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

Pneumatic tourniquets, often used to provide a bloodless operating field, carry a risk of adverse effects. Limb exsanguination by gravitation is less aggressive than by mechanical means. Skin, muscles, nerves and vessels suffer maximally under tourniquet because of mechanical pressure, with both a sagittal force, responsible for compression and an axial force responsible for stretchening. All parts of the limb are therefore affected by ischaemia. The restarting of circulation will also increase lesions at the microcirculatory level, responsible for the "no reflow" phenomena. Transient reperfusion intervals are not necessarily beneficial. These effects will significantly contribute to the post tourniquet sensory motor injuries. The tourniquet increases the risk of sepsis. Tourniquet release allows metabolites from the leg to enter into the circulation, and also carries a risk of pulmonary thromboembolism. Carbon dioxide is eliminated by spontaneous hyperventilation under regional anaesthesia. If not eliminated by an increase of mechanical ventilation during general anaesthesia, it may raise intracranial pressure in head trauma patients. Various chemotactic and cytolytic agents may cause lung injury. Mobilization of blood volume at tourniquet placement and release may have detrimental haemodynamic effects in patients with coronary or cardiac insufficiency. The tourniquet increases arterial pressure after 20 to 25 minutes under general anaesthesia. Regional anaesthesia is considered as the technique of choice for the prevention of "tourniquet hypertension", closely linked to pain and relievable by local anaesthetics. Tourniquet modifies also the pharmacokinetics of anaesthetic and other agents. It generates hyperthermia, especially in children. Prospective and comparative studies did not show any advantage as far as duration of surgery and amount of blood loss are concerned. In order to minimize its side effects, the tourniquet must be used within the frame of a strict procedure, with a well adapted and regularly checked equipment. Duration of ischaemia should be as short as possible and not continue for more than two hours, with a reperfusion of 15 minutes every hour. Local hypothermia seems to be a safe means for decreasing side effects.
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PMID:[Pneumatic tourniquets in orthopedics]. 873 36

Lipopolysaccharide (LPS), an endotoxin, produces pain behavior, inflammation, and changes in immune function. Many of these effects are secondary to the production of cytokines. In the present study, we investigated the effect of LPS on the releasing function of afferent terminals as measured by calcitonin gene-related peptide (CGRP) release in ex vivo perfused rat trachea, and examined the possible role of the cytokines interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) as intermediaries in this effect. Systemic injection of LPS (0.75 mg/kg, i.p.) in adult rats induced an increase in body temperature followed by hypothermia, indicating ongoing infection. We observed that capsaicin-induced (0.1 microM) tracheal CGRP release was significantly enhanced in the LPS-treated animals after 5 hr. This enhancement of the peptide release by LPS was blocked by IL-1beta tripeptide antagonist Lys-D-Pro-Thr (10 microM) and mimicked by IL-1beta and TNF-alpha (10-100 pg/ml), suggesting that the potentiating effect of LPS on CGRP release is mediated by generation of IL-1beta and TNF-alpha. IL-1beta-induced augmentation of CGRP release was blocked by Lys-D-Pro-Thr. Additionally, the cyclooxygenase inhibitor ketorolac (10 microM) significantly attenuated the facilitatory effects of LPS and IL-1b, indicating involvement of prostanoids. These findings suggest that endotoxin treatment generated cytokines such as IL-1b and TNF-alpha that regulated the peripheral releasing function of primary sensory afferents by sensitizing the terminals and facilitating peptide release. This effect is prostanoid dependent.
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PMID:Involvement of cytokines in lipopolysaccharide-induced facilitation of CGRP release from capsaicin-sensitive nerves in the trachea: studies with interleukin-1beta and tumor necrosis factor-alpha. 876 61

