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

Direct cardiac and vascular effects of the antikaliuretic diuretic potassium-canrenoate were measured in cardio-surgical patients during extracorporal circulation and immediatly after operations, each time in neuroleptanalgesia. During "steady state" extracorporeal circulation (aorta cross-clamped, constant flow rate of heart-lung-machine, constant hypothermia), in 13 patients no significant influence on peripheral circulation was found after i.v.-injection of 800 mg potassium-canrenoate. Neither arterial perfusion pressure (representing an arterial vascular reaction) nor changes in oxygenator-volume (indicating venous vasodilation or contraction) demonstrated significant differences in comparison to a control group. After cardiac surgery haemodynamic measurements were performed for a period of 60 minutes in 10 patients given 800 mg potassium-canrenoate. In comparison with a control group (n = 6), no significant differences in arterial pressure, heart rate, cardiac index and pulmonary arterial pressure were found. Left ventricular measurements, using a catheter tip manometer, revealed no direct positive inotropic effect of a single i.v.-injection of potassium-canrenoate. In acute myocardial failure during anaesthesia or in "low cardiac ouptut" following open heart surgery no improvement in myocardial contractility is obtained by i.v.-application of potassium-canrenoate; at the present there seems no alternative to other positive inotropic agents such as calcium, glucagon, dopamine, orciprenaline and epinephrine.
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PMID:[Extrarenal effects of potassium-canrenoate. Haemodynamic investigations during neuroleptanalgesia in cardiosurgical patients (author's transl)]. 31 42

We report our experience of anaesthesia for orthotopic liver transplantation in seven patients. Pre-, intra- and postoperative management requires highly cooperative team-work. Advantages of neuroleptanalgesia are pointed out for this operative procedure. Intraoperative problems such as mass transfusion, clotting disturbances, changes in haemodynamic parameters, metabolic acidosis, hypovolaemia, hypoglycaemia and hypothermia are discussed and adequate therapeutic measures proposed. The value of an extensive perioperative monitoring is demonstrated. Controlled ventilation has been performed during the immediate postoperative period in all patients.
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PMID:[Orthotopic liver transplantation in man from the anaesthesiological point of view (author's transl)]. 36 80

The physiological changes associated with accidental hypothermia are considered. Current methods of management of the hypothermic patient are reviewed.
Anaesthesia 1979 Mar
PMID:Accidental hypothermia. 37 18

The effect of glucose on the release of insulin from the pancreas of 19.5- to 21.5-day-old rat fetuses has been studied in utero. Fetal hyperglycemia was induced by a square-wave glucose infusion into pregnant rats over a period of 150 min. The infusion of glucose raised the fetal blood glucose concentration to that of the mother and induced a rapid increase of plasma insulin levels on day 19.5 of gestation. There was a progressive rise of the insulin response as the gestation proceeded, with an increase of the two phases of the hormonal secretion. Maternal hypothermia induced by pentobarbital anesthesia decreased markedly the insulin response to hyperglycemia in the mothers and their fetuses. In fetuses decapitated on day 18.5 and studied on day 21.5, the increase of plasma insulin concentration after a 1-hour hyperglycemia was similar to that in the littermate control fetuses.
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PMID:Dynamics of glucose-induced plasma insulin increase in the rat fetus at different stages of gestation. Effects of maternal hypothermia and fetal decapitation. 38 63

The warming effect of two apparatuses using dry heat and of one apparatus with blood warming by microwaves is measured at the entry of the blood into the venous circulation. The following facts were compared: the time needed to prepare the apparatus, any occuring technical hazards, the relationship between blood temperature and blood flow, and finally the economy of the equipment. The results show alternative indications, on one hand for the use of warmers with dry heat, on the other hand for those with microwaves. The low flows are of interest in the warming procedure of patients with hypothermia following trauma and the blood transfusion applied to infant anaesthesia.
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PMID:[Comparative studies of the warming capacity of 2 blood warmers]. 41

The effects of pentobarbital on survival times of mice exposed to oxygen, 5 per cent, were studied over a large dosage range in normal mice and in mice made tolerant to the effect of barbiturates. Tolerance was induced by pretreatment with phenobarbital, 210 mg/kg, for three days, which increased the median anesthetic dose (AD50) for pentobarbital from 34 to 53 mg/kg. In nontolerant mice there was a dose-related increase in mean survival times for doses between 35 and 60 mg/kg, with a maximum increase to 303 per cent above control. At doses of more than 60 mg/kg survival times progressively decreased toward control. For tolerant mice survival time as a function of pentobarbital dosage was shifted to the right, i.e., protection necessitated higher doses. This shift was not explained by lower brain concentrations of pentobarbital in tolerant animals, but rather parallelled the increased tolerance to the anesthetic effect of the barbiturate. The authors conclude that in this model the protective effect of barbiturate is a function of the anesthetic effect rather than the barbiturate concentration in brain per se. Hypothermia (29 C) resulted in an increase in mean survival time comparable to that in barbiturate-treated animals. This supports the hypothesis that protection is ultimately a function of decreased cerebral metabolism, whether produced by anesthesia or by hypothermia. This model measures only the effect on spontaneous respiration during hypoxia. It is possible that other mechanisms are involved if barbiturates protect in other situations, such as during or after periods of complete ischemia.
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PMID:Barbiturate protection in tolerant and nontolerant hypoxic mice: comparison with hypothermic protection. 45 57

