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Query: UMLS:C0020672 (
hypothermia
)
17,327
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Metabolic suppression by temperature is a key to successful organ preservation. Additional methods for inducing metabolic suppression may further improve organ preservation. Extracellular acidosis has been shown to suppress warm anoxic injury to various isolated cells. Acidosis may suppress enzymes with a pH optimum at the pH of the cytosol (pH 7.3). In this study, the combination of
hypothermia
and acidosis was used to determine if it would improve renal preservation. Dog kidneys were cold-stored (CS) for 48 h in University of Wisconsin (UW) solution with the pH adjusted to 6.4, 6.8, 7.4, or 7.8. Kidneys were also machine-perfused (MP) for 3 days with the gluconate perfusion solution (Belzer's machine perfusion solution, MPS) at pHs similar to those tested for CS. Renal function (serum
creatinine
, SCr) and survival were recorded in immediate contralateral nephrectomized recipients. On the basis of maximum SCr values, kidneys preserved by CS or MP were best preserved at pHs of 7.4 or 7.8. At a pH of 6.8, SCr values were elevated and returned to normal at a slower rate than in those preserved at higher pHs. This study shows that acidosis is not cytoprotective to cold-stored dog kidneys and causes preservation/reperfusion injury.
...
PMID:Optimal pH for simple cold storage or machine perfusion of dog kidneys with UW solution. 963 50
During 1993-1998, in winter time 14 elderly patients: 8 female and 6 male aged 65-88, were treated because of
hypothermia
. Rectal temperature on admission was 20-34.9 degrees C. Sopor was present in 2 and various grades of coma were present in 10 patients. Arterial hypotension was recorded in 5, and shock in 9 patients. Increased serum
creatinine
level was found in 8 patients. The mean rectal temperature in the whole group was 31.3 degrees C +/- 4.7, ranging from 20.0 to 34.9 degrees C, and the mean serum
creatinine
level was 172.2 +/- 93.5, in range of 66.0 to 360.0 mumol/L. Negative correlation between those two parameters was found: r = -0.572. In 2 of them parameters of renal failure were analyzed: urine sodium concentration,
creatinine
urine/plasma ratio, urine osmolality, urine/plasma osmolality ratio, renal failure index and fractional excretion of filtered sodium. In one of the patients all parameters were within the range of functional oliguria, in an other the urine sodium concentration serum showed acute renal failure, but all other findings showed borderline values between functional oliguria and acute renal failure. Twelve out of 14 patients died within 1-216 hours from admission.
...
PMID:Hypothermia and acute renal failure in the elderly. 1009 29
The purpose of the present work was to evaluate the kallikrein-kinin system and effects of
hypothermia
during renal ischemia and reperfusion. Male C57BL/KSJmdb mice were subjected to 20 or 60 min ischemia for different periods of reperfusion. Our results demonstrate that short periods of ischemia followed by reperfusion did not cause significant alterations in kallikrein activity, Evans Blue (EB) extravasation, prokallikreins, myeloperoxidase activity or plasma
creatinine
concentration. Edema was evident at 1 h reperfusion in the treated mice, but returned to basal values after 24 h reperfusion. Kallikrein activities and EB extravasation showed a significant increase in 60 min ischemic mice. Myeloperoxidase activity in the kidney of the mice confirmed net infiltration in the group with 60 min ischemia and 24 h reperfusion. The generation of kinins and activation of matrix degrading enzymes by tissue kallikrein, liberated from both renal and infiltrated leukocytes, could be responsible at least in part for the damage observed in the kidney of mice subject to 60 min ischemia and reperfusion. The
hypothermia
significantly reduced the inflammatory process in the 60 min ischemic mice, and did prevent an increase in vascular permeability. Nevertheless, the tissue edema was not shown to change between normothermic and hypothermic ischemic mice.
...
PMID:Renal ischemia-induced increase in vascular permeability is limited by hypothermia. 1059 59
We describe herein the postoperative renal functions of patients who required a suprarenal aortic cross-clamp during abdominal aortic surgery. Seven patients required a unilateral suprarenal aortic cross-clamp (group A) and six patients required a bilateral suprarenal clamp (group B). Eighty-three patients who required an infrarenal aortic clamp were assigned to group C. Renal
hypothermia
with renal perfusion or topical cooling during suprarenal clamp was not performed. No hospital deaths were encountered. In group B, the postoperative
creatinine
and blood urea nitrogen (BUN) levels remained statistically significantly higher than that of group C until the seventh postoperative day. The postoperative renal dysfunction (serum
creatinine
level >2.0 mg/dl) was 28.6% in group A and 50% in group B, while it was only 8.4% in group C, although no patient required either temporary or permanent hemodialysis. The postoperative peak BUN over 30 min suprarenal clamp was significantly higher than that within 30 min. In summary, the postoperative renal function was impaired after an extended bilateral suprarenal clamp. These findings suggest that if prolonged renal ischemia is thus expected, then renal preservation should be considered.
