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

Blood has particular rheological properties which partly condition its flow, especially in capillary vessels, and its ability to deliver oxygen. It is not subject to gravitation, pseudoplastic, thixotropic and visco-elastic. Blood viscosity depends upon macroscopic factors, such as erythrocyte aggregation and deformability. Hyperviscosity is observed in cases of increased haematocrit (polycythaemia and relative polycythaemia), increased serum proteins and changes in protein balance (e.g. rise in fibrinogen and immunoglobulins, fall in albumin) as seen in inflammation and dysglobulinaemia, drop in temperature (hypothermia), increased erythrocyte aggregation (shock, fat embolism) or imparied deformability due to various acquired or inherited disorders of red cell membrane or cytoplasma (e.g. sickle cell anaemia, renal failure, hyperlipoproteinaemias, thrombosis, diabetes). The various factors may be combined, as in diabetes. Conversely, hypoviscosity may result from decreased haematocrite, fall in blood proteins and fibrinogen, or hyperthermia. Hyperviscosity can be corrected by acting on its various constituents. Treatments include haemodilution, plasmapheresis, anti-aggregants and drugs improving red cell deformability.
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PMID:[Blood viscosity. Measurement and applications (hyper--and hypoviscosity syndromes) (author's transl)]. 723 52

The effects of surface hypothermia (25 degrees C) on arterial hematocrit value (by microcentrifuge) and plasma protein concentration (by refractometry) were studied in infants undergoing surface cooling for cardiac operations. To analyze in detail the mechanisms leading to the observed changes in patients, we performed parallel studies on normal dogs and permanently splenectomized dogs. In these dogs, measurements were also made of plasma volume (by 125I-albumin) and red cell volume (by 51Cr-erythrocytes). Arterial hematocrit value increased progressively during surface cooling in infants. Assuming that red cell volume remained constant and that the ratio of whole body red cell percentage to arterial hematocrit value during surface cooling in infants as in splenectomized dogs, we estimated percent changes in plasma volume in infants from arterial hematocrit data. The computed plasma volume decreased progressively as the body temperature was decreased. Since plasma protein concentration remained constant, the loss of plasma volume suggested a sequestration of whole plasma in portions of the circulatory bed and/or an extravasation of whole plasma into the interstitial space.
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PMID:Hemoconcentration induced by surface hypothermia in infants. 740 77

Cerebral hypothermia is the principal means of providing neurologic protection during cardiac surgery. Better understanding is needed of ways to improve brain cooling during bypass. The goal of this study is to find whether haemodilution has a significant direct effect on the rate of brain cooling, from changes in the blood's thermal properties. The brain is cooled during hypothermic cardiopulmonary bypass, almost exclusively, by the colder blood. We use the corresponding component of the bioheat transport model to predict the proportional direct effect of changing blood density and specific heat on the amplitude of the rate of brain cooling. We find that haemodilution can significantly change blood density and specific heat. For example, haemodilution with the fluorocarbon emulsion AF0104 from a haematocrit at 45% to a haematocrit at 22% increases blood density by 18%, and decreases specific heat by 21%. Nevertheless, the mathematical model predicts that the direct effect of haemodilution on the rate of brain cooling by the cold blood is small; +7%, +6% and -7% for normal saline, 5 g dl-1 albumin in normal saline, and AF0104 fluorocarbon emulsion, respectively. We conclude that, within the haemotocrit range used clinically during bypass, haemodilution with these substances has only a small direct effect on the rate of brain cooling.
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PMID:Mathematical analysis of haemodilution's direct effect on rate of brain cooling during cardiopulmonary bypass. 761 76