Minor injuries are sometimes followed by a potentially disabling syndrome of hyperalgesia, hyperesthesia, allodynia, and sudomotor disturbance as well as, eventually, weakness, muscle atrophy, trophic skin changes, and bone and joint abnormalities. Vasomotor changes frequently present as hypothermia or hyperthermia. Most of the literature refers to this syndrome as reflex sympathetic dystrophy (RSD). To observe possible early RSD changes, we studied 1000 military recruits before and during basic training. Evaluations consisted of lower limb clinical examinations and pain assessment. Infrared images were taken of anterior, posterior, medial, lateral legs, and plantar surface of the feet. If the clinical examination suggested a possible stress fracture, a bone scan was performed. Recruits were studied before training and again each time musculoskeletal complaints arose. The controls were recruits tested before the onset of training who had no musculoskeletal complaints. Two-hundred seven soldiers were injured. Regional hypothermia was noted in 8.6% of all thermograms, with 75% on the left and 25% on the right. The most common injuries causing this phenomenon were ankle pain/sprain and minor foot stress fractures, especially the left metatarsals. Hypothermia occurred within 24 to 48 h, usually beginning in the periphery and ascending proximally, lasting a few days to 6 wk (end of study). None of the recruits developed the full syndrome of RSD during the study period. Whether the continued training, even though modified, helped to prevent this complication or the observed post-traumatic hypothermia has no relationship to RSD needs to be determined.
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PMID:Regional hypothermia in response to minor injury. 877 22

Female OF1 mice were fed on a diet deficient in alpha-linolenic acid or on a control diet 3 weeks before mating and throughout pregnancy and lactation. Pups fed on the same diet as their mothers were used for experiments. The effects of dietary alpha-linolenic acid deficiency were studied in a model of learning, the Morris water maze, and on the following effects of morphine: increase in locomotor activity, modifications of rectal temperature and analgesia. In the place and in the cue versions of the Morris water maze, learning occurred at the same speed in the two diet groups; however, in the place version of the test, the level of the performance was significantly lower in the deficient mice. The probe trial and the extinction procedure did not show any difference between the two diet groups. The morphine-induced increase in locomotor activity occurred significantly earlier and was greater in the deficient diet group. Morphine induced an early hypothermia followed by a late hyperthermia; the hypothermia was significantly greater and the hyperthermia significantly smaller in the deficient mice. The pain thresholds and the morphine-induced analgesia were unmodified by the dietary deficiency. The plasma levels of morphine were similar in the two diet groups.
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PMID:Influence of a dietary alpha-linolenic acid deficiency on learning in the Morris water maze and on the effects of morphine. 884 19

Environmental stress causes the activation of two types of endogenous pain inhibitory systems in animals: opioid analgesia is antagonized by opiate receptor blockers (e.g., naloxone and naltrexone), whereas analgesia produced by nonopioid systems is insensitive to such antagonism. A large literature documents that the parameters of the laboratory stressor will determine the neurochemical identity of the resultant analgesia. In rats, low severity stressors produce opioid analgesia and higher severity stressors produce nonopioid analgesia. A recent parametric analysis of swim stress-induced analgesia (SSIA) in the female Quackenbush mouse, however, observed the opposite pattern. The present study is a parametric analysis of SSIA using a range of swim temperatures (15-38 degrees C), swim durations (45 s to 7 min), and genetic models [male Swiss-Webster mice, and mice selectively bred from this outbred strain for high (HA), low (LA), or control SSIA]. We find that in nonselected mice low severity swims (i.e., warm temperature, short duration) produce naloxone-sensitive opioid SSIA, whereas high severity swims (i.e., cold temperature, long duration) produce nonopioid SSIA. This pattern is also seen in HA mice displaying very high analgesic magnitudes, but not in LA mice displaying minimal SSIA. In the selectively bred mice, analgesia and hypothermia from forced swimming are positively correlated, but can be dissociated both genetically and neurochemically. Furthermore, swimming in body temperature (38 degrees C) water produces analgesia without concommitant hypothermia, and the increased magnitude of 38 degrees C SSIA displayed by HA mice over control levels is entirely opioid.
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PMID:Opioid and nonopioid swim stress-induced analgesia: a parametric analysis in mice. 884 71

