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

In the present study, an effort was made to establish the procedure for 60 minutes selective profound hypothermia below 20 degrees C of the abdominal viscera. In 6 mongrel dogs, hemodynamic changes were investigated during 60 minutes normothermic vascular exclusion of the abdominal viscera by occluding the aorta and inferior caval vein just above the diaphragm. Hemodynamic state just after the combined occlusion of these vessels was stable, but 60 minutes occlusion was followed by hypoperfusion of the cranial half of the body. In 15 mongrel dogs, the 60 minutes selective profound hypothermia below 20 degrees C of the abdominal viscera was performed after occluding these vessels with an aid of extracorporeal circuit. Pooled blood in the splanchnic region during hypothermia was warmed and drained to jugular vein to maintain the hemodynamic state in the cranial half of the body. Twelve of 15 dogs survived 2 weeks after the procedure with minimal hepatic damage. In 7 mongrel dogs, blood coagulation system was investigated. Decrease of platelet, fibrinogen, plasminogen, anti-thrombin III, prothrombin and cold insoluble globulin concentration, elongation of prothrombin time and partial thromboplastin time, and elevation of FDP occurred during and after the selective profound hypothermia. But these changes were self limiting and recovered soon after heparin neutralization. In 9 mongrel dogs, extended pancreatectomy with splenectomy and combined resection of portal vein using selective profound hypothermia was performed. Bleeding and splanchnic congestion during extended pancreatectomy was minimum. Five of 9 dogs survived 2 weeks with slight hepatic and renal damage.
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PMID:[Experimental studies on the selective profound hypothermia of the abdominal viscera by descending aorta and inferior caval vein occlusion]. 667 63

The peak incidence of DIC in the pediatric age group is in the neonatal period. The newborn infant is particularly susceptible to DIC because of several handicaps, such as physiological hypofunction of anticoagulant and fibrinolytic systems, an underdeveloped capacity in the reticuloendothelial system and a tendency to develop acidosis, hypothermia, hypoxia and shock. Although some criteria have been reported for the diagnosis of DIC in adults, based on clinical and laboratory findings, these are not necessarily applicable to the diagnosis of DIC in newborn infants. This is because a large blood sample is required, a long period of time is necessary for assay and difference in several coagulation and fibrinolysis factors exist between newborn infants and adults. We therefore established a criteria for the diagnosis of DIC in newborn infants, based on data obtained from newborn infants with DIC. Diagnostic procedures of many molecular markers of hemostasis have been developed from this. Some of them, such as FDP-D dimer are valuable for the diagnosis in children but others are not necessarily useful because of the susceptibility to the venipuncture technique. Our criteria for the diagnosis of DIC in newborn infants must be modified in the diagnosis of DIC in very low birth weight infants.
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PMID:[New approach to the diagnosis of disseminated intravascular coagulation in childhood]. 843 30

Although reliable hemostasis screening in the newborn is difficult to obtain, the information gained from such testing is essential in differentiating the inherited from the acquired bleeding disorder. Sick infants are at risk for developing hemorrhage or thrombosis in response to a variety of diseases or injuries. Screening tests must be interpreted using appropriate normal ranges for term or preterm infants. Neonates are particularly susceptible to DIC because of their underdeveloped reticuloendothelial system and their tendency to develop acidosis, hypothermia, hypoxia, and shock. Bleeding is commonly the results of intravascular coagulation or decreased synthesis of clotting factors by the liver. Criteria based on clinical and laboratory findings have been determined in adults; however, these criteria are not necessarily applicable to neonates. A study reviewing 74 cases of newborns with suspected DIC reported that the most reliable diagnostic tests are the platelet count, D-dimer or FDP, PT, PTT, and fibrinogen. Whatever the test, the nurse's accurate assessment of the neonate, careful collection of blood, and reporting of abnormal results remain paramount in obtaining timely, appropriate care.
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PMID:DIC screening in the newborn. 936 97

This study was undertaken to determine the factors that influence the final outcome after the operation of acute aortic dissection. Twenty-one patients, the median age was 59 years (range 44 to 81), were operated at acute phase in 92 admitted into our hospital during the 13-year period between May 1985 and Jan. 1998. Preoperative complications included cardiac in 5 and ruptured with shock in 7, myocardial ischemia in 3 and stroke in 4. The ascending aortic reconstruction (9, 43%), ascending aorta and arch reconstruction (7, 33%) and other procedures (4, 19%) were performed using cardiopulmonary bypass with deep hypothermia and circulatory arrest or selective cerebral perfusion. The 30-day operative deaths were 6 (29%) and 5 (24%) late death occurred. Three out of 5 were aneurysm related deaths. The cause specific survival rates were 61% at 5 years and 51% at 8 years. The multivariably determined risk factors for death were as follows (p < 0.05): preoperative FDP; bleeding volume; postoperative renal complications; postoperative stroke.
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PMID:[Early and long-term outcome for surgical treatment of acute aortic dissection]. 974 94

A 63-year-old woman presenting with thrombocytepenia and signs of intravascular coagulation (prothronbin time, 59%: FDP, 100 micrograms.ml-1) due to a giant hemangioma of the liver (Kasabach-Merritt syndrome) was scheduled for the resection of the right lobe of the liver. In order to protect the liver on occlusion of the right hepatic artery and portal vein, we induced mild hypothermia technique with vasodilation and surface cooling by convecting warming device together with hepatoprotective agents of PGE1 and ulinastatin. Severe, acute massive bleeding occurred due to the injury of the middle hepatic vein and from the resected surface of the liver. Her rectal temperature was 31.9 degrees C during massive bleeding. Her hemoglobin decreased to 3.9 g.dl-1. Total estimated blood loss was 22,000 ml. The weight of the resected liver was 2.5 kg. The maximum postoperative levels of T-Bil and GOT were 2.47 mg.dl-1 and 171 IU.l-1, respectively. The liver seemed to have been well preserved and no other complications were observed. The hemangioma was completely removed by excision of the right lobe of the liver. Subsequently, all coagulation parameters returned to normal, indicating a complete reversibility of the coagulopathy. Surface-induced mild hypothermia is a useful and valuable method for protecting the liver during severe massive bleeding.
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PMID:[Surface-induced mild hypothermia anesthesia for hepatectomy in a patient with a giant hemangioma of the liver (Kasabach-Merritt syndrome)]. 985 99