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

Blood has particular rheological properties which partly condition its flow, especially in capillary vessels, and its ability to deliver oxygen. It is not subject to gravitation, pseudoplastic, thixotropic and visco-elastic. Blood viscosity depends upon macroscopic factors, such as erythrocyte aggregation and deformability. Hyperviscosity is observed in cases of increased haematocrit (polycythaemia and relative polycythaemia), increased serum proteins and changes in protein balance (e.g. rise in fibrinogen and immunoglobulins, fall in albumin) as seen in inflammation and dysglobulinaemia, drop in temperature (hypothermia), increased erythrocyte aggregation (shock, fat embolism) or imparied deformability due to various acquired or inherited disorders of red cell membrane or cytoplasma (e.g. sickle cell anaemia, renal failure, hyperlipoproteinaemias, thrombosis, diabetes). The various factors may be combined, as in diabetes. Conversely, hypoviscosity may result from decreased haematocrite, fall in blood proteins and fibrinogen, or hyperthermia. Hyperviscosity can be corrected by acting on its various constituents. Treatments include haemodilution, plasmapheresis, anti-aggregants and drugs improving red cell deformability.
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PMID:[Blood viscosity. Measurement and applications (hyper--and hypoviscosity syndromes) (author's transl)]. 723 52

In four infants of primiparous mothers, critical dehydration, hypothermia, and azotemia developed while they were being breast-fed exclusively. Three had significant hypernatremia, one had a perforated duodenal ulcer, and one had transient renal failure. Although the causes of the inadequate nutrition are unclear, these cases emphasize the necessity of close follow-up for breast-fed babies, especially those of primiparous mothers and those in whom there has been excessive weight loss while in the hospital.
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PMID:Critical weight loss and malnutrition in breast-fed infants. 724 85

Cardiovascular failure (shock) associated with acute alcohol ingestion and severe hypothermia (core temperature 23 and 21 degrees C) was studied in 2 patients. In each case, perfusion failure was associated with lactacidemia, severe bradycardia, and agonal respirations. Infusion of fluids and mechanical ventilation reversed shock and prevented a fatal outcome. One case, complicated by renal failure and volume overload with pulmonary edema, was managed with peritoneal dialysis. These findings suggest that perfusion failure associated with severe accidental hypothermia after acute alcohol ingestion is due to a combination of hypovolemia, bradycardia, and respiratory depression.
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PMID:Shock due to profound hypothermia and alcohol ingestion: report of two cases. 727 11

The high mortality of open-heart operations in infants with congenital heart disease has traditionally led to deferral of definitive operation and to use of medical therapy or palliative procedures. The technique of deep hypothermia with circulatory arrest and advances in intensive care have made early repair possible. Since 1973, we have repaired life-threatening but correctable lesions in 11 infants in the first week of life. There are 7 survivors. Four patients had total anomalous pulmonary venous drainage, 2 had truncus arteriosus (1 with aortic arch interruption), and 1 each had pulmonary atresia and intact ventricular septum, critical pulmonary stenosis and intact ventricular septum, D-transposition of the great vessels, tetralogy of Fallot, and left ventricular-aortic tunnel. Postoperative hypoglycemia (less than 50 mg per 100 ml) developed in 4 patients and hypocalcemia (less than 7 mg per 100 ml), in 5. These problems responded appropriately to replacement therapy. Three of the survivors experienced renal failure, a complication subsequently prevented by use of mild hemodilution perfusion. Two patients had major bleeding, which now is prevented by finer suturing and administration of vitamin K and platelets. One infant, moribund with pH of 6.8 when brought to operation, sustained a cardiac arrest with subsequent brain damage. We conclude that newborns with life-threatening malformations can undergo successful repair. Attention must be paid to their unique metabolic demands, and surgical technique must be meticulous. Early operation before clinical deterioration is essential.
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PMID:Open-heart surgery in the first week of life. 735 63

Family physicians can help prevent spinal cord injuries by patient education about alcohol, drugs, seat belts, and football safety rules. Immobilization at the site of injury is essential to prevent incomplete cord injuries from becoming complete. Treatment is urgent; hemorrhagic necrosis of the cord is reversible only up to four hours after injury. Physicians must inform patients and families that regional spinal injuries centers provide the best care, with lowest total costs, and shortest hospital stay. Initial treatment includes immobilization, with or without surgery, prophylactic anticoagulants, and sometimes steroids and local hypothermia. Intermittent catheterization has revolutionized bladder control and reduced the incidence of infections. The most common causes of death are renal failure and pulmonary complications, sitting stability, strengthening non-paralyzed muscles, and providing equipment for maximum function. Psychologists, who work with families as well as patients in developing coping strategies, are important members of rehabilitation teams. Seventy percent of paraplegics return to the community within six months of injury, and nearly 50 percent achieve satisfactory sexual activity.
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PMID:Management of spinal cord injury. 746 33

Inferior vena cava (IVC) thrombosis or obstruction is a complication rarely associated with blunt trauma. We present a case of IVC thrombo-occlusive lesion with both hepatic and renal failure which developed after a thoracoabdominal blunt trauma. Direct thrombectomy and patch cavoplasty were successfully carried out under deep hypothermia using cardiopulmonary bypass.
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PMID:Acute Budd-Chiari syndrome due to inferior vena cava occlusion following blunt trauma. 750 90

