scholarly journals Hypothermia and cardiac electrophysiology: a systematic review of clinical and experimental data

2018 ◽  
Vol 115 (3) ◽  
pp. 501-509 ◽  
Author(s):  
Erik Sveberg Dietrichs ◽  
Torkjel Tveita ◽  
Godfrey Smith
Keyword(s):  
Experimental Data ◽  
Ventricular Arrhythmias ◽  
Cardiac Electrophysiology ◽  
Clinical Evidence ◽  
Core Body Temperature ◽  
Accidental Hypothermia ◽  
Class Iii ◽  
Severe Hypothermia ◽  
Pubmed Database ◽  
Core Body

Abstract Moderate therapeutic hypothermia procedures are used in post-cardiac arrest care, while in surgical procedures, lower core temperatures are often utilized to provide cerebral protection. Involuntary reduction of core body temperature takes place in accidental hypothermia and ventricular arrhythmias are recognized as a principal cause for a high mortality rate in these patients. We assessed both clinical and experimental literature through a systematic literature search in the PubMed database, to review the effect of hypothermia on cardiac electrophysiology. From included studies, there is common experimental and clinical evidence that progressive cooling will induce changes in cardiac electrophysiology. The QT interval is prolonged and appears more sensitive to decreases in temperature than the QRS interval. Severe hypothermia is associated with more pronounced changes, some of which are proarrhythmic. This is supported clinically where severe accidental hypothermia is commonly associated with ventricular fibrillation or asystole. J-waves in human electrocardiogram recordings are regularly but not always observed in hypothermia. Its relation to ventricular repolarization and arrhythmias is not obvious. Little clinical data exist on efficacy of anti-arrhythmic drugs in hypothermia, while experimental data show the potential of some agents, such as the class III antiarrhythmic bretylium. It is apparent that QT-prolonging drugs should be avoided.

scholarly journals Clinical relevance of impaired consciousness in accidental hypothermia: A Japanese multicenter retrospective study

2021 ◽  
Author(s):  
Masahiro Fukuda ◽  
Masahiro Nozawa ◽  
Yohei Okada ◽  
Sachiko Morita ◽  
Naoki Ehara ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Core Body Temperature ◽  
Staging System ◽  
Accidental Hypothermia ◽  
Impaired Consciousness ◽  
Odds Ratios ◽  
Severe Hypothermia ◽  
Threatening Condition ◽  
Life Threatening ◽  
Core Body

Abstract Background This study aimed to investigate the association between level of impaired consciousness and severe hypothermia less than 28°C among accidental hypothermia. Severe accidental hypothermia (AH) is a life-threatening condition, and early identification can enable transport to an appropriate medical facility. The Swiss staging system has been used to classify patients with AH, but little is known regarding the association between the level of impaired consciousness and core body temperature (BT) in AH. This study aimed to clarify the association between level of impaired consciousness and core BT and determine whether the level of impaired consciousness could be used to predict severe hypothermia and in-hospital mortality among patients with AH. Results The study included 505 of 572 patients in the J-point registry. Relative to mildly impaired consciousness (Glasgow coma scale (GCS) 13–15), the adjusted odds ratios for severe hypothermia were moderate (GCS9-12) 3.26 (95% CI: 1.69–6.25) and severe (GCS < 9) 4.68 (95% CI: 2.40–9.14) for severely impaired consciousness. Relative to mildly impaired consciousness (GCS 13–15), the adjusted odds ratios for in-hospital mortality were moderate (GCS9-12) 1.65 (95% CI: 0.95–2.88) and severe (GCS < 9) 2.10 (95% CI: 1.17–3.78). Conclusions The level of impaired consciousness in patients with accidental hypothermia may predict severe hypothermia and in-hospital mortality.

scholarly journals IS AN EMERGENCY DEPARTMENT A SAFER PLACE FOR HYPOTHERMIC VICTIMS THAN AN AMBULANCE? A COMPARISON OF THE KNOWLEDGE OF MEDICAL PERSONNEL CONCERNING HYPOTHERMIA

2019 ◽  
Vol 72 (2) ◽  
pp. 209-215
Author(s):  
Paweł Podsiadło ◽  
Adam Nogalski ◽  
Sylweriusz Kosiński ◽  
Tomasz Sanak ◽  
Kinga Sałapa ◽  
...  
Keyword(s):  
Independent Risk Factor ◽  
Core Body Temperature ◽  
Medical Personnel ◽  
Initial Management ◽  
Severe Hypothermia ◽  
Post Test ◽  
E Learning ◽  
Level Of Knowledge ◽  
Post Traumatic ◽  
Core Body

Introduction: Improper initial management of a victim in severe hypothermia is associated with a risk of cardiac arrest. At the same time, an uncontrolled drop in core body temperature in trauma victims is an independent risk factor for mortality. Medical personnel require a thorough understanding of the pathophysiology and treatment of hypothermia. Gaps in this understanding can lead to serious complications for patients. The aim: To compare knowledge concerning hypothermia between medical personnel working in emergency departments (ED) and emergency medical services (EMS). Materials and methods: A total of 5,362 participants were included in the study. In this study, EMS and ED personnel were encouraged to participate in an e-learning course on hypothermia. Subsequently, the scores of a pre-test, lesson tests and post-test completed by participants of this course were compared. Results: Pre-test scores were significantly higher among personnel working in EMS compared with those working in EDs. Nurses employed in EDs had significantly more failures in completing the course than EMS nurses. The most difficult topics for all practitioners were post-traumatic hypothermia and hypothermia-related clotting disorders. Conclusions: EMS personnel have a higher level of knowledge of hypothermia than ED personnel. Moreover, an e-learning course is an effective tool for improving medical personnel’s knowledge of hypothermia.

