- Diffusion-Controlled Recrystallization of Water Sorbed into Poly(meth)acrylates Revealed by Variable Temperature Mid-infrared Spectroscopy and Molecular Dynamics Simulation. [Journal Article]
- JPJ Phys Chem B 2017 Apr 27
- Recrystallization behaviors of water sorbed into four poly(meth)acrylates; poly(2-methoxyethyl acrylate) (PMEA), poly(tetrahydrofurfuryl acrylate) (PTHFA), poly(methyl acrylate) (PMA), and poly(methy...
Recrystallization behaviors of water sorbed into four poly(meth)acrylates; poly(2-methoxyethyl acrylate) (PMEA), poly(tetrahydrofurfuryl acrylate) (PTHFA), poly(methyl acrylate) (PMA), and poly(methyl methacrylate) (PMMA), are investigated by variable-temperature mid-infrared (VT-MIR) spectroscopy and molecular dynamics (MD) simulation. VT-MIR spectra demonstrate that recrystallization temperatures of water sorbed into the polymers are positively correlated with their glass transition temperatures reported previously. The present MD simulation shows that a lower limit temperature of the diffusion for the sorbed water and the glass transition temperatures of the polymers also have a positive correlation, indicating that the recrystallization is controlled by diffusion mechanism rather than reorientation mechanism. Detailed molecular processes not only of recrystallization during rewarming but also of crystallization during cooling and hydrogen-bonding states of water in the polymers are systematically analyzed and discussed.
- [Severe accidental hypothermia : Treatment using an intravascular temperature management catheter]. [Journal Article]
- MKMed Klin Intensivmed Notfmed 2017 Apr 26
- Different techniques have been reported for the treatment of severe accidental hypothermia. In this case, we successfully used an intravascular catheter temperature management system which has been d...
Different techniques have been reported for the treatment of severe accidental hypothermia. In this case, we successfully used an intravascular catheter temperature management system which has been developed to induce reversible therapeutic hypothermia in patients following resuscitation. In our patient, the initial core temperature was 26.7 °C, and the temperature management system allowed for successful rewarming without complications with a maximum rate of about 1 °C/h.
- Temperature Variation After Rewarming from Deep Hypothermic Circulatory Arrest Is Associated with Survival and Neurologic Outcome. [Journal Article]
- THTher Hypothermia Temp Manag 2017 Mar 01
- Therapeutic hypothermia is recommended by international guidelines after cardio-circulatory arrest. However, the effects of different temperatures during the first 24 hours after deep hypothermic cir...
Therapeutic hypothermia is recommended by international guidelines after cardio-circulatory arrest. However, the effects of different temperatures during the first 24 hours after deep hypothermic circulatory arrest (DHCA) for aortic arch surgery on survival and neurologic outcome are undefined. We hypothesize that temperature variation after aortic arch surgery is associated with survival and neurologic outcome. In the period 2010-2014, a total of 210 consecutive patients undergoing aortic arch surgery with DHCA were included. They were retrospectively divided into three groups by median nasopharyngeal temperature within 24 hours after rewarming: hypothermia (<36°C; n = 65), normothermia (36-37°C; n = 110), and hyperthermia (>37°C; n = 35). Multivariate stepwise logistic and linear regressions were performed to determine whether different temperature independently predicted 30-day mortality, stroke incidence, and neurologic outcome assessed by cerebral performance category (CPC) at hospital discharge. Compared with normothermia, hyperthermia was independently associated with a higher risk of 30-day mortality (28.6% vs. 10.9%; odds ratio [OR] 2.8; 95% confidence interval [CI], 1.1-8.6; p = 0.005), stroke incidence (64.3% vs. 9.1%; OR 9.1; 95% CI, 2.7-23.0; p = 0.001), and poor neurologic outcome (CPC 3-5) (68.8% vs. 39.6%; OR 4.8; 95% CI, 1.4-8.7; p = 0.01). No significant differences were demonstrated between hypothermia and normothermia. Postoperative hypothermia is not associated with a better outcome after aortic arch surgery with DHCA. However, postoperative hyperthermia (>37°C) is associated with high stroke incidence, poor neurologic outcome, and increased 30-day mortality. Target temperature management in the first 24 hours after surgery should be evaluated in prospective randomized trials.
