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

Pulmonary preservation is improved by hypothermia, but the optimal preservation temperature is not known. The effects of two different preservation temperatures, 4 degrees and 10 degrees C, on lung function were studied in a canine left lung allograft survival model allowing selective perfusion of either lung. After donor treatment with high-dose prostaglandin E1, (25 micrograms/kg), lungs were flushed with modified Euro-Collins solution (50 ml/kg) and stored in Euro-Collins solution for 18 hours at 4 degrees C in group I (n = 8) and 10 degrees C in group II (n = 6). Pulmonary gas exchange and hemodynamics were compared on the day of transplantation (day 0) and 3 days later (day 3). Rapid, high-flow, low-pressure flush was achieved uniformly in both groups (flush time: group I, 35.1 +/- 2.4 second; group II, 35.3 +/- 3.0 seconds; p = 0.96; flush pressure: group I, 9.8 +/- 0.7 mm Hg; group II, 10.1 +/- 1.1 mm Hg; p = 0.8). Transplanted lungs provided similar excellent oxygenation in both groups on day 0 (arterial oxygen tension, group I, 451 +/- 82 mm Hg; group II, 497 +/- 37 mm Hg; p = 0.61; inspired oxygen fraction = 1.0) and day 3 (arterial oxygen tension, group I, 551 +/- 57 mm Hg; group II, 587 +/- 19 mm Hg; p = 0.55), with a statistically significant improvement from day 0 to day 3 in both groups (group I, p = 0.034; group II, p = 0.038). There was no difference in arterial carbon dioxide tension, base excess, cardiac output, blood pressure or pulmonary artery pressure between the two groups. We conclude that a large bolus of prostaglandin E1 into the pulmonary artery produces a high-flow, low-pressure flush with modified Euro-Collins solution; with this technique, equivalent, reliable 18-hour lung preservation can be achieved at 4 degrees and 10 degrees C flush and storage temperatures.
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PMID:Reliable eighteen-hour lung preservation at 4 degrees and 10 degrees C by pulmonary artery flush after high-dose prostaglandin E1 administration. 159 77

Previous studies have shown that elevated blood glucose is detrimental to the outcome in acute carbon monoxide (CO) poisoning. The present goals were to characterize the blood lactate and catecholamine changes and to determine whether elevated blood glucose results in increases in the levels of these substances. Two groups of adult Sprague-Dawley, Levine-prepared, female rats (n = 22 each) were exposed to 2400 ppm CO for 90 min: one group received nothing (CO alone), while the other group was infused with a 50% glucose solution (4 ml/kg) (CO + glucose). The usual hypothermia, hypotension, bradycardia and hemoconcentration associated with acute severe CO poisoning were observed. Survival rates were 68% and 54% in the CO alone and CO + glucose groups, respectively. Arterial blood pressure tended to decline more in rats that died; the difference was significant in the CO + glucose group. In the CO alone group, plasma glucose concentration was significantly lower after CO exposure in rats that died than in survivors (35 +/- 15 vs. 99 +/- 16 mg/dl). In the CO + glucose group, glucose concentration was significantly higher after 45 min in rats that died (d) than in survivors (s) (447 +/- 29 vs. 324 +/- 31 mg/dl). Elevated blood glucose in the CO + glucose group failed to significantly increase blood lactate; however, lactate tended to be higher in rats that died in both groups [CO alone group: 175 +/- 17 (d) vs. 138 +/- 9 (s); CO + glucose group: 154 +/- 10 (d) vs. 143 +/- 8 (s)]. Plasma epinephrine and norepinephrine increased significantly 6-10-fold and 2-6-fold in each of the two groups, respectively; however, catecholamine levels were not related to either the administration of glucose or survival. With regard to CO poisoning in this animal model, the results do not support the hypotheses that elevated blood glucose exacerbates the increase in blood lactate, that increased catecholamine increases glucose, or that greater CO-induced hypoglycemia results from increased lactate production. The results do show that death is related to abnormally high or low blood glucose, but that it is not due to higher blood lactate or catecholamine levels.
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PMID:Blood lactate and catecholamine levels in the carbon monoxide-exposed rat: the response to elevated glucose. 160 27

O2 consumption (VO2), CO2 production (VCO2), and minute ventilation (VE) have been measured during normoxia and hypoxia (10-20 min in 10% O2) in specimens of 27 species from 6 mammalian orders, ranging in body mass (M) from a few grams to several kilograms. In normoxia, both metabolism and VE scaled close to M3/4, VE/VO2 and VE/VCO2 therefore being independent of M. In hypoxia, VE/metabolism increased in all species (on average greater than 100%), mostly because of a drop in VO2. On average, VE was 23% above the normoxic value but in some species decreased below normoxia. VO2 dropped in all but one species, on average 35%. Body temperature decreased by variable amounts, usually more in the smallest species. The decrease in metabolism during hypoxia was positively correlated with the resting metabolic rate of the species in a manner very similar to what can be calculated from data of previously studied newborn mammals. Hence hypoxia may decrease metabolic rate by decreasing thermogenesis, with larger effects in smaller animals, whether newborns or adults, because of their higher thermogenic requirements. We conclude that 1) hypoxic hypometabolism is a general characteristic of the mammalian response to hypoxia and cannot be neglected in the interpretation of ventilatory and cardiovascular responses and 2) its magnitude is inversely related to the resting VO2 of the species and therefore could be less prominent or possibly absent in adults of larger species.
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PMID:Metabolism and ventilation in acute hypoxia: a comparative analysis in small mammalian species. 162 57