Thirty consecutive infants undergoing hypothermia and circulatory arrest for repair of ventricular septal defect, transposition of the great vessels, or atrioventricular canal defects were alternately selected for conventional high flow nonpulsatile perfusion or pulsatile perfusion during core cooling and rewarming. All received morphine anesthesia, 30 mg/kg of Solu-Medrol, and 10 to 15 mcg/kg of phentolamine. Those receiving nonpulsatile flow were perfused at a rate of 160 to 180 cc/kg/min with a roller pump and oxygenator with arterial pressure of 50 to 55 mm Hg. In the pulsatile flow group, a roller pump and oxygenator were used, and an especially constructed Datascope PAD (pulsatile assist device) was interposed in the arterial line to provide pulsatile perfusion with 75/40 mm Hg pressure at slightly reduced flow (150 cc/kg/min). The average rectal, esophageal, and tympanic membrane temperatures were reduced to approximately 16 degrees C prior to circulatory arrest. Following repair, perfusion was resumed until these temperatures returned to 37 degrees C. Cooling and rewarming were enhanced by pulsatile perfusion, with over 30% reduction in total pump time. Additionally, the larger patients in the pulsatile group cooled almost as rapidly as the smaller. The rates of decline and subsequent rise of rectal, esophageal, and tympanic membrane temperatures were equal in the pulsatile group, but the rectal temperature lagged far behind in the nonpulsatile group. Urine production during bypass was 100% greater in the pulsatile group. The plasma free hemoglobin was similar in both groups. The average postrewarming pH was 7.31 in the nonpulsatile group and 7.42 in the pulsatile group. Infants receiving pulsatile flow awakened more quickly, were more alert, and required less postoperative mechanical ventilation. We suggest that pulsatile perfusion for core cooling and rewarming of infants is safe and is more rapid and physiological than conventional high-flow nonpulsatile perfusion.
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PMID:Pulsatile perfusion versus conventional high-flow nonpulsatile perfusion for rapid core cooling and rewarming of infants for circulatory arrest in cardiac operation. 49 21

A male patient, aged 42, (No. 780624) was admitted to the Department of Neurosurgery of Hirosaki University Hospital, complaining recent weight loss, intolerance to cold and visual disturbance of the right eye. Ophthalmological examination revealed the optic atrophy with decreased visual acuity and concentric visual defect of the right eye. Endocrinological examination showed almost general suppression of adenohypophyseal function except abnormal high level resetting of cortisol diurnal rhythm. Radiological examination revealed the accessory middle cerebral artery and giant internal carotid aneurysm of the right side which was displayed by contrast-enhanced CT scan, with the enlarged sella turcica. Good cross filling was seen in left CAG through the anterior communicating artery. Extra-intracranial end to end anastomosis of the right internal carotid artery was performed with long venous graft under general anesthesia with hypothermia and induced hypotension, on Oct. 26 '78. Unroofing of the right optic canal was very useful to preserve the optic nerve, and the body of the giant aneurysm was opened and sutured tightly to reduce its mass effect. Interlacing suture for the anastomosis of the cervical internal carotid artery was employed successfully. The blood flow of the bypass graft, measured as enough volume with square wave flowmeter during the operation, was also confirmed with postoperative angiography. After the episodes of gastrointestinal bleeding, hypotensive attack and hemorrhagic infarction of right frontal base, the postoperative final result was successful and the patient is doing well, 6 months after the operation.
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PMID:[A case of extra-intracranial bypass venous graft for giant internal carotid aneurysm (author's transl)]. 52 56

The concentrations of adrenaline and noradrenaline, and dopamine-beta-hydroxylase in the plasma, and certain haemodynamic parameters, were determined in 14 children undergoing surgical correction of congenital cardiac defects under hypothermia at 30 degrees C and methoxyflurane anaesthesia. During the pre-operative phase of hypothermia at 30 degrees C, the adrenaline levels rose to about 300% of the inital levels, and the noradrenaline levels to about 200%. During the postoperative phase of re-warming at 34 degrees C, a further dysregulative release of catecholamines led to an increase in adrenaline levels to a critical concentration of about 800% of the norm, and in noradrenaline levels of about 400% of the norm. No change was seen in dopamine-beta-hydroxylase activity. Hypothermia thus results in a massive activation of the sympatho-neuronal and sympatho-adrenal systems, which is not prevented by methoxyflurane anaesthesia, and which may endanger the recently operated heart, particularly during the early post-operative period, because of the increased oxygen requirements imposed on the myocardium. In normothermia, on the other hand, methoxyflurane anaesthesia results in only a slight degree of activation of the sympathetic nervous system, which increased only slightly during the post-operative period. Under these conditions, the plasma dopamine-beta-hydroxylase activity remains unchanged. Unlike the changes in plasma catecholamine levels, dopamine-beta-hydroxylase activity cannot be regarded as an index of changes in sympatho-neuronal activity.
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PMID:[The effect of hypothermia and methoxyflurane-anaesthesia on sympatho-neuronal and sympatho-adrenal activity in the course of cardiac surgery (author's transl)]. 53 49

The prevention and control of massive bleeding has always been a problem in neurosurgical procedures, particularly in patients with arteriovenous malformations, intracranial aneurysms, and large vascular tumors. During the past 25 years, new technics have reduced the risk of hemorrhage; however, these have been most suitable for adult patients. Vascular intracranial lesions during infancy present even more complex problems. This is a report of the anesthetic management of a 7-month-old infant with an aneurysm of the v cerebri magna (great vein of Galen). Anesthetic management consisted of (1) halothane-N2O-O2 general endotracheal anesthesia, (2) surface-induced profound hypothermia, and (3) low-flow extracorporeal circulation. Phenothiazine premedication was used with halothane anesthesia to antagonize reflex vasoconstriction during hypothermia, hypothermia and low cardiac output to lessen the possibility of hemorrhage, aneurysmal rupture, and neurologic damage, and surface-induced hypothermia because it provides better core perfusion than central cooling. This technic allowed a successful outcome in an otherwise high-risk procedure.
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PMID:Anesthetic management of an intracranial arteriovenous malformation in infancy. 55 21


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