- Temperature and oxygenation during organ preservation: friends or foes? [Journal Article]
- COCurr Opin Organ Transplant 2017 Apr 19
- CONCLUSIONS: The relationship between temperature and oxygenation in organ preservation is more complex than physiological laws would suggest. Rather than one default perfusion temperature/oxygenation standard, perfusion protocols should be tailored for specific needs of grafts of different quality.
- No association between hand and foot temperature responses during local cold stress and rewarming. [Journal Article]
- EJEur J Appl Physiol 2017 Apr 18
- CONCLUSIONS: Results suggest that there is generally a lower temperature in the toes than the fingers after a short time of local cold exposure and that the thermal responses of the fingers/hands are not readily transferable to the toes/foot.
- Therapeutic Hypothermia for Neonates with Hypoxic Ischemic Encephalopathy. [Review]
- PNPediatr Neonatol 2017 Mar 27
- Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan ...
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH.
- [The prognostic value of cerebral oxygen saturation measurement for assessing prognosis after cardiopulmonary resuscitation]. [Journal Article]
- RBRev Bras Anestesiol 2017 Apr 12
- CONCLUSIONS: Despite higher values of rSO2 on survivors than non-survivors, we found no statistically considerable difference between groups on baseline and the rewarming rSO2 values. Since the measurement is simple, and not affected by hypotension and hypothermia, the rSO2 may be a useful predictor for determining the prognosis after CPR.
- Frostbite. [Review]
- EMEmerg Med Clin North Am 2017; 35(2):281-299
- Deep frostbite is a thermal injury associated with significant morbidity. Historically, this has been associated with military personnel; however, increasingly it is becoming an injury that afflicts ...
Deep frostbite is a thermal injury associated with significant morbidity. Historically, this has been associated with military personnel; however, increasingly it is becoming an injury that afflicts the civilian population. The use of intravenous iloprost or intra-arterial thrombolytics has led to promising tissue salvage. This article provides an up-to-date understanding of frostbite pathophysiology, classification, prevention, and management. It also highlights the role of telemedicine in optimizing patient outcomes. To further the understanding of optimal frostbite management, larger, likely multicenter, high-quality trials are required. An international frostbite register would facilitate data gathering.
- Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia. [Review]
- EMEmerg Med Clin North Am 2017; 35(2):261-279
- Accidental hypothermia is an unintentional drop in core temperature to 35°C or below. Core temperature is best measured by esophageal probe. If core temperature cannot be measured, the degree should ...
Accidental hypothermia is an unintentional drop in core temperature to 35°C or below. Core temperature is best measured by esophageal probe. If core temperature cannot be measured, the degree should be estimated using clinical signs. Treatment is to protect from further heat loss, minimize afterdrop, and prevent cardiovascular collapse during rescue and resuscitation. The patient should be handled gently, kept horizontal, insulated, and actively rewarmed. Active rewarming is also beneficial in mild hypothermia but passive rewarming usually suffices. Cardiopulmonary resuscitation should be performed if there are no contraindications to resuscitation. CPR may be delayed or intermittent.
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- The esophageal cooling device: A new temperature control tool in the intensivist's arsenal. [Journal Article]
- HLHeart Lung 2017 Apr 11
- CONCLUSIONS: When used as a sole modality, objective performance parameters of the esophageal-cooling device were found to be comparable to standard temperature control methods. More research is required to further quantify efficacy, safety, assess utility in other patient populations, and examine patient outcomes with device use in comparison to standard temperature control modalities.