- Implementation of Targeted Temperature Management in a Patient with Cerebral Arterial Gas Embolism. [Journal Article]
- THTher Hypothermia Temp Manag 2018 Jul 17
- Cerebral arterial gas embolism (CAGE) shows various manifestations according to the quantity of gas and the brain areas affected. The symptoms range from minor motor weakness, headache, and confusion...
Cerebral arterial gas embolism (CAGE) shows various manifestations according to the quantity of gas and the brain areas affected. The symptoms range from minor motor weakness, headache, and confusion to disorientation, convulsions, hemiparesis, unconsciousness, and coma. A 46-year-old man was transferred to our emergency department due to altered sensorium. Immediately after a controlled ascent from 33 m of seawater, he complained of shortness of breath and rigid extremities, lapsing into unconsciousness. He was intubated at another medical center, where a brain computerized axial tomography scan showed no definitive abnormal findings. Pneumothorax and obstructing lesions were apparent in the left thorax of the computed tomography scan. Following closed thoracostomy, we provided hyperbaric oxygen therapy (HBOT) using U.S. Navy Treatment Table (USN TT) 6A. A brain magnetic resonance imaging diffusion image taken after HBOT showed acute infarction in both middle and posterior cerebral arteries. We implemented targeted temperature management (TTM) to prevent worsening of cerebral function in the intensive care unit. After completing TTM, we repeated HBOT using USN TT5 and started rehabilitation therapy. He fully recovered from the neurological deficits. This is the first case of CAGE treated with TTM and consecutive HBOTs suggesting that TTM might facilitate salvage of the penumbra in severe CAGE.
- Expert consensus on the evaluation and diagnosis of combat injuries of the Chinese People's Liberation Army. [Journal Article]
- MMMil Med Res 2018 02 13; 5(1):6
- The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discu...
The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second annual meeting of the Professional Committee on Disaster Medicine of the Chinese People's Liberation Army (PLA). In this consensus agreement, the massive hemorrhage, airway, respiration, circulation and hypothermia (MARCH) algorithm, which is a simple triage and rapid treatment and field triage score, was recommended to assess combat casualties during the first-aid stage, whereas the abbreviated scoring method for combat casualty and the MARCH algorithm were recommended to assess combat casualties in level II facilities. In level III facilities, combined measures, including a history inquiry, thorough physical examination, laboratory examination, X-ray, and ultrasound examination, were recommended for the diagnosis of combat casualties. In addition, corresponding methods were recommended for the recognition of casualties needing massive transfusions, assessment of firearm wounds, evaluation of mangled extremities, and assessment of injury severity in this consensus.
- Effects of perioperative warm socks-wearing in maintaining core body temperature of patients undergoing spinal surgery. [Journal Article]
- JCJ Clin Nurs 2018; 27(7-8):1399-1407
- CONCLUSIONS: The use of perioperative warmed socks for spinal surgery patients was effective in maintaining perioperative core temperature, preventing shivering and maintaining subjective thermal comfort.Considering cost-effectiveness of warmed socks, it might be worth trying option for the maintenance of core temperature in spinal surgery patients.
- Using polyethylene plastic bag to prevent moderate hypothermia during transport in very low birth weight infants: a randomized trial. [Journal Article]
- JPJ Perinatol 2018; 38(4):332-336
- CONCLUSIONS: Placing VLBW infants in polyethylene plastic bags during transport reduces the occurrence of hypothermia, especially moderate hypothermia.
- Effects of bilateral pallidal deep brain stimulation on chorea after pulmonary thromboendarterectomy with deep hypothermia and circulatory arrest: a case report. [Journal Article]
- ANActa Neurochir (Wien) 2018; 160(2):393-395
- A 41-year-old man was diagnosed with chronic pulmonary thromboembolism and underwent pulmonary thromboendarterectomy (PTE) with deep hypothermia and circulatory arrest. Five days after the operation,...
A 41-year-old man was diagnosed with chronic pulmonary thromboembolism and underwent pulmonary thromboendarterectomy (PTE) with deep hypothermia and circulatory arrest. Five days after the operation, chorea emerged in the lower extremities. The patient was referred to our hospital for disabling chorea 16 years after PTE. Neurological examination revealed choreatic movements in the four extremities. Brain magnetic resonance images indicated atrophy in the bilateral head of the caudate nuclei. The patient underwent deep brain stimulation (DBS) of the bilateral globus pallidus interna (GPi). Continuous GPi-DBS diminished the choreatic movements. GPi-DBS may be a treatment option for sustained choreatic movements after PTE.
- The effects of local forearm muscle cooling on motor unit properties. [Randomized Controlled Trial]
- EJEur J Appl Physiol 2018; 118(2):401-410
- CONCLUSIONS: Since muscle contractility is impaired with muscle cooling, these findings suggest a compensatory increase in the number of active motor units, and small but coupled changes in motor unit firing rates and recruitment threshold to produce the same force.
- Temperature Probe Placement during Preterm Infant Resuscitation: A Randomised Trial. [Randomized Controlled Trial]
- NNeonatology 2018; 113(1):27-32
- CONCLUSIONS: Dorsal, thoracic, or axillary temperature probe positioning during resuscitation yield similar admission temperatures in moderately preterm infants. Further studies are required in infants below 28 weeks of gestation to determine the best practice.
- Forced-Air Warming in Patients Undergoing Endovascular Procedures: Comparison between 2 Thermal Blanket Models. [Journal Article]
- AVAnn Vasc Surg 2018; 47:98-103
- CONCLUSIONS: We conclude that upper thermal blanket is more effective thanunderbody thermal blanket in patient warming and hypothermia prevention during endovascular abdominal aortic aneurysm repair and lower limb angioplasty after 150 min of anesthetic-surgical time duration.
- Between fire and ice: refractory hypothermia and warmth-induced pain in inherited erythromelalgia. [Case Reports]
- BCBMJ Case Rep 2017 Jul 26; 2017
- Inherited erythromelalgia (IEM) is a well-described pain disorder caused by mutations of sodium channel Nav1.7, a peripheral channel expressed within dorsal root ganglion and the sympathetic ganglion...
Inherited erythromelalgia (IEM) is a well-described pain disorder caused by mutations of sodium channel Nav1.7, a peripheral channel expressed within dorsal root ganglion and the sympathetic ganglion neurons. Clinically, IEM is characterised by paroxysmal attacks of severe pain, usually in the distal extremities, triggered by warmth or exercise. Pain is not adequately treated by existing pharmacological agents. Individuals with IEM classically cool their limbs for relief, in some cases resulting in tissue injury. We describe a patient from a family with IEM due to the L858F mutation of Nav1.7 who presented with refractory hypothermia due to overcooling. This presentation of refractory hypothermia necessitating warming strategies, complicated by severe warmth-induced pain, posed a substantial therapeutic challenge. We report our experience in overcoming hypothermia lasting 3 weeks in a child with IEM, discuss possible pathophysiological mechanisms underlying this unusual complication and suggest potential therapeutic interventions.
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- Neuromuscular function during knee extension exercise after cold water immersion. [Journal Article]
- JPJ Physiol Anthropol 2017 Jun 23; 36(1):28
- CONCLUSIONS: The lower shift of EMG frequency would be connected with the decrease in the nerve and muscle fibers conduction velocity. To compensate for the impairment of each muscle fibers function, more muscle fibers might be recruited to maintain the working load. This might result in the greater amplitude of EMG after the cold immersion.