Cold agglutinins are commonly found in sera of healthy persons. They rarely become clinically apparent due to their activity at low temperatures. In these patients, cardiovascular operations requiring hypothermia can result in complications such as hemolysis, renal failure, and myocardial damage and can cause unexpected morbidity and mortality. The literature on cold-reactive proteins is reviewed, and methods of diagnosis and management related to cardiac surgery are suggested. Ideally all patients should be routinely tested preoperatively for the antibodies, and appropriate changes in cardiopulmonary bypass and myocardial management plans should be made in positive patients. Preoperative plasmapheresis may be a useful adjunct, especially in patients requiring operation under profound hypothermia and circulatory arrest. Currently, warm heart surgery appears to be the most expedient method. Unexpected detection of agglutination during operation or hemolysis after operation requires a specific treatment plan.
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PMID:Cardiac surgery and cold-reactive proteins. 757 76

Hypothermia in the elderly is a medical emergency with mortality varying from 32-80%. Its most frequent predisposing factors, as reported in the current literature, are extremes of age, cold environment and alcoholism. In the Negev (southern region of Israel, mostly desert area) the mean temperature range during November-March is 9.6 to 15.2 degrees C and during April-October, 16-25.9 degrees C. The records of all patients with hypothermia, aged 65 and above admitted over a 5-year period (1984-1988) were reviewed (44 admissions of 39 patients of whom 23 were females). 34 were admitted during the winter months and 10 during the rest of the year. Important associated or predisposing conditions included infections in 54.5%, renal failure in 29.5% and diabetes mellitus in 29.5%. Alcoholism (13.6%) was relatively infrequent. Those of Asian or African origin appeared to be at greater risk, constituting 73% of admissions, but only 47% of the elderly population of the Negev. The annual incidence of up to 4/1000 of elderly patients admitted to our medical wards, which serve a population of 350000, indicates that hypothermia is not rare in this desert region.
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PMID:[Hypothermia in the elderly in the Negev]. 781 22

Since 1987, 33 patients were operated on for aneurysm of the descending thoracic aorta using temporary bypass with a heparin-coated centrifugal pump and heparin-coated tubes at Kobe University Hospital. Sixteen patients had true aneurysms of the descending thoracic aorta, 7 had thoraco-abdominal aneurysms and 10 had aortic dissection (DeBakey's type III). Heat exchanger and oxygenator were not included in the bypass circuit in all cases. Perfusion time was from 42 to 205 minutes (average 90 minutes). Left heart bypass was established with 1 mg/kg of systemic heparinization in 5, 0.5 mg/kg in 5, and 0 mg/kg in 23 cases. There were no complications such as perioperative embolism, acidosis, or hypothermia. During aortic cross-clamping, the arterial pressure of the lower extremity was maintained over 70 mmHg, but there was no relationship between the distal perfusion pressure and bypass flow. The urine output during temporary bypass was significantly related to the distal perfusion flow by centrifugal pump (r = 0.455, p < 0.01). Seven out of 23 patients who were bypassed under 40 ml/kg/min of distal perfusion flow showed transient renal dysfunction postoperatively, and two developed postoperative renal failure, while the other patients bypassed over 40 ml/kg/min of pump flow stayed in the normal range of the renal function, where there were statistically differences (p < 0.05). Postoperative paresis occurred in 2 patients who were also perfused under 40 ml/kg/min of bypass flow. Therefore, it is concluded that temporary bypass with centrifugal pump is a safe and well acceptable circulatory support in the surgical treatment of aneurysm of the descending aorta.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical study of optimal bypass flow for temporary bypass with centrifugal pump in surgical treatment of aneurysm of the descending thoracic aorta]. 805 20

Since 1987, 33 patients have undergone surgery at Kobe University Hospital for aneurysm of the descending aorta using left heart bypass with a heparin-coated centrifugal pump and heparin-coated tubes. Sixteen patients had true aneurysms of the descending thoracic aorta, 7 had thoracoabdominal aneurysms, and 10 had aortic dissection (DeBakey's Type III). Heat exchangers and oxygenators were not included in the bypass circuit in any of the cases. Perfusion time was from 42 to 205 min (average 90 min). Left heart bypass was established with 1 mg/kg of systemic heparinization in 5 cases, 0.5 mg/kg in 5 cases, and 0 mg/kg in 23 cases. There were no complications such as perioperative embolism, acidosis, or hypothermia. During aortic cross-clamping, the arterial pressure of the lower extremity was maintained above 70 mm Hg, but there was no relationship between the distal perfusion pressure and bypass flow. The urine output during left heart bypass was related to the distal perfusion flow by centrifugal pump. Of 23 patients who underwent bypass with less than 40 ml/kg/min of distal perfusion flow, 7 showed transient renal dysfunction postoperatively, and 1 developed postoperative renal failure. The other patients who were bypassed with over 40 ml/kg/min of pump flow stayed in the normal range of renal function. Postoperative paresis occurred in 2 patients, who were also perfused with less than 40 ml/kg/min of bypass flow. It could be concluded that left heart bypass by centrifugal pump is safe and acceptable as a circulatory support in the surgical treatment of aneurysm of the descending aorta.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical treatment for aneurysms of the descending aorta using temporary perfusion by a centrifugal pump: clinical analysis of 33 cases. 811 57


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