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

It has been established that tissue cooling to 15-20 degrees C brings about a short-term spasm of smooth muscles of the intestine, peripheral vessels and of the visceral vessels, replaced by an appreciable spasmolytic effect at the 5th-8th minute of hypothermia. The maximal hyperemia develops by the 15th-20th minute of the cooling and persists over the whole period of the cooling. It is assumed that inhibition of oxidative phosphorylation in the mitochondria of the smooth muscles underlies the spasmolytic action of cold. In addition, cold produces a marked hypocoagulation effect.
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PMID:[Improved blood flow in the organs and the prevention of thrombus formation with cold]. 401 35

Increasing doses of clonidine enhanced the retention of sulfobromophthalein (BSP) in plasma and liver, while reducing elimination of this dye into bile. The ED50 of clonidine for these effects was 0.05 to 0.2 mg/kg s.c. In clonidine-treated mice which were warmed to reverse drug-induced hypothermia, plasma and liver BSP levels were raised as compared to saline-treated mice. Clonidine also raised plasma and liver levels of the BSP analog, dibromosulfophthalein, which is not conjugated before biliary elimination. Hepatic glutathione levels, activity of glutathione-S-transferase and ratios of conjugated to unconjugated BSP were not affected by clonidine. In mice with cannulas in their common bile ducts to prevent duct spasm, clonidine reduced the amounts of BSP eliminated into bile. Thus, the alpha-2 adrenoceptor agonist, clonidine, raised plasma and liver levels of anionic dyes and reduced their levels in bile by mechanisms other than altered conjugation, hypothermia or bile duct spasm.
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PMID:Clonidine effects on sulfobromophthalein disposition in mice. 405 76

Coronary arterial spasm observed during the course of two repeated anaesthesias in a patient having undergone aorto-femoral bypass grafting is reported by the authors. Such complications are accompanied by serious ventricular arrhythmias, though transient and healing without sequelae. Clinical and electrocardiographic characteristics of peroperative coronary arterial spasm are underlined. In patients prone to developing such spasm, peroperative alkalosis, hypothermia and parasympathetic stimuli should be avoided. Are emphasized the efficiency of preventive treatment with calcium antagonists and that of intravenous nitroglycerin in the treatment of peroperative coronary arterial spasm when it does occur.
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PMID:[Coronary spasm during repeated anesthesia]. 633 7

The effect of thrombolytic therapy is well-documented in acute myocardial infarction. In acute cerebral infarction, thrombolytic therapy has been evaluated in small series of patients. The point of thrombolytic therapy is to avoid or reduce ischemic damage of neuronal tissue by rapid arterial recanalization. In thrombolytic therapy of cerebral vascular occlusion, the pathophysiology of reperfusion needs further investigation and documentation. This review describes studies of thrombolysis in embolic stroke using animals embolized by intracarotid injections of blood clots. Vascular occlusion was demonstrated by angiography and measurement of cerebral blood flow. Thrombolytic therapy with recombinant tissue-type plasminogen activator was initiated after varying periods of time. Reperfusion, cellular function, and brain damage were examined by angiography and by clinical and pathoanatomical examination. Based mainly on results from our own investigations, the following theses concerning ischemic stroke were made: (a) Cerebral infarction caused by arterial occlusion is due to delayed, incomplete, or no reperfusion. Spasms, or hemodynamic mechanisms, seem to be of only minor importance. (b) Early thrombolytic therapy in animal models increases the degree of reperfusion and reduces brain damage, clinical deficits, and mortality. (c) Early arterial reperfusion reduces cerebral infarction and related edema. With early reperfusion, the extent of brain damage correlates to the length of the delay from onset of ischemia. (d) Cerebral stunning is caused by arterial occlusion followed by very early spontaneous or induced reperfusion, as neurons temporarily lose their functional capabilities without dying. (e) Multiple embolic microclots in experimental stroke result in more brain damage than a single macroclot, and with clots the extent of brain damage is dependent on the structural composition and volume of emboli. (f) The ability to recanalization in experimental embolic stroke is related to the amount of red cells in the emboli and inversely related to the volume of emboli and to the fibrin content and density of the clots. (g) Infarct-limiting effects in experimental stroke can be obtained by ischemic neuroprotectants or by hypothermia, either alone or with thrombolytic therapy, which then reduces brain damage further.
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PMID:Thrombolytic therapy in experimental embolic stroke. 781 66

In replantation and tissue transplantation an ischemic period is inevitable until blood flow is reestablished. This study evaluated the reflow patterns of the rat cremaster microcirculation after warm and cold ischemia with the use of vital microscopy. The present studies indicate that hypothermia (cold temperatures of about 5 degrees C) protects arteries from excessive spasm during ischemia and also lessens the reactive hyperemia. The enhanced reflow patterns may be attributed to decreased vessel injury and the diminution of metabolic needs of the hypothermic muscle. These results support the use of hypothermia even for short ischemic periods during microsurgery procedures in order to prevent adverse effects on the reflow patterns of the tissue.
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PMID:Effects of cold ischemia on reflow patterns in the rat cremaster muscle microcirculation. 891 45

