avitaminosis E; (8) cardiovascular defects; (9) infectious diseases; (10) multiple births; (11) hypocalcemia; (12) hypothermia; (13) hemorrhagic tendency; (14) delayed coaptation of the retina, and (15) spastic diplegia.
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PMID:Risk factors for retrolental fibroplasia. 668 25

The hearing of 98 perinatal intensive care survivors with a mean birth weight of 1,540 g was assessed at a mean age of 6 1/2 years. They represented 73% of the long-term survivors with birth weights of 1,800 g or less who had been cared for in our neonatal unit during the three-year period 1971 through 1973. Nine of the 98 infants had sensorineural hearing loss, and 14 had exudative otitis media. During their neonatal period, the infants with hearing loss experienced more frequent apneic attacks, hyperbilirubinemia (serum bilirubin level, greater than 14 mg/dL), and hypothermia compared with their healthy counterparts. There was no evidence that the duration of stay in the incubator or the use of stay in the incubator or the use of ototoxic drugs had affected the hearing of these low-birth-weight infants.
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PMID:Hearing loss in low-birth-weight infants. 720 Dec 36

In recent years kernicterus at autopsy has been observed in sick premature infants in the absence of markedly elevated levels of serum bilirubin. Potentiating factors have been suggested to explain kernicterus in such a setting. In order to establish which factors are associated with increased risk for kernicterus in these small babies, this retrospective matched control study was undertaken. Thirty-two infants with kernicterus at autopsy were matched for gestational age, birth weight, length of survival, and year of birth to 32 control infants without kernicterus. Multiple historical, clinical, and laboratory factors were compared, including therapy, sepsis, hypothermia, asphyxia as reflected by Apgar score, hematocrit, acidosis, hypercarbia, hypoxia, hypoglycemia, and hyperbilirubinemia. No statistically significant differences between the kernicteric and nonkernicteric infants were demonstrated for any of these factors, including peak total serum bilirubin levels. Multivariant analysis also failed to determine a group of factors associated with increased risk for kernicterus. It was not possible to separate those infants with and without kernicterus at autopsy on the basis of the clinical factors evaluated.
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PMID:Lack of identifiable risk factors for kernicterus. 743 34

From 1982 to 1994, 45 patients (1.22 episodes per 10,000 discharged patients) were treated for citrobacter bacteremia at National Taiwan University Hospital (Taipei). All patients had at least one underlying disease. Citrobacter bacteremia most commonly occurred in patients with malignancies (48.9%) or hepatobiliary stones (22.2%). Intraabdominal tumors comprised the majority (59.1%) of malignancies. Bacteremia commonly originated from sites such as the abdominal cavity (51.1%), urinary tract (20%), and lung (11.1%). Polymicrobial bacteremia was diagnosed in 15 patients (33.3%); for nine (60%) of these patients, the source of the infection was intraabdominal. Prior treatment with a third-generation cephalosporin was significantly associated (P < .01) with the development of multidrug resistance among the isolates. The mortality associated with citrobacter bacteremia was 17.8%. Poor prognostic factors included pneumonia, altered mental status on presentation, hypothermia, oliguria, septic shock, deterioration in mental status, hyperbilirubinemia, azotemia, and thrombocytopenia. Combination therapy, as compared with other regimens, improved the outcome of citrobacter bacteremia.
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PMID:Bacteremia due to Citrobacter species: significance of primary intraabdominal infection. 887 78

Necrotizing enterocolitis (NEC) is responsible for substantial infant morbidity and mortality. NEC has been hypothesized to result from hypoxemia and mucosal injury, aggravated by feeding and bacterial proliferation. A study conducted at Kasturba Hospital Manipal in Karnataka, India, during 1990-94 attempted to further define risk factors for NEC. The 34 infants with NEC represented 1.38% of total admissions to the hospital's Neonatal Intensive Care Unit during the study period. The mean birth weight of NEC infants was 1584.56 g, with a mean gestational age of 33.53 weeks. 28 infants (82.35%) were preterm and 33 (97.05%) weighed under 2500 g. The most frequent clinic signs in infants with NEC were abdominal distension (79.4%), hyperbilirubinemia (67.6%), hypoglycemia (58.8%), and umbilical erythema (55.9%). When the 23 infants with NEC born within the hospital were compared with 46 weight-matched controls, there were no significant differences in birth weight, gestational age, or feeding patterns. However, NEC cases had a higher frequency of pregnancy-induced hypertension, low mean Apgar scores, polycythemia, hypothermia, and septicemia than controls. These findings suggest that poor gut blood flow may be another important etiologic factor in NEC.
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PMID:Neonatal necrotizing enterocolitis. 925 Dec 79

During the study period there were 2063 live births. Of these 573 (27.8%) were low birth weight (LBW), 277 (13.4%) preterm and 148 (7.1%) small for date (SFD) babies. In all, 263 (12.7%) newborns suffered from one or the other morbidity. Birth asphyxia of varying severity developed in 130 (6.3%) babies [88 LBW and 42 normal birth weight (NBW) (p < 0.001)]. Respiratory distress syndrome was diagnosed in 82 (3.9%) babies, most being due to hyaline membrane diseases (31.7%), which affected 26 (9.4%) of preterm babies. Deep infections were seen in 109 (5.3%) newborns [60 LBW and 49 NBW, (p < 0.001)] and superficial infections were seen in 79 (3.8%) babies [46 LBW and 33 NBW, (p < 0.001)]. Hyperbilirubinemia was detected in 78 (3.8%) babies. In one fifth of the babies, the cause of hyperbilirubinemia remained unidentified even after detailed investigations. Hypothermia was observed in 59 (2.9%) newborns [48 LBW and 11 NBW, (p < 0.001] and congenital malformations were seen in 24 (1.7%) babies. Morbidity was found to be high amongst LBW and preterm babies. The incidence of deep infections and hypothermia was high in our study.
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PMID:Neonatal morbidity in a hospital at Shimla. 1079 31

Pediatricians in the hospital setting must frequently treat children who require massive transfusion (MT) in a variety of clinical situations ranging from major trauma to neonatal hyperbilirubinemia. After identifying the need for massive transfusion, the pediatrician must select the appropriate blood components. Different blood components have specific temperature, preservative, and time requirements for their storage. Changes, termed storage lesions, occur over time in blood components during storage; biochemical changes include decreased levels of 2,3-DPG, a decrease in pH, and an increase in supernatant potassium (K+) with a concurrent decrease in intracellular K+. These changes may affect the function and the viability of components. Additionally, physical changes such as deformation of the red cell membrane occur during storage. Knowledge of these storage lesions is necessary for the pediatrician to make the most appropriate decisions regarding the preparation and selection of components during MT. Serious complications of MT include hemostatic abnormalities, biochemical/metabolic abnormalities, hypothermia, mechanical injury and the effect of Rh incompatibility, each of which has a specific management response. Pediatricians need to be aware of the potential complications associated with massive transfusion, to take measures to prevent them when possible, to anticipate additional transfusion requirements, and to know how to manage them in the pediatric patient.
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PMID:Massive blood transfusion. 1128 83


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