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

The influence of phenobarbitone anaesthesia on cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRo2) during hypothermia (23 degrees C & 27 degrees C) was studied in the rat, using a modification of the Kety & Schmidt (1948) technique and arterio-venous differences for oxygen. Phenobarbitone (150 mg/kg) was found to decrease CMRo2 by 40-60% during hypothermia, when compared to N2O anaesthesia. At a body temperature of 23 degrees C, and during phenobarbitone anaesthesia, CMRo2 was reduced to about 15% of normal control value (about 10.3 ml.100g-1). CBF was reduced to about 50% of the phenobarbitone control value but was similar to the value obtained with N2O anaesthesia at 22 degrees C. It is concluded that the combination of phenobarbitone anaesthesia and hypothermia results in a more pronounced reduction in cerebral metablic rate for oxygen than can be achieved by administration of barbiturates to normothermic animals, or by reducing body temperature by 15 degrees C during superficial anaesthesia.
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PMID:Reduction of cerebral blood flow and oxygen consumption with a combination of barbiturate anaesthesia and induced hypothermia in the rat. 63 8

To permit utilization of the Kety-Schmidt technique for measuring cerebral blood flow during hypothermia, the brain-blood partition coefficients for 85krypton at 37 C and 29.5 C were determined in a series of cats. At 37 C the partition coefficient for 85krypton was 1.092 +/- 0.009; it was 0.931 +/- 0.007 (SE) at 29.5 C. These values were significantly different from each other (P less than .001).
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PMID:Brain-blood partition coefficients of 85Krypton at 37 C and 29.5 C. 126 9

Therapies including hyperventilation (HV) and hypothermia (HT) are currently simultaneously used in brain-injured children at risk for cerebral swelling to reduce cerebral blood flow (CBF) and alter cerebral metabolic rate for oxygen (CMRO2). Since HV and HT may contribute to significant patient morbidity, we evaluated the effects of these treatments in combination on CBF, CMRO2, and cross-brain oxygen extraction (CBO2) using the Kety-Schmidt technique before controlled bleeding to alter blood viscosity in 20 lightly anesthetized, paralyzed cats, and after bleeding in another 17 cats. The degree of HV (PaCO2 24 to 26 torr) and HT (32 degrees and 30 degrees C) used were representative of that employed in pediatric neurointensive care. HV at normothermia resulted in a significant decline in CBF (P less than .05) and an unchanged CMRO2. HV and HT together to 32 degrees C resulted in a further significant fall in CBF and CMRO2 (p less than .05), but an unchanged CBO2. Further cooling of the animal to 30 degrees C during HV, both before and after controlled bleeding, resulted in no further significant fall in CBF, CBO2, or CMRO2. This relationship was found despite a significant fall in Hgb (p less than .001), suggesting that blood viscosity did not significantly influence CBF at this temperature. Our data suggest that HT to 32 degrees C during HV may have therapeutic benefit by decreasing CBF and CMRO2, but further cooling to 30 degrees C may not result in further cerebral protective effects.
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PMID:Effects of hyperventilation, hypothermia, and altered blood viscosity on cerebral blood flow, cross-brain oxygen extraction, and cerebral metabolic rate for oxygen in cats. 276 65

This study examines the relationship between core temperature and whole body energy expenditure, cerebral oxygen consumption (CMRO2), cerebral blood flow (CBF), and intracranial pressure (ICP) in severely head injured children. A total of 107 serial measurements of temperature, energy expenditure, CMRO2, CBF, and ICP were made in 18 head injured children receiving neurointensive care. Energy expenditure was measured using indirect calorimetry, and CMRO2 and CBF using the Kety-Schmidt technique. The mean rectal temperature was 37.8 degrees C (34-39.1 degrees C) despite modification with paracetamol. Within each child there was a positive relationship between rectal temperature and energy expenditure, energy expenditure increasing by a mean of 7.4% per degree C. There was no evidence of significant relationships between rectal temperature and CMRO2, CBF, or ICP. Mild induced hypothermia in two children did not result in decreased CMRO2 or CBF measurements. The efficacy of interventions aiming to modify cerebral energy metabolism by changing core temperature cannot be readily assessed by the response of the whole body.
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PMID:Temperature response to severe head injury and the effect on body energy expenditure and cerebral oxygen consumption. 761 35

This study simultaneously compared the standard Kety-Schmidt and the modified xenon-133 (133Xe) clearance techniques for measuring cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) during cardiac operations. The validity of the CBF method is important because our management of the patient during cardiopulmonary bypass (CPB) is based, in part, on our understanding of the cerebral hemodynamics during CPB. In 20 patients undergoing coronary artery bypass grafting, CBF and CMRO2 were determined by both methods. Measurements were made before onset of CPB and once during CPB. Ten patients underwent CPB with systemic normothermia (37 degrees C) and 10 with systemic hypothermia (27 degrees C). Anesthesia consisted of fentanyl and midazolam. CPB pump flows were kept at 2.2 to 2.4 L.min-1.m-2 and alpha-stat pH management was used. Xenon-133 clearance significantly underestimated CBF and CMRO2 relative to the Kety-Schmidt technique before CPB and at both bypass temperatures. Values obtained by 133Xe clearance were approximately 50% of that measured by the Kety-Schmidt method. The modified 133Xe technique as typically used during cardiac operations does not appear to measure CBF accurately; this leads to corresponding errors in CMRO2 calculations. Determination of CMRO2 and cerebral autoregulatory function during cardiac operations appears to be more appropriate if based on the more direct Kety-Schmidt technique. Accordingly, our management of CPB with respect to cerebral perfusion as it has been determined by the modified 133Xe clearance method may require reassessment.
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PMID:Cerebral blood flow during cardiac operations: comparison of Kety-Schmidt and xenon-133 clearance methods. 788 88

Cor triatriatum is uncommon in all congenital heart diseases. It is a malformation resulting in a separation of the left atrium or right atrium into two chambers due to a congenitally abnormal diaphragm. We wish to present a case of cor triatriatum in which MRI was found most useful for preoperative diagnosis and surgical procedure. A 2-year-old girl was transferred to us for severe pulmonary congestion as shown on chest X-ray. Echocardiography showed abnormal diaphragm in the left atrium. MRI demonstrated clearly the relationship between left pulmonary vein and the abnormal diaphragm. Therefore we should preoperatively determine type I A according to the Lucas and Schmidt's classification. Cardiac catheterization showed moderate pulmonary hypertension and confirmed cor triatriatum. The resection of the abnormal diaphragm was performed under extracorporeal circulation with moderate hypothermia. The postoperative course was uneventful. MRI is a very useful non-invasive technique in making a diagnosis and in choosing the appropriate surgical procedure for cor triatriatum.
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PMID:[A case report of cor triatriatum benefit of MRI for preoperative diagnosis and surgical method]. 823 Sep 35