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

The dilution of whole blood leads to a significant improvement of its rheologic properties based on a decrease in hematocrit and, hence, blood viscosity. Under conditions of normovolemia and an adequate response of the cardiorespiratory system, the acute dilution of blood will enhance the venous return to the heart and thereby improve total and capillary blood flow significantly. In the hematocrit range of 25 to 30 per cent (limited hemodilution), this increase in flow rate is able to compensate fully for the diminished oxygen content of the blood. Changes in oxygen extraction or in oxygenhemoglobin affinity are only encountered at hematocrits below 20 per cent or if hemodilution is associated with hypovolemia. Since normovolemia is the condition sine qua non for the heart to increase its output compensatorily, intentional hemodilution should preferably be performed with colloid solutions which are capable of maintaining the colloid osmotic pressure of plasma and the circulating volume in normal limits. Limited normovolemic hemodilution with its beneficial effects on microcirculatory flow and tissue nutrition is emphasized for the treatment of impaired microcirculation as occurring in shock and low flow states, polycythemia, and high viscosity syndromes. Acute preoperative hemodilution is a means of reducing the use of bank blood and of avoiding the risks of blld transfusions in patients undergoing major elective surgery. Extreme hemodilution and total body washout in hypothermia appear to be effective clinical tools.
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PMID:Hemodilution. 113 50

The tolerance of altitude-acclimatized (18,000 ft 4 wk) and unacclimatized rats to exercise at 5 degrees was determined. Fewer unacclimatized than acclimatized rats became fatigued during 9 hr of exercise in the cold. Normal body temperatures were maintained in both groups during 9 hr in the cold at rest, but after exercise unacclimatized rats became mildly hypothermic (body temperature 35 degrees) and acclimatized rats severely hypothermic (body temperature 27.9 degrees). Polycythemia (hematocrit 69) was produced during the altitude acclimatization. Altitude-acclimatized rats developed more severe hypoglycemia and lower liver glycogen and serum lactic acid concentrations after exercise than did controls. No pathological changes were found in resting altitude-acclimatized rats, but after exercise in the cold, a higher percentage of acclimatized than unacclimatized rats developed focal myocardial necrosis within 4 days. Reduced exercise tolerance is attributed to severe hypothermia with associated decreased metabolism, polycythemia, hypoglycemia, and a higher incidence of pathological changes in the cardiac and striated muscles.
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PMID:Tolerance of altitude-acclimatized rats to exercise in the cold. 114 56

The present paper is dealing with cerebral irrigation aspects in three patients with vera polycythemia and 16 with Cooley's anaemia using the non-invasive rheoencephalographic method. The rheographic exploration was done with a 4-channel I.C.E. rheograph, being recorded on a B-channel Galileo multirecorder in parallel with the mathematical derivative of the wave and an EKG lead. The analysis of the rheographic parameter revealed that in patients with vera polycythemia there is an obvious venous stasis as well as important vasomotor tonus modifications induced by an affected blood viscosity. In patients with Cooley's anaemia, modifications in the cerebral irrigation are dominated by chronic anaemia; the latter causes chronic hypoxia of the whole body and a reduced cerebral irrigation due to a depressed cardiac volume and vasomotor tonus to the effect of hypothermia--explained through cerebral vascular self-regulation mechanisms. The investigated groups are interesting because their diseases are rare and severe; their cardiac performance was severely affected, with severe hemodynamic disturbances in the cerebral circulation, too.
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PMID:Rheographic vascular manifestations in some rare malignant hemopathies. 311 16

Blood has a number of rheological properties which partially determine flow, especially at capillary level, and its capacity to deliver oxygen. It is non-Newtonian, pseudoplastic, thixotropic and viscoelastic. Viscosity can be studied with different types of viscosimeters (coaxial cylinder or capillary viscosimeters). It can be defined by the ratio of stress of deformation to rate of deformation. Viscosity depends on macrorheological parameters: hematocrit, serum proteins, especially fibrinogen and globulins, and also on microrheological parameters: degree of aggregation and red blood cell deformability. Viscosity rises when the temperature falls and decreases with the radius of the tube through which the blood flows (Fahraeus-Linqvist effects). Blood viscosity is studied clinically at different temperatures, and, above all, at different rates of deformation by carefully recording the hematocrit. Plasma viscosity, fibrinogen, albumia and immunoglobulin levels, the viscosity of blood cell suspensions in normal saline must also be taken into consideration. Special investigations (rheoscopy, filtrability) provide information about red cell aggregation and deformability. Hyperviscosity syndromes are observed with: --raised hematocrit (polycythemia and pseudopolycythemia), --conditions with raised serum proteins or changes in their composition (especially hyperfibrinogenemia, raised immunoglobulins, low albumin levels); inflammatory syndromes, dysglobulinemias (Fahey's syndrome of plasma hyperviscosity), --low temperature (hypothermia), --increased red cell aggregability (shock, fat embolism), --reduced red cell deformability due to various congenital and acquired conditions (sickle cell anemia, renal failure, hyperlipoproteinemia, thrombosis, diabetes). Conversely, hypoviscosity may occur with a low hematocrit, hypoproteinemia, hypofibrinogenemia, and hyperthermia. Increased viscosity results in a slowing of blood flow, stagnation of its constituents and in ischemia. Therapeutic interventions may be considered on the different components of the hyperviscosity syndrome: hemodilation, plasmapheresis, dispersion of aggregants, agents acting on red cell deformability.
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PMID:[Blood hyperviscosity syndromes. Classification and physiopathological understanding. Therapeutic deductions]. 636 7