...
PMID:Postoperative renal function after an abdominal aortic aneurysm repair requiring a suprarenal aortic cross-clamp. 1064 80
The renal function is often affected in asphyxiated newborn infants. The pharmacokinetics of drugs like aminoglycosides eliminated through the kidneys may be impaired and require a different than usual dosage regimen. A decrease in body temperature is associated with a decrease in glomerular filtration rate and may, therefore, impair the elimination of aminoglycosides. When
hypothermia
is applied as neuronal rescue therapy after birth asphyxia, the pharmacokinetics of kidney-eliminated drugs may be impaired even more. We used our well-established global hypoxia-asphyxia newborn pig model to evaluate the effect of mild
hypothermia
after hypoxia-ischemia on gentamicin pharmacokinetics. Newborn pigs underwent global hypoxia-ischemia followed by normothermia (39 degrees C) for 72 h (n = 8) or mild
hypothermia
(35 degrees C) for 24 h followed by normothermia (39 degrees C) for 48 h (n = 8). Gentamicin pharmacokinetics was studied after three gentamicin doses: before hypoxia-ischemia, after hypoxia-ischemia during mild
hypothermia
or normothermia, and during normothermia 48 h after the first dose. The gentamicin pharmacokinetics variables were calculated using a SAAM II program. Hypoxia-ischemia altered renal function and gentamicin pharmacokinetics. The gentamicin clearance correlated with the
creatinine
plasma concentration (r = 0.89) and with the kidney pathology score (r = 0.55). There was no significant difference in gentamicin pharmacokinetics at 35 and 39 degrees C in newborn pigs after hypoxia-ischemia. The gentamicin pharmacokinetics variables were not different in the hypothermic or normothermic pigs after all three studied doses. Mild
hypothermia
for 24 h after hypoxia-ischemia does not affect gentamicin pharmacokinetics.
...
PMID:Influence of mild hypothermia after hypoxia-ischemia on the pharmacokinetics of gentamicin in newborn pigs. 1065 31
Clinicophysiological, haematological and biochemical effects of xylazine (0.05mgkg(-1)) and medetomidine (0.01mgkg(-1)) were studied in nine adult goats after lumbosacral subarachnoid administration. The onset of analgesia by xylazine and medetomidine was observed in 9.11+/-1.07 and 8.66+/-2.37min (mean+/-S.E.), respectively. Both alpha(2)-agonists produced moderate analgesia of hind quarter, perineum and flank, mild ataxia and sedation. The duration of analgesia after xylazine administration was 134.44+/-8.87min and that after medetomidine was 158.33+/-9.96min (mean+/-S.E.). Xylazine and medetomidine induced significant (p<0.05) decrease in heart rate, respiratory rate and
hypothermia
. Haemoglobin (Hb), packed cell volume (PCV) and total leukocyte count (TLC) decreased significantly. Changes in the physiological and haematological parameters were transient in nature. Xylazine and medetomidine produced a significant (p<0.05) increase in
creatinine
and glucose levels. However, these parameters fluctuated within normal range and started to recover within 120min. However, serum urea nitrogen (SUN), serum chloride, sodium and potassium did not show any significant change. The effects produced by xylazine and medetomidine were however, comparable at these dose levels. The study indicates that xylazine at 0.05mgkg(-1) and medetomidine at 0.01mgkg(-1) did not induce any serious alteration in the physiological, haematological and biochemical parameters and can be safely used in inducing hind quarter, flank and perineal analgesia in goats.
...
PMID:Physiologic and biochemical effects of subarachnoidally administered xylazine and medetomidine in goats. 1102 38
Selective cerebral perfusion (SCP) and open distal anastomosis (OD) with
hypothermia
has been used as a popular means for circulatory assistance in aortic arch surgery. Although SCP has become accepted for brain protection, the influence of OD accompanying circulatory arrest on lower body ischemia is not known. We studied gastric tonometry (gastric intramucosal pH [pHi]) to estimate splanchnic ischemia during OD, and its relationship to postoperative organ function. In five patients (pts) (range, 65-78 years; mean, 71 years; group OD) who underwent arch replacement using SCP and OD with moderate
hypothermia
(25 degrees C) during the period from March to August of 1999, pHi was measured precardiopulmonary bypass (pre-CPB), 30 min of CPB (CPB30), 10 min after OD (OD10), at end of CPB, and post-CPB. Eight pts (range, 52-78 years; mean; 66 years) who underwent standard CPB (33 degrees C) during the same period (coronary artery bypass surgery in six and valve surgery in two) served as controls (group C). In group OD, pHi was significantly decreased at OD10 (7.35 +/- 0.03 at CPB30 vs. 7.23 +/- 0.07 at OD10, p < 0.05) but recovered by the end of CPB (7.32 +/- 0.02).
