- [Advances in pre-hospital recognition and cooling treatment of exertional heat stroke]. [Journal Article]
- ZWZhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018; 30(10):1006-1010
- Heat stroke (HS) is a life-threatening illness characterized by an altered level of consciousness with an elevated core body temperature 40 centigrade, which may be further classified as exertional h...
Heat stroke (HS) is a life-threatening illness characterized by an altered level of consciousness with an elevated core body temperature 40 centigrade, which may be further classified as exertional heat stroke (EHS) or classical heat stroke (CHS) according to the etiology of the condition. In recent years, the morbidity of EHS increases year by year. The severity and clinical outcome for an EHS casualty have a strong correlation with the area under the time and temperature curve for heat exposure. The early recognition and rapid cooling body core temperature ≤ 38.9 centigrade within 30 minutes of EHS results in the best clinical outcome and minimize severe multiple organ dysfunction and death for patients. Cold water immersion (CWI) is considered as an optimum cooling method for the reversal of hyperthermia in EHS. Some alternative modalities have also shown acceptable cooling rate, for example, the subjects immersed in a circulated water bath controlled below 20 centigrade, tarp-assisted cooling with oscillation, body cooling unit, undressed, air-conditioned room, the whole body and large vessels placed ice packs, massaging the extremities; cold intravenous saline applied to dehydrated one. It is necessary to monitor body core temperature for hypothermia and/or recurrent hyperthermia, and to provide physical care for shivering, agitation, or concerns with the potential discomfort combativeness that may occur during cooling process. In this paper, pre-hospital recognition, care, monitoring and rapid cooling treatment measures of EHS have been reviewed to provide references for early identification of EHS and scientific, reasonable and effective cooling treatment.
- Changes in the Biomechanical Properties of Human Skin in Hyperthermic and Hypothermic Ranges. [Journal Article]
- WWounds 2018; 30(9):257-262
- CONCLUSIONS: As per the results, the investigators believe these hyperthermic- and hypothermic-induced alterations in biomechanical skin properties are due to increased blood flow, in addition to a reversible increase in interstitial and intracellular fluid contents, thermal contraction, and expansion of collagen and elastic fibers, all of which are precursors to irreversible damage.
- Implementation of Targeted Temperature Management in a Patient with Cerebral Arterial Gas Embolism. [Journal Article]
- THTher Hypothermia Temp Manag 2018; 8(3):176-180
- 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.
- Editorial Commentary: Hip Arthroscopy Pump Pressure Must Be Managed and Monitored. [Editorial]
- AArthroscopy 2018; 34(1):133-134
- Fluid pump management is essential for successful hip arthroscopy. Low pressures can lead to poor visualization. High pressures can lead to fluid extravasation and complications. Fluid extravasation ...
Fluid pump management is essential for successful hip arthroscopy. Low pressures can lead to poor visualization. High pressures can lead to fluid extravasation and complications. Fluid extravasation during hip arthroscopy can lead to intra-abdominal compartment syndrome, which can be life-threatening. Risk factors for extravasation included higher pump pressures and iliopsoas tenotomy. By accurately measuring pump pressures, minimizing the necessary pressure, avoiding excessive capsulotomies, performing iliopsoas tenotomy only if needed and performing it at the end of the operation, and monitoring the patient for abdominal distention and hypothermia, complications can be minimized.
- 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 plantar hypothermia on quasi-static balance: Two different hypothermic procedures. [Journal Article]
- GPGait Posture 2018; 60:194-199
- Inducing hypothermia to examine its effects on balance is performed with various approaches. However, data interpretations of underlying postural mechanisms often do not consider the applied hypother...
Inducing hypothermia to examine its effects on balance is performed with various approaches. However, data interpretations of underlying postural mechanisms often do not consider the applied hypothermic protocol. In this context, the effects of diminished plantar mechanoreceptor activity on quasi-static balance performance were investigated, examining the applicability of a continuously cooling thermal platform in comparison with conventional ice pads. Increased instability for the thermal platform compared to cooling with ice pads was hypothesized, since we expected increased temperatures for the ice pad group directly after balance tests. Similar scores on a Visual Analogue Scale (VAS) were predicted regarding subjective pain. Results showed that both cooling procedures successfully induced plantar hypothermia. However, the thermal platform was more effective with respect to reaching and maintaining the desired temperature throughout the trials, especially when comparing temperatures before and after balance tests. Therefore, balance tests indeed demonstrated increased COP parameters exclusively after permanent cooling via the thermal platform as early as after the first 10 min of cooling. Reduced plantar input may result in this postural instability, but without the need of other sensory systems to compensate. The VAS generally demonstrated higher pain scores for the ice pads, rejecting our hypothesis. This is an important finding, since pain is known to influence balance. Therefore, permanent and controllable cooling via the thermal platform should be taken into consideration when conducting related research.
- 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.
New Search Next
- 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.