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

Although cardiopulmonary bypass (CPB) with hypothermia and circulatory arrest is routinely used for certain cardiovascular procedures, its advantages have infrequently been applied for other unusual surgical problems. Fourteen patients (six men and eight women, average age 48 years, range 29 to 74 years) underwent 15 operations over a 4-year period beginning in November 1978. Preoperative diagnosis included giant middle cerebral aneurysm (n = 8), internal carotid aneurysm (3), basilar artery aneurysm (2), and medullary hemangioblastoma (2). All patients had lesions that were considered inoperable by standard neurosurgical techniques. Operative technique consisted of peripheral cannulation with a long and short femoral vein cannula for venous return (24 to 28F) and a single femoral arterial cannula (18 to 24F). CPB flows ranged from 1 to 3.5 L/min, and the total CBP times averaged 146 minutes (range 66 to 282 minutes). Circulatory arrest times averaged 21 minutes (range 5 to 51 minutes), with two patients having no period of circulatory arrest. Lowest core temperature ranged from 16 degrees to 20 degrees C, with cooling and rewarming aided by Brown-Harrison heat exchangers placed in a countercurrent fashion within the venous return line. The heart spontaneously defibrillated in six patients, and external countershock was required in nine patients. No difficulty was encountered with cardiac distention. The intended operation was accomplished in all cases with 13 of 14 patients being discharged from hospital, having had a good neurosurgical result. One patient sustained a hemorrhagic infarction of the cerebellum and pons and is presently recovering. Our experience indicates that peripheral CPB with induced hypothermia and circulatory arrest is a safe technique for approaching otherwise inoperable neurosurgical lesions.
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PMID:Reappraisal of cardiopulmonary bypass with deep hypothermia and circulatory arrest for complex neurosurgical operations. 687 41

Many invertebrates and ectothermic vertebrates successfully cope with a fluctuating supply of ambient oxygen-and consequently, a highly variable tissue oxygenation-through increasing their antioxidant barriers. During chronic deprivation of oxygen, however, the hypometabolic defense mode of the fruit fly Drosophila, the hypoxia-induced behavioral hypothermia of the crayfish Pacifastacus leniusculus, and the production of ethanol during anoxia by the crucian carp Carassius carassius all indicate that these animals are also capable of utilizing a suite of genetic and physiological defenses to survive otherwise lethal reductions in tissue oxygenation. Normally, much of an organism's gene response to hypoxia is orchestrated via the hypoxia-inducible transcription factor HIF. Recent developments expand our view of HIF function even further by highlighting regulatory roles for HIF in the hypometabolism of insects, in the molting and the normoxic immune response of crustaceans, and in the control-via the downstream effector gene erythropoietin-of the hypoxic ventilatory response and pulmonary hypertension in mammals. These and related topics were collectively presented by the authors in a symposium of the 2008 ICA-CBP conference at Mara National Reserve, Kenya, Africa. This synthesis article communicates the essence of the symposium presentations to the wider community.
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PMID:Hypoxia tolerance in animals: biology and application. 2056 33

There is potential for heat loss and hypothermia during anesthesia and also for hyperthermia if heat conservation and active warming measures are not accurately titrated. Accurate temperature monitoring is particularly important in procedures in which the patient is actively cooled and then rewarmed such as during cardiopulmonary bypass surgery (CPB). We simultaneously measured core, nasopharyngeal, and brachial artery temperatures to investigate the last named as a potential peripheral temperature monitoring site. Ten patients undergoing hypothermic CPB were instrumented for simultaneous monitoring of temperatures in the pulmonary artery (PA), aortic arterial inflow (AI), nasopharynx (NP), and brachial artery (BA). Core temperature was defined as PA temperature before and after CPB and the AI temperature during CPB. Mean deviations of BA and NP temperatures from core temperature were calculated for three steady-state periods (before, during, and after CPB). Mean deviation of BA and NP temperatures from AI temperature was also calculated during active rewarming. A total of 1862 measurements were obtained and logged from eight patients. Mean BA and NP deviations from core temperature across the steady-state periods (before, during, and after CBP) were, respectively: .23 +/- .25, -.26 +/- .3, and -.09 +/- .05 degrees C (BA), and .11 +/- .19, -.1 +/- .47, and -.04 +/- .3 degrees C (NP). During steady-state periods, there was no evidence of a difference between the mean BA and NP deviation. During active rewarming, the mean difference between the BA and AI temperatures was .14 +/- .36 degrees C. During this period, NP temperature lagged behind AI and BA temperatures by up to 41 minutes and was up to 5.3 degres C lower than BA (mean difference between BA and NP temperatures was 1.22 +/- .58 degrees C). The BA temperature is an adequate surrogate for core temperature. It also accurately tracks the changing AI temperature during rewarming and is therefore potentially useful in detecting a hyperthermic perfusate, which might cause cerebral hyperthermia.
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PMID:Brachial arterial temperature as an indicator of core temperature: proof of concept and potential applications. 2393 Mar 77