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

A nationwide survey of institutions in the United States that perform congenital heart disease surgery was conducted to obtain an overview of the current use of myocardial protection in pediatric patients (aged 0-16 years). One hundred and one (55%) of 183 institutions responded, completing a 4-page questionnaire about pediatric cases in 1989. A total of 12,072 cases were represented. Caseloads ranged from 7 to 498 at these institutions (mean 124, median 30). Cardioplegia was used by 100 institutions (44 blood, 45 crystalloid, 11 both). Administration was guided by formulas alone in 69 and by clinical criteria alone in 32. A wide variety of compositions of cardioplegic solutions was found with no preference for any particular type. No correlation between caseloads and cardioplegic solutions was found. Hypothermia was used by all institutions, with a mean of 25.8 +/- 3.5 degrees C for a simple ventricular septal defect closure. Deep hypothermia and circulatory arrest were used in 3048 cases (25.2%). A clear trend indicated that circulatory arrest was used more frequently in larger institutions (p less than 0.0001). Fibrillation as a strategy was used in 45 institutions. Twenty-five institutions changed cardioplegia technique during 1989. The findings suggest that, even though no consensus exists about its ideal composition, cardioplegia in conjunction with hypothermia is currently the strategy most often used for pediatric myocardial protection.
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PMID:Pediatric myocardial protection in the United States: a survey of current clinical practice. 141 97

Cyclopiazonic acid (CPA) was found to have many pharmacological properties in common with the antipsychotic drugs chlorpromazine and reserpine. Thus, in mice CPA at ip doses of 5-14 mg/kg body weight produced hypokinesia, hypothermia, catalepsy, ptosis, sedation without loss of righting reflex, tremor, gait disturbance, dyspnoea, opisthotonus, atypical convulsion and prolonged barbiturate-induced sleep. The ip LD50 of CPA was found to be 13 +/- 0.05 mg/kg. The tremors induced by near-lethal doses of CPA were associated with voluntary or forced movements (action tremors); they worsened during the days following treatment, but they were weak compared with the exhausting and continuous tremors of the whole body caused by 20 mg tremorine/kg (used for comparison). When death occurred only 24-259 min after administration of CPA (11-14 mg/kg), it was preceded by dypsnoea, cyanosis, opisthotonus and clonic leg movements and tonic extension of hind legs (convulsions). When death was delayed (2-6 days after CPA administration), it was preceded by prostration, ptosis, hypothermia, tremor and cessation of food and water intake resulting in cachexia; convulsions were not seen in this group of mice. CPA did not affect the rate of convulsion or death caused by either maximal electroshock or metrazol administration but it did delay the onset of metrazol-induced seizures. In rabbits, 10 mg CPA/kg body weight initially produced tachycardia, tachypnoea and sedation with an activated electroencephalogram. Of three rabbits given 10 mg CPA/kg one died, and in this rabbit slow delta waves were seen just before and during a brief period with clonic leg movements. In this animal death was accompanied by tonic extension of the hind legs, respiratory arrest and cardiac fibrillation; and epileptiform EEG was not seen at any time. The unexpected EEG activation with sedation in rabbits treated with CPA was similar to the effect of reserpine on EEG.
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PMID:Toxicity and neuropharmacology of cyclopiazonic acid. 404 83

Hypothermia and rewarming are associated with an increased incidence of lethal arrhythmias in man. The relationship between reduction in body temperature and ventricular fibrillation threshold was studied in 7 pentobarbital anaesthetized dogs using programmable electrical stimulation while cooling and rewarming between 37 degrees C and 25 degrees C in steps of 3 degrees C. Fibrillation threshold was defined as the number of extrastimuli required to evoke ventricular fibrillation. QRS-durations and corrected QT-intervals (QTc) were measured from surface electrocardiograms. Monophasic action potential durations were recorded from the base and apex of the heart. Fibrillation threshold decreased with decreasing temperatures; e.g., at 37 degrees C ventricular fibrillation was not inducible after 5 extrastimuli, while at 25 degrees C only 2 extrastimuli were required. From 37 degrees C to 25 degrees C QRS-width, monophasic action potential durations and QTc increased while conduction velocity decreased. The differential effects on conduction and monophasic action potential duration provide a basis for induction of ventricular fibrillation during acute hypothermia. This model of hypothermia-induced ventricular fibrillation should prove useful for future studies aimed at understanding the mechanisms responsible for hypothermia-related deaths.
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PMID:Changes in ventricular fibrillation threshold during acute hypothermia. A model for future studies. 866 48

Mild hypothermia (32-34 deg C) treatment alleviates vital organ damage after cardiac arrest. A new cooling device, the Thermosuit operates by applying of a thin layer of water directly to the body surface. Hypothermic patients may experience sequential fibrillation. Therefore, we examined whether defibrillation could be administered safely and effectively in water. A 35 kg swine was anesthetized and placed inside the Thermosuit system. This consists of a water containing surround and pumping system. Conventional AED disposable defibrillation electrodes were applied to the animal's chest. Fibrillation was created by applying a 50-volt signal to a pacing wire introduced into the heart. Following a 30-second period of fibrillation, defibrillation was attempted using Medtronic AED 1000 defibrillator. Defibrillation voltage and current were measured. There were three test cases: dry in the system, wet in the functioning system, and damp. Cooling water in the system was contaminated with saline to simulate potential conditions in clinical application. In each fibrillation-defibrillation sequence, the heart was restarted successfully; this required less than 220 joules. Only a small difference was measured in the overall defibrillation voltage and current as applied to the electrodes for the different cases. Thus, underwater defibrillation is safe and can be performed effectively.
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PMID:Successful defibrillation in water: a preliminary study. 1794 19