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

Septic episodes in thermal injuries are usually hallmarked by a series of physiologic parameters that include tachypnea, prolonged paralytic ileus, hyperthermia or hypothermia, altered mental status, thrombocytopenia, leukocytosis or unexplained leukopenia, acidosis, and hyperglycemia. Recent studies with polycystic kidney disease have clearly indicated that the limulus amebocyte lysate (LAL) assays were predictive of fungal infections in this patient population. Because both bacteria and fungi produce lipopolysaccharide that can be identified with the LAL assay, we randomly assayed sequential sera of 45 patients with major thermal injuries for positivity in the LAL assay, with use of the QCL-1000 kit (BioWhittaker, Walkersville, Md). The average burn size of this patient population was 63.43% total body surface area. The average age of the patient was 6.2 years. The sex distribution included 30 males and 15 females. The infectious agents included gram-positive cocci and gram-negative rods, and 14 patients had concomitant fungal infections. Eighty-five percent of the patients tested were positive for endotoxin, with levels ranging from < 0.1 EU/mL to > 1.0 EU/mL. The predominant organism isolated before or on the date the serum was drawn was Pseudomonas aeruginosa (51%), followed by Klebsiella pneumoniae (15%). The remaining 34% were a variety of Enterobacteriaceae. Of the 14 patients who yielded a fungus, 3 had negative LAL assays. Two patients with an elevated LAL grew only Staphylococcus epidermidis in the bloodstream and the wounds. These data clearly indicate that the LAL assay cannot be relied on as the sole predictor of septic episodes; however, it can be an adjunctive test to confirm sepsis when the other parameters have been considered.
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PMID:Is the limulus amebocyte lysate the sole predictor of septic episodes in major thermal injuries? 984 41

(1) We measured cooling rate for neonatal mink during a 10min coldroom (3.9 degrees C) exposure and subsequent warming rate during a 20min incubator (37.2 degrees C) exposure, the behaviour of the kits and the changes in their pelage between 1 and 46d of age, in an attempt to monitor the ontogeny of their thermoregulatory capacity. (2) Body weight of the 1d old kits averaged only 12.8+/-2.3g (n=4), but they gained weight rapidly reaching 226.1+/-28.3g (males, n=4) and 207.6+/-16.1g (females, n=4) at 30-31d of age, and 562.3+/-43.2g (males, n=3) and 435.7+/-35.5g (females, n=4) at 45-46d of age. (3) Body cooling rate (C(rate) ( degrees C/min); n=80) was affected by the age (between 1 and 31d), BW, initial rectal temperature (T(r0)), and sex of the kits, in addition to their body posture (P(cold), 1=extended, 2=curled-up) during coldroom exposure. C(rate) ( degrees C/min)=-0.34-0.02age-0.002BW+0.05T(r0)-0.06sex-0.20P(cold) (R(2)=0.75). (4) Body warming rate (W(rate) ( degrees C/min); n=80) was influenced by the age(2) and rectal temperature of the kit after the coldroom exposure (T(r10)). W(rate)( degrees C/min)=1.24+0.0002age(2)-0.04T(r10) (R(2)=0.76). (5) Kit fur fibre length increased from 5.45+/-0.63mm (males, n=2) and 6.20+/-0.20mm (females, n=3) at 22-23d of age to 9.43+/-1.44mm (males, n=4) and 8.70+/-1.89mm (females, n=4) at 30-31d of age, and to 12.93+/-0.47mm (males, n=3) and 11.38+/-0.41mm (females, n=4) at 45-46d of age, the growth averaging about 0.26mm per day. (6) Under normal circumstances newborn mink kits are hypothermic.Their thermoregulation develops only gradually and is dependent on increase in body mass, insulation and behavioural thermoregulation. Their strategy of survival is based on the ability to withstand hypothermia and on the nutrition and warmth provided by the dam.
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PMID:Observations on thermoregulatory ontogeny of mink (Mustela vison). 1107 Mar 39

In mink (Mustela vison) kits newborn mortality is very high. One of the major causes of death is hypothermia. The objectives of this study were to observe the development of thermoregulation in mink kits, and their ability to maintain their body temperature during the postnatal period (1-50 days of age). Based on the kit's body weight (BW), and rectal and ambient temperature measurements during cold (+4 degrees C) and warm (+40 degrees C) exposures, a homeothermy index (HI) and cooling and warming rates were calculated. No significant differences in the body temperatures were found between the kits and the dam after 36 days of age. The kits were able to maintain homeothermy by 22 days of age (HI 90%). The body cooling rate was 0.88+/-0.04 degrees C min(-1) on day 1 but only 0.35+/-0.03 degrees C min(-1) at 22 days of age. The body WR was lower: day 1, 0.85+/-0.04 degrees C min(-1) and 0.22+/-0.03 degrees C min(-1) at 22 days of age. All measured and calculated thermophysiological variables were significantly influenced by BW and age of the kit.
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PMID:The development of homeothermy in mink (Mustela vison). 1512 6

