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

The morphological and functional changes of the single kidney were investigated in experiment on 133 dogs after removal of 45--50% of its tissue. Resection of the single kidney under normothermal conditions was established to result in the animal's death within 1--14 days due to acute renal insufficiency. The operation executed under conditions of cooling to 25 degrees C is of high risk. Resection under 5 degrees C hypothermia fails to cause an acute renal insufficiency but considerably disturbs the renal function. The use of local hypothermia to 15 degrees C in resection of the single kidney gives the optimal temperature regimen since it prevents the development of acute renal insufficiency and the compensatory-restorative processes in the kidney can develop successfully.
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PMID:[Optimal local hypothermia regimen in the experimental resection of the single kidney]. 50 7

The clinic of such injuries is characterized by marked local manifestations (solid progressive edema of the injured limb leading frequently to decompensated ischemia) and a high incidence of acute renal insufficiency. Hemostatic disorders are manifested in hyperkalemia, hyponatremia, hypocalcemia, cell-extracell transfer of electrolytes, metabolic disorders in the myocardium, as evidenced by EEG findings. It is the authors' opinion that therapeutic measures should be aimed at liquidation of the progressive edema (hypothermia, fasciotomy), prevention of acute renal insufficiency and correction of metabolic disorders.
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PMID:[Postural crush syndrome]. 101 97

The first 100 liver transplantations at the Mayo Clinic were performed in 83 patients, who required a total of 917 patient days in the intensive-care unit (ICU). The mean duration of stay in the ICU was 5.91 days after liver transplantation and 6.15 days for patients who subsequently required readmission to the ICU. During the immediate postoperative period, hypothermia and hyperglycemia invariably occurred. Later during the initial admission or on readmission to the ICU, there arose the possibility of infections and renal insufficiency. Prompt diagnosis and treatment are necessary for hypertension, hypokalemia, severe metabolic alkalosis, fever, altered mental status, oliguria, and signs of graft failure in liver transplant patients. In our patient series, selective bowel decontamination minimized the occurrence of gram-negative and fungal sepsis, and use of antihypertensive agents and correction of coagulopathies may have decreased the risk of intracranial bleeding in patients with hypertension and clotting defects. Anticipation of potential conditions postoperatively and early implementation of treatment are key factors in the successful ICU management of patients who have undergone liver transplantation.
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PMID:Intensive-care unit experience in the Mayo liver transplantation program: the first 100 cases. 265

Thoracoabdominal aortic aneurysms can be repaired successfully with acceptable rates of morbidity and mortality. Twenty-three men and seven women (an average age of 67 years) underwent 23 elective and seven emergency operations. Pulmonary complications were the most common, but renal insufficiency and paraplegia were the most serious postoperative problems. The average time of suprarenal aortic occlusion was 47 minutes, but neither renal insufficiency nor paraplegia was directly related to suprarenal clamp time. Four deaths occurred after elective procedures, two from postoperative bleeding (one death from a technical error) and two deaths from multisystem organ failure. Four late deaths were caused by myocardial infarction. The remaining patients are alive at two to 79 months after infarction. DeBakey's technique (multiple sidearm grafts from the main aortic graft) was used in the first three procedures, and the graft inclusion technique of Crawford, in the remainder. The graft inclusion technique reduced operating time and loss of blood by 50 per cent and intraoperative fluid requirements by 33 per cent. Hypothermia was minimized by extraperitoneal, rather than intraperitoneal, abdominal aortic exposure, heated ventilation and warmed intravenous fluids. Selective renal cooling was performed by catheter perfusion of the renal arteries. Extreme care must be taken in making openings and attaching grafts to visceral arteries to avoid troublesome hemorrhage. In contrast with patients with infrarenal aneurysms, those with thoracoabdominal aneurysms require prolonged ventilatory support and have considerably higher fluid requirements. Precise surgical technique is mandatory.
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PMID:Clinical observations and lessons learned in the treatment of patients with thoracoabdominal aortic aneurysms. 296 43

A case of acute postoperative hypothyroidism in a 62-year old woman is presented. One month before emergency admission because of a perforated gastric ulcer the patient had normal thyroid function, despite removal of a thyroid adenoma 20 years earlier. Following surgery the patient developed circulatory instability, renal insufficiency, hypothermia and immeasurable concentrations of thyroxine (T4) and triiodothyronine (T3). Treatment with triiodothyronine was commenced but the patient died following an episode of severe hypotension.
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PMID:Acute hypothyroidism in a severely ill surgical patient. 334 57