In pigeons, during shallow nocturnal hypothermia induced by food deprivation, body temperature falls to values between 35 degrees C and 38 degrees C. Body temperature, oxygen consumption, and arterial blood pH and PCO2 were recorded during the entrance into such nocturnal hypothermic periods. In vivo pH was kept constant, while in vivo PCO2 increased slightly during hypothermia. This caused the temperature-corrected value of pH (pH*, measured at 40 degrees C) to fall by -0.014 units/degrees C, and the total CO2-content to rise by 3.2 mM, an increase of 16%. These changes in the acid-base balance represent, in effect, a respiratory acidosis that closely parallels the normal buffer line for pigeons. Q10 values, relating oxygen uptake to body temperature, were higher than 4.0 at the very beginning of the entrance into hypothermia, indicating that the metabolic rate was actively inhibited. However, the present results do not indicate any relationship between the acidosis and the inhibition of the metabolic rate.
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PMID:Oxygen consumption and acid-base balance during shallow hypothermia in the pigeon. 162 38

Levine-prepared, female Sprague-Dawley rats were used to investigate the effects of carbon monoxide (CO) and cyanide (CN) on heart rate, blood pressure, hematocrit, body temperature, blood glucose, lactate, and neurologic function. Rats were exposed to either 2400 ppm CO, 1500 ppm CO, 4 mg/kg NaCN, or both 1500 ppm CO and 4 mg/kg NaCN for 90 min, followed by 4 h of room air recovery. Following exposure to 2400 ppm CO, rats exhibited a significant bradycardia which normalized by 2 h of recovery. All groups exhibited an initial hypotension which was either maintained or exaggerated during exposure in all but the rats exposed to CN, and which returned to pre-exposure values by 90 min. All groups experienced a significant hypothermia during the exposure period, with those in the 1500 ppm CO or the CN returning to initial values over the recovery period. The only significant change in hematocrit was due to 2400 ppm CO (4.1% increase). During exposure, all groups experienced an initial surge in glucose concentration which was maintained in all but rats exposed to 2400 ppm CO. The greatest hyperglycemic response resulted from the combination of CO and CN, whereas 2400 ppm CO produced the smallest. CN alone produced no significant rise in lactate concentration. However, lactate concentration in all other groups was significantly elevated during the exposure period, returning to initial values by 4 h of recovery. Lactate concentrations and neurologic deficit in rats exposed to 1500 ppm CO, when added to those rats treated with CN, closely approximated the lactate and neurologic deficit of the combination treatment. Neurologic deficit was greatest in rats exposed to 2400 ppm CO. While in most cases the responses of the rats to CO and CN differed whether the substances were administered alone or in combination, a synergistic relationship is not suggested. An additive or less than additive relationship is more likely.
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PMID:Cardiovascular, metabolic and neurologic effects of carbon monoxide and cyanide in the rat. 164 71

Retrograde cerebral perfusion through a superior vena caval cannula is a new technique for protecting the brain during aortic arch operations. In mongrel dogs (n = 10; 13 to 15 kg) we have performed retrograde cerebral perfusion (300 mL/min) by infusing blood through a superior vena caval cannula with aortic and inferior vena caval drainage. We have measured the cerebral tissue blood flow, oxygen consumption, and carbon dioxide exudation during retrograde cerebral perfusion at normothermia (NT, 37 degrees C) and hypothermia (HT, 20 degrees C) and have compared these values with values obtained in dogs during cardiopulmonary bypass (1,200 mL/min). Cerebral tissue blood flow was measured by the hydrogen clearance method. During retrograde cerebral perfusion about 20% of the superior vena caval perfusate was returned through the aorta and the rest drained from the inferior vena cava. Cerebral vascular resistance during retrograde cerebral perfusion was lower than that during cardiopulmonary bypass (NT, 63.8 +/- 52.5 versus 126.9 +/- 58.4; HT, 28.4 +/- 32.8 versus 69.5 +/- 28.7 x 10(3) dynes.s.cm(-5). Retrograde cerebral perfusion provided half the cerebral tissue blood flow of cardiopulmonary bypass (NT, 14.7 +/- 6.4 versus 34.3 +/- 7.8; HT, 17.6 +/- 5.6 versus 37.2 +/- 10.6 mL/min). Retrograde cerebral perfusion also provided a third of the oxygen (NT, 4.4 +/- 2.1 versus 12.3 +/- 7.1; HT, 1.4 +/- 0.8 versus 4.2 +/- 1.3 mL/min) and discharged 20% of the carbon dioxide (NT, 0.24 +/- 0.08 versus 1.19 +/- 0.58; HT, 0.15 +/- 0.06 versus 0.51 +/- 0.17 mmol/min) when compared with cardiopulmonary bypass. Retrograde cerebral perfusion may reduce ischemic damage during interruption of cerebral blood flow.
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PMID:Retrograde cerebral perfusion through a superior vena caval cannula protects the brain. 172 41