Limited medical training of mountain rescuers may adversely affect the outcome of casualties. Thus, this study evaluated medical training of mountain rescuers in countries associated with the International Commission of Mountain Emergency Medicine. A questionnaire was completed by 33 mountain rescue services from 18 countries in America and Europe. First-aid topics taught most often are (absolute values, percentage): chest compression, hypothermia, cold injuries (32 of 33 organization 97%); avalanche rescue, first-aid kit of rescuer, cervical collar (31, 94%); hemorrhagic shock, automated blood pressure measurement, wound dressing (30, 91%); and heat injuries and SAM SPLINT (29, 88%). Cardiopulmonary resuscitation manikins are used in 32 (97%) organizations, and in 17 (52%) organizations manikins have feedback functionality. After training, exams are compulsory in 27 (83%) organizations. Yearly retraining is done in 12 (36%) organizations; 22 (67%) organizations would like to increase medical training. The study shows high variability in the medical training programs among the surveyed organizations and the need to improve medical education. The authors recommend standardization of medical training and examinations on an international level. Additional topics tailored to the typical injury and illness patterns of a particular area should supplement this core training. Training should be performed by highly qualified instructors on a yearly basis.
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PMID:Current status of medical training in mountain rescue in America and Europe. 1955 98

The Blood Far Forward (BFF) research program was established to conduct blood product efficacy and safety studies, donor performance studies, and research on optimal training methods to improve the safety of blood collection and transfusion performed by Norwegian Naval Special Operation Commando soldiers. The use of intravenous fluids for volume replacement during hemorrhagic shock is controversial, but it is currently the standard of care. In the far-forward environment, large volume resuscitation for massive bleeding is a great challenge. Crystalloid and colloid solutions add weight and bulk to the medic's kit, require temperature sensitive storage, and should be warmed before infusion to prevent hypothermia. Excessive use of these solutions causes a dilutional coagulopathy, acidosis, and potentially increased inflammatory injury compared with blood products. Type-specific whole blood from an uninjured combat companion on the other hand is almost always available. It is warm, replaces intravascular volume, and provides oxygen delivery and hemostatic capacity to prevent or treat shock and coagulopathy. Whole blood may be ideal for the resuscitation of combat casualties with hemorrhagic shock. BFF program pilot studies on use of platelet-sparing leukoreduction filters, whole blood transport tolerance, donor performance, and autologous reinfusion of 24-hour ambient temperature stored whole blood have been performed and suggest the feasibility of expanding whole blood use in resuscitation. If successful, the BFF program will change tactics, techniques, and procedures with a new lifesaving capability.
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PMID:Blood Far Forward--a whole blood research and training program for austere environments. 2330 64

To investigate the effect of deep hypothermic circulatory arrest (DHCA) on the expression of a CD34(+)/C-kit(+) progenitor cell population in peripheral blood in infants. The expression of CD34(+)/C-kit(+) stem cells in peripheral blood of 10 patients after DHCA was measured before institution of cardiopulmonary bypass (CPB) (T0), at 12-24 hours (T1) and 4-5 days (T2) after cessation of CPB, respectively. The level of CD34(+)/C-kit(+) stem cells in peripheral blood was significantly higher in the DHCA group at T1 and T2 (p<0.01). Our data show that DHCA may cause the increase of CD34(+)/C-kit(+) stem cells in peripheral blood after surgery. The role of increase of CD34(+)/C-kit(+) stem cells in peripheral blood on the beneficial effects of DHCA needs to be studied.
Ther Hypothermia Temp Manag 2013 Sep
PMID:The Expression of CD34(+)/C-kit(+) Stem Cells in Peripheral Blood in Infants After Deep Hypothermia Circulatory Arrest. 2483 42

