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

Cardiac hypertrophy was produced in embryonic chicks by decreasing the incubation temperature from 38 degrees C to 32 degrees C on day 11. Increases in ventricular protein, RNA, and DNA support the cardiac enlargement. Cytochrome-c oxidase activity and citrate synthase activity were depressed in hypothermic ventricles by 63% and 56%, respectively. No significant differences were seen in enzyme activities in pectoralis muscles. The involvement of mitochondrial gene replication and transcription was evaluated using a cDNA clone for the mitochondrially encoded subunit III of cytochrome-c oxidase (CO III). Quantitative slot-blot analysis demonstrated that the relative CO III mRNA concentration was reduced in hypothermic ventricles. In contrast, the relative mitochondrial DNA concentration was increased in hypothermic ventricles. Taken together, these data indicate that a hypothermia-induced decrease in cytochrome-c oxidase activity is associated with a decrease in CO III mRNA, which is not coupled to a decrease in the mitochondrial DNA copy number. This dissociation of mitochondrial gene replication and transcription may provide a useful model for examining the regulation of mitochondrial biogenesis.
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PMID:Mitochondrial DNA replication and transcription are dissociated during embryonic cardiac hypertrophy. 166 4

Mild hypothermia (32-34 deg C) treatment alleviates vital organ damage after cardiac arrest. A new cooling device, the Thermosuit operates by applying of a thin layer of water directly to the body surface. Hypothermic patients may experience sequential fibrillation. Therefore, we examined whether defibrillation could be administered safely and effectively in water. A 35 kg swine was anesthetized and placed inside the Thermosuit system. This consists of a water containing surround and pumping system. Conventional AED disposable defibrillation electrodes were applied to the animal's chest. Fibrillation was created by applying a 50-volt signal to a pacing wire introduced into the heart. Following a 30-second period of fibrillation, defibrillation was attempted using Medtronic AED 1000 defibrillator. Defibrillation voltage and current were measured. There were three test cases: dry in the system, wet in the functioning system, and damp. Cooling water in the system was contaminated with saline to simulate potential conditions in clinical application. In each fibrillation-defibrillation sequence, the heart was restarted successfully; this required less than 220 joules. Only a small difference was measured in the overall defibrillation voltage and current as applied to the electrodes for the different cases. Thus, underwater defibrillation is safe and can be performed effectively.
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PMID:Successful defibrillation in water: a preliminary study. 1794 19

Epilepsy is the most common neurological disorder; approximately 1% of the population worldwide have epilepsy. Moreover, sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Information concerning risk factors for SUDEP is conflicting, but potential risk factors include: age, early onset of epilepsy, duration of epilepsy, uncontrolled seizures, seizure frequency and AED number. Additionally, the cause of SUDEP is still unknown; however, the most commonly suggested mechanisms are cardiac abnormalities during and between seizures. Very recently, our research group was the first to annunciate that winter temperatures may lead a cardiac abnormalities and hence sudden death, become a new potential risk factor to SUDEP. Quite interesting, several mammalian species have evolved to develop a physiological phenomenon called hibernation as a strategy for survival under adverse cold conditions. From cardiovascular point of view, it has been established that hibernating mammals inherited a stable cardiovascular function as a result of adaptation to extreme external and internal environments during hibernation. For instance, hibernating mammals show resistance to hypothermia at a cellular level, the membrane potentials and excitability are more stable in the cardiac cells of these animals (action potentials (60 mV) have been recorded in hibernators myocardium at -5 degrees C), the aortic smooth muscle cells from hibernators are able to maintain ionic gradients upon prolonged exposure to low temperatures, and cardiac myocytes from hibernating mammals maintain constant levels of intracellular free calcium and forceful contractility at 10 degrees C or lower. Taken together, in this paper we postulate that hibernators have some cardiovascular particularities that confer heart protection that could positively influence the cardiovascular system of patients with epilepsy.
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PMID:Hibernating mammals in sudden cardiac death in epilepsy: what do they tell us? 1805 32

Key changes in Guideline 2010 by Japanese Resuscitation Council were described and the reasons of the change were explained based on 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with Treatment Recommendations. In BLS, the value of chest compression was further emphasized and it became an initial skill of CPR In ALS, post resuscitation care was systemized by incorporating hypothermia, PCI, and other diagnostic and therapeutic modalities. Indication of hypothermia was further expanded to non-VF categories. Use of AED was expanded to infant. Education, Implementation and Teams were newly included as a chapter to promote the knowledge and skill of resuscitation science into the society.
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PMID:[New evidences in the 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with Treatment Recommendations]. 2159 11

The aim was to establish scientifically supported recommendations for termination of cardiopulmonary resuscitation (CPR) in mountain rescue, which can be applied by physicians and nonphysicians. A literature search was performed; the results and recommendations were discussed among the authors, and finally approved by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) in October 2011. 4166 abstracts were reviewed; of these, 96 were relevant for this article and are included in this literature review. In mountain rescue, CPR may be withheld or terminated in a patient with absent vital signs when the risk is unacceptable to the rescuer, the rescuer is exhausted or in extreme environments where CPR is not possible or any of the following apply: decapitation; truncal transection; whole body incinerated, decomposed, or frozen solid; avalanche victim in asystole with obstructed airway and burial time >35 min. Also, CPR may be terminated when all of the following criteria apply: unwitnessed loss of vital signs, no return of spontaneous circulation during 20 min of CPR, no shock advised at any time by AED or only asystole on ECG, and no hypothermia or other special circumstances warranting extended CPR. In situations where transport is not possible, mitigation of special circumstances is not possible, and further resuscitation is futile, CPR should be terminated. Medical directors of rescue teams should interpret these recommendations in the context of local conditions and laws, and create team-specific training and protocols for determining when to withhold and terminate CPR in a patient with absent vital signs.
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PMID:Termination of cardiopulmonary resuscitation in mountain rescue. 2299 20

Refractory status epilepticus (RSE) is a common challenge in the setting of post resuscitation care. We describe how multimodal neurological approach can lead treatment and improve the prognosis. We report on three survivors of cardiac arrest (CA) who had good neurological outcomes after mild hypothermia (TH), despite exhibiting persisting RSE requiring treatment with several antiepileptic (AED) and anesthetic drugs, including barbiturate-induced coma. No evidence-based data exist to guide management of RSE in the setting of anoxic brain injury. Our cases emphasize the need for continuous active treatment led by a multimodal approach in order to improve neurological outcome.
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PMID:Multimodal neurological approach can lead the treatment in postcardiac arrest persistent refractory status epilepticus. 2505 34