Because of the iatrogenic hypothermic stress of a 0.3 degrees C loss created by carbon dioxide pneumoperitoneum insufflation at laparoscopy, it is important to reduce this danger to a minimum. The risk is diminished by increasing the temperature of the delivered carbon dioxide gas to 30.0-30.5 degrees C. This was demonstrated by evaluating 20 patients undergoing laparoscopies with unheated carbon dioxide pneumoperitoneum and 20 with heated carbon dioxide pneumoperitoneum. All procedures were performed without the use of laser or cautery. The group receiving the heated gas had lower and more stable thermal losses. Warming of the carbon dioxide prior to abdominal delivery is recommended to counteract hypothermia.
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PMID:Correction of laparoscopic insufflation hypothermia. 183 66

Operative laparoscopy is experiencing an increase in its use and indications. This expansion exposes patients to increased operating time, larger volumes of carbon dioxide for maintenance of a pneumoperitoneum, and higher gas flow rates for intraperitoneal delivery. Patients with medical complications, advancing age, and potentially contaminated procedures are now considered acceptable candidates for operative endoscopic techniques via laparoscopy. A previously observed but unquantified amount of hypothermia was measured and evaluated by changes in core temperature after known quantities of carbon dioxide were delivered intra-abdominally over measured periods of time and with controlled flow rates. A decrease of 0.3 degrees C in the core temperature was observed for each 50 L of carbon dioxide delivered.
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PMID:Laparoscopic hypothermia. 183 97

Weaning of patients from IPPV after cardiopulmonary bypass (CPB) is usually monitored by frequent arterial blood gas analysis. Non-invasive monitoring has the advantage of providing continuous and instantaneous information and could reduce the frequency of arterial blood gas sampling. Twenty patients were studied to determine the reliability of capnometry and pulse oximetry in this situation. The effects of hypothermia and moderate haemodynamic instability were examined. A further 40 patients were then weaned using non-invasive monitoring. Correlation between PaCO2 and PETCO2 was 0.64-0.79 for the mass spectrometer and 0.67-0.81 for the infra-red analyser. No clinical problems arose. The detection rate for mild hypercarbia was 78.6 per cent and 50 per cent for hypoxia. Possible reasons for this are discussed. Once CO2 and O2 gradients are established, pulse oximetry and capnometry provide sufficiently reliable monitoring to enable weaning from IPPV, with the advantage of continuous display, and allow a reduction in the use of arterial blood gas analyses.
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PMID:Weaning from ventilation after cardiopulmonary bypass: evaluation of a non-invasive technique. 175 13

Three postoperative analgesic protocols were assigned randomly to 24 healthy dogs after thoracotomy at the left fourth intercostal space. Morphine was administered parenterally to eight dogs after tracheal extubation; selective intercostal nerve blocks with bupivacaine hydrochloride and epinephrine were administered to eight dogs before closure of the thorax; and bupivacaine hydrochloride and epinephrine were administered through an interpleural catheter to eight dogs after tracheal extubation. Heart rate, respiratory rate, rectal temperature, hematocrit, plasma protein, blood gas, and pain score evaluations were recorded before surgery and 30 minutes, 1 hour, 2 hours, and 3 hours after extubation. Morphine caused significant decreases in blood pH and blood oxygen tensions, and significant increases in carbon dioxide tensions. Dogs treated with intercostal nerve blocks had no significant changes in these parameters, and dogs treated with interpleural bupivacaine had significant decreases in blood oxygen tension. All dogs had significant decreases in rectal temperature, and hypothermia was prolonged after morphine. Analgesia was initially adequate in most dogs, but some dogs in each treatment group had recurrence of pain and were treated with interpleural bupivacaine. One dog developed pneumothorax. Interpleural administration of bupivacaine produced analgesia equal to that produced by systemic administration of morphine or selective intercostal nerve block with bupivacaine. Bupivacaine was easily readministered through an interpleural catheter. Respiratory compromise was less in dogs treated with bupivacaine than in dogs treated with morphine. After intercostal thoracotomy, interpleural bupivacaine provided prolonged analgesia with fewer blood gas alterations than morphine.
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PMID:Analgesia in dogs after intercostal thoracotomy. A comparison of morphine, selective intercostal nerve block, and interpleural regional analgesia with bupivacaine. 190 Nov 83


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