We investigated the effects of nest box climate on early mink kit mortality and growth. We hypothesised that litters in warm nest boxes experience less hypothermia-induced mortality and higher growth rates during the 1st week of life. This study included data from 749, 1-year-old breeding dams with access to nesting materials. Kits were weighed on days 1 and 7, dead kits were collected daily from birth until day 7 after birth, and nest climate was measured continuously from days 1 to 6. We tested the influences of the following daily temperature (T) and humidity (H) parameters on the number of live-born kit deaths and kit growth: T mean, T min, T max, T var (fluctuation) and H mean. The nest microclimate experienced by the kits was buffered against the ambient climate, with higher temperatures and reduced climate fluctuation. Most (77.0%) live-born kit deaths in the 1st week occurred on days 0 and 1. Seven of 15 climate parameters on days 1 to 3 had significant effects on live-born kit mortality. However, conflicting effects among days, marginal effects and late effects indicated that climate was not the primary cause of kit mortality. Five of 30 climate parameters had significant effects on kit growth. Few and conflicting effects indicated that the climate effect on growth was negligible. One exception was that large nest temperature fluctuations on day 1 were associated with reduced deaths of live-born kit (P<0.001) and increased kit growth (P=0.003). Litter size affected kit vitality; larger total litter size at birth was associated with greater risks of kit death (P<0.001) and reduced growth (P<0.001). The number of living kits in litters had the opposite effect, as kits in large liveborn litters had a reduced risk of death (P<0.001) and those with large mean litter size on days 1 to 7 had increased growth (P=0.026). Nest box temperature had little effect on early kit survival and growth, which could be due to dams' additional maternal behaviour. Therefore, we cannot confirm that temperature is the primary reason for kit mortality, under the conditions of plenty straw access for maternal nest building. Instead, prenatal and/or parturient litter size is the primary factor influencing early kit vitality. The results indicate that the focus should be on litter size and dam welfare around the times of gestation and birth to increase early kit survival in farmed mink.
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PMID:Early kit mortality and growth in farmed mink are affected by litter size rather than nest climate. 2821 1

For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients. The HPMK is ideal for those working in civilian Emergency Medical Services and austere prehospital care environments. This kit is a low cost, lightweight, small dimension commercial product that can provide effective passive management or active rewarming for both accidental (primary) and trauma-induced (secondary) hypothermia patients.
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PMID:Battlefield Trauma-Induced Hypothermia: Transitioning the Preferred Method of Casualty Rewarming. 2893 73

Hypothermia is a common problem encountered by search and rescue teams. Although mildly hypothermic patients can be rewarmed in the field and can then self-evacuate, the Wilderness Medical Society hypothermia guidelines suggest that a moderately hypothermic patient in the wilderness requires warming in a medical facility. The hypothermia prevention and management kit, developed by the US military, consists of a chemical heat blanket (CHB) and a heat-reflective shell. We present a case in which a hypothermia wrap and the CHB from a hypothermia prevention and management kit were used successfully to rewarm a patient with apparent moderate hypothermia in the field. We are unaware of previous reports of successful field rewarming of a patient with moderate hypothermia. We believe the use of the CHB in conjunction with a hypothermia wrap made field rewarming possible. We recommend that a CHB, along with the components of a hypothermia wrap, be carried by search and rescue teams when a hypothermic patient might be encountered. Although there were no documented core temperatures, we believe this case is consistent with the hypothesis that if a hypothermic patient who is found lying down and shivering is allowed to stand or walk before insulation is applied and before there has been an additional period of 30 min during which the patient continues to shiver, there may be increased afterdrop with deleterious results.
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PMID:Successful Field Rewarming of a Patient with Apparent Moderate Hypothermia Using a Hypothermia Wrap and a Chemical Heat Blanket. 3082 66

Ischemia/reperfusion-derived myocardial dysfunction is a common clinical scenario in patients after cardiac surgery. In particular, the sensitivity of cardiomyocytes to ischemic injury is higher than that of other cell populations. At present, hypothermia affords considerable protection against an expected ischemic insult. However, investigations into complex hypothermia-induced molecular changes remain limited. Therefore, it is essential to identify a culture condition similar to in vivo conditions that can induce damage similar to that observed in the clinical condition in a reproducible manner. To mimic ischemia-like conditions in vitro, the cells in these models were treated by oxygen/glucose deprivation (OGD). In addition, we applied a standard time-temperature protocol used during cardiac surgery. Furthermore, we propose an approach to use a simple but comprehensive method for the quantitative analysis of myocardial injury. Apoptosis and expression levels of apoptosis-associated proteins were assessed by flow cytometry and using an ELISA kit. In this model, we tested a hypothesis regarding the effects of different temperature conditions on cardiomyocyte apoptosis in vitro. The reliability of this model depends on strict temperature control, controllable experimental procedures, and stable experimental results. Additionally, this model can be used to study the molecular mechanism of hypothermic cardioprotection, which may have important implications for the development of complementary therapies for use with hypothermia.
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PMID:In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model. 3319 22


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