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

The dramatic advances that have taken place in recent years in the care of sick and premature infants also have been matched by a similar increase in the use of blood transfusion therapy. Haematological features indicate that a newborn has a blood volume of 85-125 ml/kg the foetal haemoglobin is 60-85% and average Hb in full term infant is 18 gm/dl. By 2-3 months it falls to 11-12 g/dl the main cause of anemia are iron poor diet, weaning diets recurrent or chronic infections and hemolytic episodes in malarious areas. The red cells transfusions are usually top up transfusions, exchange transfusions, partial exchange transfusions. Top up- are for investigational losses and correction of mild degrees of anemias, upto to 5-15 ml/kg. They comprise 90% of all neonatal transfusions and are used in low birth babies in special care units for a maximum of 9-10 episodes. The walk in donor programs once popular are not much in vogue. The threshold for transfusion is 8-10 g/dl Hb for upto 5 weeks. Exchange transfusions are done for correction of anemia, removal of bilirubin, removal of antibodies and replacement of red cells. Ideally plasma reduced red cells that are not older than 5 days are used. It is prepared by removal of 120 ml of standard whole blood donation. The advantage of fresh cells is that hyperkalemia is avoided and good post transfusion survival acceptable red cell oxygen affinity. However it has to be screened for sickle cell disease and G6PD deficiency. Indications for exchange transfusion are kernicterus, neonatal hemolysis, G6PD deficiency, ARDS, neonatal sepsis, DIC and neonatal isoimmune thrombocytopaenia. Complications include over transfusion, perforation of major vessels, hypocalcaemia, citrate toxicity, hypothermia, hypoglycaemia, thrombocytopenia, necrotizing enterocolitis, GVHD, bacterial, viral infections. Partial exchange transfusions are done for symptomatic anemia, where Hb<10 g/dl, it is indicated in polycythemia and hyperviscosity syndromes. Exchange volume = Blood volume x (observed Hct-Desired HCt) divided observed Hct. Points to consider-there is weak expression of ABO antigens so particular care while grouping. Transfusing volumes should be 2-5 ml/kg/hour in paediatric bags of 50-100 ml with infusion devices. Platelet transfusion are indicated in neonatal throbocytopaenia, thrombocytopaenia due to sepsis, DIC, bacterial pathogens, CMV, TORCHS, Obstetric conditions such as pre eclampsia, intrauterine death abruption placenta birth injury hypoxia schock neonatal iso immune thrombocytopaenia and maternal ITP. Administration 1 RDE/pack per 2.5 kg single dose of fresh platelets less than 24hrs which contains 55 x 10(9) cells. This also contributes fresh plasma so is useful for coagulation defects also, though there is a risk of CMV and GVHD due to leucocyte contamination. Granulocyte concentrate; Gravity leucopheresis-1:8 ratio of 60 ml of 6% HES made to stand for 1hr.
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PMID:Component therapy. 1451 88

Tuberculin shock due to inoculation of Mycobacterium tuberculosis antigens in patients with tuberculosis is a serious syndrome originally described over 100 years ago by Robert Koch. Here, we present experimental evidence that a single M. tuberculosis recombinant protein, CFP-10, triggers this syndrome. Intradermal inoculation of CFP-10 elicits in M. tuberculosis-infected mice high levels of serum tumor necrosis factor alpha and causes tuberculin shock in infected guinea pigs characterized by hypothermia and death within 6 to 48 h after the antigen inoculation. Autopsies of these animals revealed intense polycythemia and hemorrhagic patches in the lung parenchyma, a pathological observation consistent with tuberculin shock. These results point to the possible occurrence of tuberculin shock in sensitive individuals inoculated with highly purified M. tuberculosis recombinant proteins as vaccine candidates or skin test reagents.
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PMID:Skin test performed with highly purified Mycobacterium tuberculosis recombinant protein triggers tuberculin shock in infected guinea pigs. 1590 55

Subcutaneous fat necrosis (SCFN) is an inflammatory disorder of adipose tissue. The main risk factors for the development of SCFN are perinatal asphyxia and hypothermia. Presented here is a case of a newborn who developed SCFN in association with polycythemia and hypocalcemia following treatment by passive cooling. Neonates who undergo passive or whole body cooling therapy should be closely monitored for any signs of SCFN.
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PMID:A neonate with subcutaneous fat necrosis after passive cooling: does polycythemia have an effect? 2393 11

Intrauterine growth restriction (IUGR) is associated with various prenatal risks and postnatal adverse outcomes. The aim of this study is to choose the most sensitive newborn anthropometric measure, which is closely associated with IUGR-related risks and outcomes, to substitute IUGR after delivery. Data were obtained from the Collaborative Perinatal Project, a multicenter prospective cohort study in the United States from 1959 to 1976. Maternal heavy smoking and severe hypertensive disorders during pregnancy, neonatal polycythemia and hypothermia, low intelligence quotient (<70) at age 7 years were chosen as IUGR-related risks and outcomes. Eight anthropometric measures at birth were tested by logistic regression model. Birth weight-to-head circumference (W/HC) had the largest odds ratio (OR) for neonatal polycythemia (OR = 1.8, 95% confidence interval [CI] = 1.5-2.0), severe hypertensive disorders (OR = 1.9, 95% CI = 1.5-2.2), and maternal heavy smoking (OR = 1.9, 95% CI = 1.7-2.1) during pregnancy. It also had the highest summary OR (9.3). Thus, W/HC may be a good measure for IUGR.
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PMID:Choosing the Best Newborn Anthropometric Measure Associated With the Risks and Outcomes of Intrauterine Growth Restriction. 2585 88

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.
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PMID:Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. 2744 Oct 6


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