Physiological Impact of Hypothermia: The Good, the Bad and the Ugly

Physiology ◽  
2021 ◽  
Author(s):  
Torkjel Tveita ◽  
Gary C. Sieck
Keyword(s):  
Body Temperature ◽  
Therapeutic Hypothermia ◽  
Clinical Medicine ◽  
Core Body Temperature ◽  
Accidental Hypothermia ◽  
Striking Difference ◽  
Neurosurgical Procedures ◽  
Protective Agent ◽  
Core Body ◽  
The Impact

Hypothermia is defined as a core body temperature of < 35°C, and as body temperature is reduced the impact on physiological processes can be beneficial or detrimental. The beneficial effect of hypothermia enables circulation of cooled experimental animals to be interrupted for 1-2 h without creating harmful effects, while tolerance of circulation arrest in normothermia is between 4 and 5 min. This striking difference has attracted so many investigators, experimental as well as clinical, to this field, and this discovery was fundamental for introducing therapeutic hypothermia in modern clinical medicine in the 1950's. Together with the introduction of cardiopulmonary bypass, therapeutic hypothermia has been the cornerstone in the development of modern cardiac surgery. Therapeutic hypothermia also has an undisputed role as a protective agent in organ transplantation and as a therapeutic adjuvant for cerebral protection in neonatal encephalopathy. However, the introduction of therapeutic hypothermia for organ protection during neurosurgical procedures or as a scavenger after brain and spinal trauma has been less successful. In general, the best neuroprotection seems to be obtained by avoiding hyperthermia in injured patients. Accidental hypothermia occurs when endogenous temperature control mechanisms are incapable of maintaining core body temperature within physiologic limits and core temperature becomes dependent on ambient temperature. During hypothermia spontaneous circulation is considerably reduced and with deep and/or prolonged cooling, circulatory failure may occur, which may limit safe survival of the cooled patient. Challenges that limit safe rewarming of accidental hypothermia patients include cardiac arrhythmias, uncontrolled bleeding, and "rewarming shock".

scholarly journals Novel Measurement Approaches Are Needed In The Pre-Hospital Setting To Prevent Accidental Hypothermia.

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Timothy Binyon ◽  
BENJAMIN MACKIE
Keyword(s):  
Body Temperature ◽  
Best Practice ◽  
Core Body Temperature ◽  
Hospital Setting ◽  
Accidental Hypothermia ◽  
Effective Management ◽  
Reliable Measurement ◽  
Practice Approach ◽  
Unconscious Patients ◽  
Core Body

Accidental hypothermia can be fatal if not recognised early, and effective management relies on the accurate recording of core body temperature. The focus of this critique - a recent study by Podsiado et al. (2019) – highlighted the need for reliable measurement of core body temperature in the pre-hospital and austere setting. An esophageal temperature probe may prove to be a reliable, and best practice approach for measuring core body temperature in critically unwell, unconscious patients suffering accidental hypothermia.

Core body temperature changes after sauna exposition in healthy subjects

2012 ◽  
Vol 26 (2) ◽  
Author(s):  
Joanna Pawlak ◽  
Paweł Zalewski ◽  
Jacek J. Klawe ◽  
Monika Zawadka ◽  
Anna Bitner ◽  
...  
Keyword(s):  
Body Temperature ◽  
Healthy Subjects ◽  
Core Body Temperature ◽  
Temperature Changes ◽  
Core Body

Covid-19 and Autoimmune Diseases: A Systematic Review of Reported Cases

2020 ◽  
Vol 16 ◽  
Author(s):  
Mariam Ahmed Saad ◽  
Mostafa Alfishawy ◽  
Mahmoud Nassar ◽  
Mahmoud Mohamed ◽  
Ignatius N Esene ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autoimmune Disease ◽  
Kawasaki Disease ◽  
Autoimmune Diseases ◽  
English Language ◽  
Clinical Evidence ◽  
Eligibility Criteria ◽  
Thrombocytopenic Purpura ◽  
Pubmed Database ◽  
Viral Illness

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations. Methods: We searched PubMed database using all available keyword for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstract. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected. Results: Among 10006 articles, searches yielded, Thirty-two relevant articles for full-text assessment. Twenty studies meet the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain–Barré syndrome (48.5%). Conclusions: COVID-19 has been implicated in the development in a range of autoimmune diseases which may shed a light on the association between autoimmune diseases and infections.

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