A 81-year-old man was admitted to our hospital because of hoarseness. Chest CT scan and aortogram showed distal arch aneurysm measuring 7.5 cm in diameter. Under deep hypothermia and selective cerebral perfusion, the distal aortic arch aneurysm was completely replaced with a woven Dacron graft with three limbs for the arch vessels. After the aortic cross clamp was released, severe low output syndrome (LOS) continued because of perioperative myocardial infarction. Then, a coronary artery bypass grafting (CABG) to the left anterior descending artery (LAD) was performed, after which the cardiopulmonary bypass was easily weaned under intra-aortic balloon counterpulsation (IABP) assistance. The postoperative course was uneventful. The perioperative myocardial infarction was thought to be induced by left coronary spasm, as comparison of the preoperative and postoperative coronary arteriograms showed no change.
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PMID:[A case report of total aortic arch replacement for distal aortic arch aneurysm in an octogenarian]. 912 Oct 29

Cerebral palsy is the result of an injury to the developing brain during the antenatal, perinatal or postnatal period. Clinical manifestations relate to the area affected. Some of the conditions associated with cerebral palsy require surgical intervention. Problems during the peri-operative period may include hypothermia, nausea and vomiting and muscle spasm. Peri-operative seizure control, respiratory function and gastro-oesophageal reflux also require consideration. Intellectual disability is common and, in those affected, may range from mild to severe. These children should be handled with sensitivity as communication disorders and sensory deficits may mask mild or normal intellect. They should be accompanied by their carers at induction and in the recovery room as they usually know how best to communicate with them. Postoperative pain management and the prevention of muscle spasm is important and some of the drugs used in the management of spasm such as baclofen and botulinum toxin are discussed. Epidural analgesia is particularly valuable when major orthopaedic procedures are performed.
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PMID:Anaesthesia and pain management in cerebral palsy. 1079 81

W. James Gardner, a skillful neurosurgeon and inventor, is best remembered for his cervical tongs and hydrodynamic theory of syringomyelia. A pioneer of modern neurosurgery, Gardner trained under Charles Frazier in Philadelphia, and in 1929 he moved to Ohio where he became chief of neurosurgery at the Cleveland Clinic, a position he was to hold for the next 33 years. A large surgical practice made it imperative for Gardner to develop surgical methods that were quick, effective, and advantageous for patient and surgeon. He was an early proponent of the sitting position for patients undergoing cranial surgery, which led to the development of a neurosurgical chair with a head fixation device. To reduce the risks of hypotension and air embolism when the patient is in the sitting position, Gardner invented the clinical G suit. He was the first to advocate and use induced arterial hypotension for intracranial surgery and the first neurosurgeon in the US to publish his experiences performing lumbar discography. He converted an operating table so that he could induce hypothermia during aneurysm surgery and then applied pneumatic cuffs to occlude the major arterial supply to the brain. His pioneering work has been documented in many other areas such as hemifacial spasm and trigeminal neuralgia, for which he performed the first vascular decompression, in cervical sympathectomy for treatment of various ailments, and in the use of intrathecally delivered steroid drugs for sciatica. During his career, he authored 256 publications and one book on the dysraphic states. Many of his contributions to the discipline of neurosurgery are now taken for granted.
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PMID:W. James Gardner: pioneer neurosurgeon and inventor. 1513 20

Cerebral palsy (CP) is a group of nonprogressive, motor impairment patterns due to an insult to the developing encephalon. Clinical manifestations vary by the specific motor deformity, anatomically affected region, and location of the brain injury. Spasticity is common, resulting in skeletal muscle weakness and loss of fine motor control. Spasticity in a child undergoing skeletal maturation may precipitate joint contractures and dislocation. Long-term medical care is interventional. The therapeutic goals are to increase the person's independence and improve the caretaker's ability to provide daily care. Early medical intervention to control spasticity and prevent contractures may reduce the need for future orthopedic surgical intervention. Centrally acting, tone-reducing medications may decrease spasticity but cause central nervous system side effects. Orthopedic surgical procedures may be necessary to remedy the chronic effects of increased tone on the muscles and bones of the extremities and spine. Anesthetic care of children and adolescents with CP is increasing. Thorough preoperative assessment facilitates preparation of an intraoperative care plan. Intellectual disability may attend CP and limit the person's ability to participate in preoperative preparation. Perioperative complications include hypothermia, intravascular depletion, muscle spasm, limb contracture, and seizure control. Gastroesophageal reflux and poor respiratory function might complicate anesthetic management.
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PMID:Update for nurse anesthetists--part 6--Perioperative care of patients with cerebral palsy. 1730 86

The objective of the present study was to evaluate changes in the human pancreas in case of lethal hypothermia (LH). Scarce data available from the forensic medical literature give evidence of considerable morphological changes in the pancreas including irregular blood filling with areas of venous hyperemia, focal spasm of arterioles, slowed down autolysis, spasm of pancreatic ducts in the absence of desquamation of their epithelium into the lumen, secretion deposited and visualized in accessory cells. Hepatitis develops despite general hypothermia. Morphological alterations in Langerhans islets and qualitative changes in the relative number of endocrinocytes remain to be assessed more thoroughly.
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PMID:[Forensic medical evaluation of pancreatic lesions in cases of lethal hypothermia]. 2008 38


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