A 64-year-old male with an incomplete spinal cord injury had been taking baclofen 20 mg tid for 2 1/2 months without side effects. His blood urea nitrogen and serum creatinine rose from 13 and 0.9 mg%, respectively, to 59 and 2.8 mg% after ibuprofen 600 mg tid was begun. The patient displayed baclofen toxicity, developing confusion, disorientation, bradycardia, and hypothermia. His blood pressure dropped and he complained of blurred vision. Ibuprofen discontinuation and fluid repletion corrected the renal indices. Rapid tapering of baclofen was accompanied by reversal of baclofen toxicity. Patients taking baclofen must be monitored closely for toxicity when declining renal function is present. Clinicians should be alert to the possibility of renal insufficiency developing when ibuprofen is initiated. This case demonstrates the potential for ibuprofen-induced renal insufficiency to reduce baclofen clearance, thereby leading to baclofen toxicity. Published reports of ibuprofen-induced renal insufficiency are reviewed and pertinent pharmacokinetics of baclofen discussed.
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PMID:Baclofen toxicity associated with declining renal clearance after ibuprofen. 648 61

Clinical features and specific aspects of treatment were evaluated in 612 patients with gram-negative bacteremia observed over a 10 year period. Coagulation abnormalities or thrombocytopenia were observed in 64 per cent of the patients. Evidence of disseminated intravascular coagulation (DIC) was found in approximately 10 per cent of them but was of sufficient severity to be associated with subcutaneous or visceral bleeding in 3 per cent of them. The frequency of coagulation abnormalities, other than DIC, was greater in patients with more severe underlying disease but DIC occurred with similar frequency irrespective of the severity of underyling host disease. Coagulation abnormalities of all types were associated with increased fatality rates. Hypothermia was noted in 13 per cent of the patients at the onset of bacteremia but was transient and was not associated with increased fatality. Failure to mount a febrile response greater than 99.6 degrees F within the first 24 hours of bacteremia was associated with a significant increase in fatality rates. Prior corticosteroid therapy diminished the febrile response to bacteremia. Age, underlying host disease, granulocytopenia, congestive heart failure, diabetes mellitus, renal insufficiency, nosocomial infections, and antecedent treatment with antibiotics, corticosteroids, and antimetabolites significantly increased fatality rates. Appropriate antibiotic treatment reduced the fatality rate of those with bacteremia by approximately one-half among patients in each category of severity of underlying host disease. In addition, it was shown that early appropriate antibiotic therapy also reduced the frequency with which shock developed by one half. Even after development of shock, appropriate antibiotic therapy significantly reduced fatality rates. The use of combinations of antibiotics could not be demonstrated to significantly improve survival rates. Minimal differences in therapeutic efficacy could be demonstrated between individual antibiotics and various combinations of antimicrobials. Shock occurred in approximately 40 per cent of the patients and its frequency was not influenced by the species of etiologic agent. Contrary to previous reports, corticosteroid therapy in patients with shock did not enhance survival and treatment with an average of 4.0 g/day of hydrocortisone or its equivalents was associated with a significant increase in fatality rates.
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PMID:Gram-negative bacteremia. IV. Re-evaluation of clinical features and treatment in 612 patients. 698 71

The author reviewed records of 10 patients who had experienced acute loxapine overdose. The most frequent medical complications were CNS depression, sinus tachycardia, hypertension, and hypothermia; 6 patients had had generalized major motor seizures, 1 had had recurrent paroxysmal atrial tachycardia, and 2 had had transient renal insufficiency from rhabdomyolysis and myoglobinuria. Other clinical effects from loxapine overdose were predominantly anticholinergic. The author recommends that loxapine-overdose patients receive ECG monitoring and treatment of medical complications in an intensive care unit.
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PMID:Seizures induced by acute loxapine overdose. 725 88

The experience of treatment of severe (41) and light (48) forms of crush syndrome enabled the authors to come to the main conclusion that so far there are no effective means for the local treatment of crushed extremities and prevention of acute renal insufficiency. According to their conviction, the degree of crush syndrome should be taken into consideration when choosing a kind of local therapy. An assessment of such methods as continuous immobilization, elastic dressing, hypothermia, amputation, fasciotomy and myotomy is given.
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PMID:[Debatable questions of local treatment of the severe form of the prolonged crush syndrome]. 729 58

The incidence of enterococcal bacteremia due to Enterococcus faecium is increasing. To understand the clinical significance of E. faecium bacteremia, we compared 16 patients who were bacteremic due to E. faecium to 56 patients who were bacteremic due to Enterococcus faecalis. E. faecium bacteremia developed most frequently in severely ill patients with fever or hypothermia accompanied by CNS, cardiovascular, and/or pulmonary dysfunction, while E. faecalis bacteremia occurred most often in less seriously ill patients. Nosocomial acquisition, cancer, neutropenia, renal insufficiency, current corticosteroid therapy, and previous treatment with broad-spectrum antibiotics were significantly more frequently associated with E. faecium bacteremia. Mortality was significantly higher among patients infected with E. faecium than among those infected with E. faecalis (50% vs. 11%; P = .001); this was true particularly among patients with monomicrobial or nosocomial bacteremia, those who had previously received antibiotic treatment, and those with cancer. Death due to enterococcal bacteremia was observed only among severely ill patients. These findings suggest that E. faecium often infects debilitated patients and that such infection appears to be a significant factor contributing to mortality.
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PMID:Enterococcus faecium and Enterococcus faecalis bacteremia: acquisition and outcome. 774 33


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