Creatinine
clearance on the first postoperative day (1POD) was significantly (p < 0.05) lower in group OD (82 +/- 40 ml/min) than in group C (126 +/- 25 ml/min), although there was no significant difference in preoperative values between the two groups. The pHi at OD10 did not correlate with the duration of OD (range, 30-47 min; mean, 38 min), whereas pHi at OD10 significantly correlated with BUN (r = -0.973, p = 0.0054), Cr(r = -0.977, p = 0.0043), and CCr (r = 0.908, p = 0.0328) on 1POD. One patient in group OD developed paraplegia and renal failure postoperatively. His pHi at OD10 was severely decreased to 7.11. These results suggest that intraoperative monitoring of pHi may be useful for the evaluation of visceral organ ischemia during OD in arch replacement and may contribute to improved technique for circulatory assistance in aortic surgery.
...
PMID:Gastric intramucosal pH during lower body circulatory arrest under open distal anastomosis with selective cerebral perfusion in aortic arch repair. 1157 35
Many cases of
hypothermia
(HT) occur in trauma victims subjected to soft tissue injury and hemorrhage. The aim of the present study was to study the effects of HT on the combination of these insults. A standardized gunshot wound was inflicted on the right hind leg of 14 anesthetized piglets. They were then exsanguinated of 50% of their blood volume and randomized to normothermia or HT (30 degrees C). The animals were observed for 4 h after the injury with measurements of hemodynamics, oxygen consumption, and of plasma catecholamines and electrolytes. The insults reduced cardiac output and the arterial pressure by approximately 50%, but no further reduction occurred when HT was induced. The oxygen extraction ratio increased from approximately 35% to 75% in both groups. The gradual reduction of oxygen consumption in HT animals (P < 0.05) decreased the oxygen extraction ratio to around 50%. Heart rate, the serum potassium and
creatinine
concentrations, and the leukocyte counts were all maintained closer to baseline in the presence of HT.
Hypothermia
tended to decrease oxygen extraction and was associated with less evidence of tissue injury. These effects are potentially beneficial in soft-tissue trauma combined with hypovolemia.
...
PMID:Induced hypothermia after high-energy soft-tissue injury and subsequent hemorrhagic shock. 1183 87
A study was performed to determine the limiting factors to expanding the donor pool with warm ischemically (WI) damaged kidneys. Canine kidneys were damaged by 30 min of WI, and then either cold stored (CS) in ViaSpan (4 degrees C) for 18 h, or warm perfused with exsanguineous metabolic support (EMS) technology (32 degrees C) for 18h, or subjected to combinations of both techniques. The kidneys were autotransplanted with contralateral nephrectomy. In kidneys with WI and CS alone, the mean peak serum
creatinine
value was 6.3mg/dL and took 14 days to normalize. In contrast, kidneys where renal metabolism was resuscitated ex vivo during 18 h of warm perfusion demonstrated mild elevations in the serum chemistries (2.6mg/dL). The damage in kidneys CS for 18h was ameliorated with 3 h of subsequent warm perfusion and eliminated by 18 h of warm perfusion. In contrast, reversing the order with CS following WI and 18h of warm perfusion resulted in a time-dependent increase in damage. These results identify
hypothermia
as a major limiting factor to expanding indications for kidney donation. While
hypothermia
represents the foundation of preservation in the heart-beating donor, its use in WI damaged organs appears to represent a limiting factor.
...
PMID:Hypothermia--a limiting factor in using warm ischemically damaged kidneys. 1220 74
We report a case of severe rhabdomyolysis associated with Salmonella encephalopathy. A 3-year-old girl was admitted to our hospital because of status convulsives and unconsciousness. She was diagnosed as having Salmonella encephalopathy with rhabdmyolysis, and was treated by mild
hypothermia
and mechanical ventilation. Five days later she developed anuria with increased serum levels of myoglobin, CK and
creatinine
. And the diagnosis of acute renal failure was made. Peritoneal dialysis was begun from 6 days after admission. Hyperinfusion, the usual therapy of rhabdomyolysis, was not performed. She survived showing gradual improvement of renal function and consciousness. In a case of rhabdomyolysis complicating a neurologic disorder, a well-known poor prognostic factor, priority should be given to brain protection rather than to symptomatic treatment of rhabdomyolysis.
...
PMID:[A case of rhabdomyolysis associated with Salmonella encephalopathy]. 1244 Jan 1
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