The renal preservation ability of a flushing solution (F-M) with fructose-1,6-diphosphate (1 g/dl) and mannitol (2 g/dl) during cold ischaemia was studied with the isolated perfused rat kidney model and compared with the Euro-Collins (EC) and University of Wisconsin (UW) solutions. Kidneys were stored in hypothermia for 4 and 18 h after initial flushing with the solution being tested, and then reperfused at 37 degrees C in an isolated perfusion circuit for 90 min with a Krebs-Henseleit solution containing 4.5% albumin. Forty-four kidneys were studied and divided in a control group and six study groups according to the cold ischaemia time and flushing solution used. Renal functional parameters of plasma flow rate (PFR), renal vascular resistance (RVR), urine flow rate (UFR) glomerular filtration rate (GFR), fractional (FRNa) and net (TNa) sodium reabsortion were assessed during reperfusion. Conventional histology and malondialdehyde tissue levels (MDA) were also evaluated. Our results show that PFR, RVR, and UFR were similar in all study groups. After 4 and 18 h of cold ischaemia, GFR, FRNa and TNa were better, and conventional histology worse in F-M than in EC flushed kidneys. After 4 and 18 h of cold ischaemia, GFR, FRNa and TNa, in fact, were not different between F-M and UW flushed kidneys. After 4 h of cold ischaemia, conventional histology was similar in F-M and UW flushed kidneys. Nevertheless, after 18 h of cold ischaemia, UW flushed kidneys showed worse histological parameters than F-M flushed kidneys. After 4 h of cold ischaemia, MDA was similar in kidneys flushed with three solutions. After 18 h of cold ischaemia MDA was higher in EC than in F-M or UW flushed kidneys. In summary, our newly developed cold storage solution shows promising results in renal preservation and its ability to preserve is at least as good as UW solution assessed in the isolated perfused rat kidney.
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PMID:Evaluation of a preservation solution containing fructose-1,6-diphosphate and mannitol using the isolated perfused rat kidney. Comparison with Euro-Collins and University of Wisconsin solutions. 762 95

To increase the storage time of livers for transplantation, a better understanding of hypothermia-induced hepatocyte damage is necessary. To this end, we have characterized the effects of hypothermia on long-term function and cytoskeletal organization of hepatocytes cultured in the collagen sandwich configuration, which maintains the expression of liver-specific functions for several weeks. In these studies, cultured hepatocytes (maintained at 37 degrees C for 7 days) were exposed to 4 degrees C in Leibovitz-15 (L15), University of Wisconsin (UW) solution, or L15 supplemented with 2.5 g% polyethylene glycol (PEG) for various time periods followed by a return to normothermia. When L15 medium was used, the long-term albumin secretion rate of cultured hepatocytes was decreased by 50% after 4 h, and by 95% after 24 h of exposure to 4 degrees C. Amorphous precipitates of F-actin and fragmented short microtubules were also observed after 4 and 12 h of hypothermia, respectively. Similar results were obtained when hepatocytes were stored in UW solution. However, in L15 supplemented with PEG, no significant reduction in long-term albumin secretion rates and intact actin and microtubule morphology was observed even after 24 h of exposure to 4 degrees C. The membrane integrity and long-term albumin secretion of hepatocytes stored in the presence of PEG were decreased to approximately 50% only after 48 h of exposure to 4 degrees C. Thus, PEG may be a useful additive in preservation solutions for hepatocytes in hepatocyte-based liver support systems and for intact tissue as well.
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PMID:Effects of hypothermia on the function, membrane integrity, and cytoskeletal structure of hepatocytes. 765 72

Bleeding occurring in a patient with multiple trauma has an unpredictable evolution; blood losses are often very important and their origins mostly unclear. These problems should not prevent the use of a strategy for optimal use of blood components. Indications for packed red cells, fresh frozen plasma, platelets and coagulation factors are discussed. Indications for packed red cells are discussed in relation with the patient's conditions (myocardial, cerebral and pulmonary functions) and the clinical status. If the patient is shocked, transfusion must be ordered to maintain a haemoglobin level greater than 10 g.100 ml-1. Considering its cost, the use of albumin must and can be reduced when fluid replacement is realized with long lasting colloids, like starch. Warming of transfused blood is necessary, especially if acceleration disposals are used to prevent or minimize hypothermia. Use of portable monitors for haemoglobin and coagulation parameters is recommended.
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PMID:[Indications of blood components and outcome of transfusion practices in hemorrhage of multiple trauma]. 781 68