Central temperature is usually tightly regulated in human beings. Anesthesia alters the normal thermoregulatory controls of the body. Intraoperatively, mild degrees of hypothermia may provide some cerebral protection. However, the risk of organ dysfunction and shivering require that the anesthesiologist be prepared to treat severe hypothermia. Appropriate measures such as warning the operating room and using forced air blankets can prevent both intraoperative hypothermia and postoperative shivering. The use of temperature measurement is not limited to the operative and immediate recovery periods. Anesthesiologists practicing in intensive care units and in pain clinics use temperature monitoring as a diagnostic tool in a variety of situations.
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PMID:Temperature monitoring. 889 53

Three new neurotropic sesquiterpenoids, veranisatins A, B and C, were isolated from star anise (Illicium verum Hook. fil., Illiciaceae). Veranisatins showed convulsion and lethal toxicity in mice at a dose of 3 mg/kg (p.o.), and at lower doses they caused hypothermia. Veranisatin A and the related compound, anisatin, were tested for the other pharmacological activities such as locomotor activity and analgesic effect. Both compounds decreased the locomotion enhanced by methamphetamine at oral doses of 0.1 and 0.03 mg/kg, respectively, and demonstrated the analgesia on acetic acid-induced writhing and tail pressure pain at almost similar doses.
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PMID:Neurotropic components from star anise (Illicium verum Hook. fil.) 890 18

Current studies verify the safety of surgery in the elderly. Delirium is a costly complication, but its incidence and severity can be reduced by pre- and postoperative interventions. Avoidance of even mild hypothermia has now been shown to reduce cardiovascular morbidity. New information available on the cardiovascular response of elderly patients to laparoscopic surgery highlights the importance of avoiding preoperative dehydration. Proper pain management minimizes complications and promotes recovery.
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PMID:Operating on the elderly woman--what are her special needs? 936 Aug 10

Pediatric burn injuries present a major challenge to the health care team, but an orderly, systematic approach can simplify the initial stabilization and management. A clear understanding of the pathology of burn injuries is essential in providing quality burn care in the prehospital setting and at the referring hospital. After the patient has been rescued from the offending agent, assessment of the burn victim begins with the primary survey and life-threatening injuries initially addressed first. This is followed by a secondary survey to document and treat other injuries or problems. Intravenous access may be established in concert with the local/regional medical control and appropriate fluid resuscitation begun. Burn wounds should be covered with clean, dry sheets, and the patient kept warm with blankets to prevent hypothermia. The patient should be transported to the local hospital ED in the most appropriate mode available. At the local hospital, it should be determined if the burn patient needs burn center care, using the ABA Guidelines. In preparing for and organizing the transfer of the burn victim, consideration must be given to the continued monitoring and management of the patient during transport. In transferring burn patients the same priorities developed for the prehospital management are still operative. During the initial assessment and treatment and throughout the transport, an adequate airway, breathing, circulation, fluid resuscitation, urine output, and pain control must be assured. Ideally, transport of burn victims will occur through and organized, protocol driven plan that includes specialized transport mechanisms and personnel. Successful transport of burn victims, whether in the pre-hospital phase or during inter-hospital transfer, requires careful attention to treatment priorities, protocols, and attention to detail.
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PMID:Emergency management of pediatric burn victims. 951 33

Actively warming patients during surgery is considered the best method of preventing inadvertent hypothermia. In order to investigate the effect of forced air warming on postoperative oxygen consumption, we studied 26 patients undergoing orthopaedic surgery using a prospective, randomized trial design. We measured oxygen consumption, carbon dioxide production, temperature, thermal comfort and pain scores. Apart from intraoperative temperature, there were no significant differences in these measurements between the two groups. This study demonstrated the gradual heat gain and also the potential for hyperthermia from pre- and intraoperative forced air warming. We conclude that forced air warming is not necessary for moderate duration non-body-cavity surgery if effective preinduction covering of patients and minimal surgical exposure is achieved.
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PMID:The effect of forced air warming on postoperative oxygen consumption and temperature in elective orthopaedic surgery. 961 20


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