Advances in myocardial preservation have led to improved patient survival after open heart operations. However, few studies have detailed the nature of national or regional patterns of cardioplegia use. To determine the regional pattern, all open heart surgery programs in Missouri were surveyed. During 1 year, it was found that cardioplegia was administered to 8,382 patients by 61 cardiothoracic surgeons at ten academic affiliated hospitals and 16 nonteaching hospitals. All cardioplegic solutions were hospital produced. Of 13 crystalloid solutions, 11 differed from one another and eight were intracellular formulations. Of 28 multidose blood-based cardioplegic solutions, there were 23 different mixtures. Most crystalloid (69%) and blood-based (89%) solutions differed substantially from commonly reported formulations. The incidences of the various additives to crystalloid solutions were as follows: bicarbonate, 92%; glucose, 69%; lidocaine, 54%; mannitol, 46%; magnesium, 31%; calcium, 23%; methylprednisolone, 15%; heparin, 8%; and acetate, 8%. Of the common blood-based cardioplegic solution additives, the following incidences were observed: glucose, 79%; bicarbonate, 43%; trishydroxyaminomethane, 36%; acetate, 29%; magnesium, 29%; procaine (or lidocaine), 25%; citrate-phosphate-dextrose, 18%; mannitol/albumin, 14%; nitroglycerin, 11%; glutamate/aspartate, 11%; calcium, 7%; insulin, 3%; and methylprednisolone, 3%. No calcium channel blocker or high-energy phosphate additives were reported. We conclude that many different cardioplegic admixtures that have not been tested experimentally are used routinely in clinical practice, presumably with acceptable results. Because the salutary effects of induced cardiac arrest and hypothermia may mask suboptimal solutions, further study of customized cardioplegia should be considered, particularly with regard to high-risk patients.
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PMID:Lack of cardioplegia uniformity in clinical myocardial preservation. 814 36

The rat erythrocytes' Na, K-ATPase activity was found to drop under the effects of five various stresses: immobilisation, hypothermia, hyperoxia, physical strain, and physical strain against the background of fasting. An endogenous digoxin-like inhibiting agent(s) acting on the Na, K-ATPase seems to appear in the blood plasma of the animals under stress. The suggestion is corroborated by the fact that albumin-less supernatants of the stressed rats' blood plasma are able to inhibit the Na, K-ATPase in the erythrocytes of the control animals.
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PMID:[The dynamics and mechanism of changes in the erythrocyte Na, K-ATPase activity of rats under the action of different types of stressors]. 816 17

Fatty acid and glucose oxidation rates were measured in isolated rat hearts undergoing hypothermia and rewarming. The hearts were perfused in the Langendorff mode with Krebs-Henseleit bicarbonate buffer containing 11.1 mM glucose plus 0.6 mM albumin-bound oleic acid as energy substrates. The hearts were stabilized at 37 degrees C and thereafter cooled progressively to 15 degrees C over a period of 60 min. The hearts were kept at this temperature for 10 min and then rewarmed to 37 degrees C during the next 30 min. Control hearts were perfused at 37 degrees C throughout the whole perfusion period. Trace amounts of [14C]glucose or [14C]oleic acid were included in the perfusate, and the rate of substrate oxidation was determined on the basis of the radioactive CO2 production. In normothermic hearts steady state oxidation rates of glucose and oleate were found to be 0.17 +/- 0.01 and 0.51 +/- 0.07 mumol min-1 g-1 dry wt, respectively (mean +/- SEM). In response to hypothermia (15 degrees C) glucose oxidation was reduced by 76% (from 0.17 +/- 0.01 to 0.04 +/- 0.01 mumol min-1 g-1 dry wt) and oleate oxidation by 47% (from 0.51 +/- 0.07 to 0.27 +/- 0.02 mumol min-1 g-1 dry wt). Upon rewarming glucose and fatty acid oxidation rates returned to essentially the same values (0.12 +/- 0.02 and 0.45 +/- 0.04 mumol min-1 g-1 dry wt) as those observed under steady state normothermic conditions. The molar ratio between glucose and fatty acid oxidation was, however, significantly (P < 0.05) lower in hypothermic than in normothermic hearts.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Substrate preference of isolated perfused rat hearts during hypothermia and rewarming. 826 3

The isolated perfused liquid-filled rat lung in a "pleural bath" was the model used to study liquid exchange across the lung epithelium. Active transport and passive solute movement between the air space, the vascular perfusate, and the bath result in concentration changes of the three markers (Evans blue-tagged albumin, 22Na+, and [3H]mannitol) instilled in the air space. A mathematical model was developed to estimate the active and passive solute transports and to interpret the results. Rat lungs were perfused at left atrial and pulmonary arterial pressures of 0 and 8 mmHg, respectively. Six rat lung experiments were conducted at 37 degrees C and six at 4 degrees C. The normothermic experiments demonstrate that active transport accounts for 26% of the Na+ movement out of the air space (17.3 +/- 0.7 nm/s) and that passive mechanisms account for the remaining 74% (48.0 +/- 5.7 nm/s). Hypothermia inhibits lung liquid clearance but does not affect passive solute movement, suggesting that lung liquid clearance is effected by active Na+ transport mechanisms.
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PMID:Active transport and passive liquid movement in isolated perfused rat lungs. 828 6


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