scholarly journals Impact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Makoto Watanabe ◽  
Tasuku Matsuyama ◽  
Sachiko Morita ◽  
Naoki Ehara ◽  
Nobuyoshi Miyamae ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Body Temperature ◽  
Hospital Mortality ◽  
Core Body Temperature ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Regression Analysis ◽  
International Classification Of Diseases ◽  
The Body ◽  
Accidental Hypothermia ◽  
Time Of Arrival

Abstract Background Accidental hypothermia (AH) is defined as an involuntary decrease in core body temperature to < 35 °C. The management of AH has been progressing over the last few decades, and numerous techniques for rewarming have been validated. However, little is known about the association between rewarming rate (RR) and mortality in patients with AH. Method This was a multicentre chart review study of patients with AH visiting the emergency department of 12 institutions in Japan from April 2011 to March 2016 (Japanese accidental hypothermia network registry, J-Point registry). We retrospectively registered patients using the International Classification of Diseases, Tenth Revision code T68: ‘hypothermia’. We excluded patients whose body temperatures were unknown or ≥ 35 °C, who could not be rewarmed, whose rewarmed temperature or rewarming time was unknown, those aged < 18 years, or who or whose family members had refused to join the registry. RR was calculated based on the body temperature on arrival at the hospital, time of arrival at the hospital, the documented temperature during rewarming, and time of the temperature documentation. RR was classified into the following five groups: ≥2.0 °C/h, 1.5–< 2.0 °C/h, 1.0–< 1.5 °C/h, 0.5–< 1.0 °C/h, and < 0.5 °C/h. The primary outcome of this study was in-hospital mortality. The association between RR and in-hospital mortality was evaluated using multivariate logistic regression analysis. Result During the study, 572 patients were registered in the J-Point registry, and 481 patients were included in the analysis. The median body temperature on arrival to the hospital was 30.7 °C (interquartile range [IQR], 28.2 °C–32.4 °C), and the median RR was 0.85 °C/h (IQR, 0.53 °C/h–1.31 °C/h). The in-hospital mortality rates were 19.3% (11/57), 11.1% (4/36), 14.4% (15/104), 20.1% (35/175), and 34.9% (38/109) in the ≥2.0 °C/h, 1.5–< 2.0 °C/h, 1.0–< 1.5 °C/h, 0.5–< 1.0 °C/h, and < 0.5 °C/h groups, respectively. Multivariate regression analysis revealed that in-hospital mortality rate increased with each 0.5 °C/h decrease in RR (adjusted odds ratio, 1.49; 95% confidence interval, 1.15–1.94; Ptrend < 0.01). Conclusion This study showed that slower RR is independently associated with in-hospital mortality.

Correlation Between Body Temperature and Survival Rate in Patients With Hospital-Acquired Bacteremia

2014 ◽  
Vol 17 (5) ◽  
pp. 469-477 ◽  
Author(s):  
Yu-Tzu Dai ◽  
Shu-Hua Lu ◽  
Yee-Chun Chen ◽  
Wen-Je Ko
Keyword(s):  
Regression Analysis ◽  
Body Temperature ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Cox Regression ◽  
Clinical Signs ◽  
The Body ◽  
Febrile Response ◽  
Cox Regression Analysis ◽  
Hospital Acquired

Background: Fever is a complex and major sign of a patient’s acute response to infection. However, analysis of the risks and benefits associated with the change in body temperature of an infected host remains controversial. Objective: To examine the relationship between the intensity of the change in body temperature and the mortality of patients with hospital-acquired bacteremia. Design: A prospective observational study. Method: Subjects were hospitalized adult patients who developed clinical signs of infection 48 hr or more after admission and had documented bacterial growth in blood culture. The maximum body temperature (maxTe) during the early period of infection measurements (i.e., the day before, the day of, and 2 days after the day of blood culture) was used to indicate the intensity of the body temperature response. Patients were categorized as discharged alive or died in hospital. Cox regression analysis was employed to analyze the data. Results: The cohort consisted of 502 subjects. The mean maxTe of subjects was 38.6°C, and 14.9% had a maxTe lower than 38.0°C. The in-hospital mortality rate was 18.9%. The highest in-hospital mortality was found in subjects with a maxTe lower than 38°C (30.7%). Multivariate Cox regression analysis determined that the maxTe and the severity of comorbidity are the two variables associated with in-hospital mortality. Conclusions: Lack of a robust febrile response may be associated with greater risk of mortality in patients with bacteremia. Clinicians must be vigilant in identifying patients at risk for a blunted febrile response to bacteremia for more intensive monitoring.

scholarly journals Pathophysiology of Fever and Application of Infrared Thermography (IRT) in the Detection of Sick Domestic Animals: Recent Advances

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2316
Author(s):  
Daniel Mota-Rojas ◽  
Dehua Wang ◽  
Cristiane Gonçalves Titto ◽  
Jocelyn Gómez-Prado ◽  
Verónica Carvajal-de la Fuente ◽  
...  
Keyword(s):  
Body Temperature ◽  
Infrared Thermography ◽  
Core Body Temperature ◽  
The Body ◽  
Farm Animals ◽  
Economic Losses ◽  
Febrile Response ◽  
Temperature Range ◽  
Stable Temperature ◽  
Core Body

Body-temperature elevations are multifactorial in origin and classified as hyperthermia as a rise in temperature due to alterations in the thermoregulation mechanism; the body loses the ability to control or regulate body temperature. In contrast, fever is a controlled state, since the body adjusts its stable temperature range to increase body temperature without losing the thermoregulation capacity. Fever refers to an acute phase response that confers a survival benefit on the body, raising core body temperature during infection or systemic inflammation processes to reduce the survival and proliferation of infectious pathogens by altering temperature, restriction of essential nutrients, and the activation of an immune reaction. However, once the infection resolves, the febrile response must be tightly regulated to avoid excessive tissue damage. During fever, neurological, endocrine, immunological, and metabolic changes occur that cause an increase in the stable temperature range, which allows the core body temperature to be considerably increased to stop the invasion of the offending agent and restrict the damage to the organism. There are different metabolic mechanisms of thermoregulation in the febrile response at the central and peripheral levels and cellular events. In response to cold or heat, the brain triggers thermoregulatory responses to coping with changes in body temperature, including autonomic effectors, such as thermogenesis, vasodilation, sweating, and behavioral mechanisms, that trigger flexible, goal-oriented actions, such as seeking heat or cold, nest building, and postural extension. Infrared thermography (IRT) has proven to be a reliable method for the early detection of pathologies affecting animal health and welfare that represent economic losses for farmers. However, the standardization of protocols for IRT use is still needed. Together with the complete understanding of the physiological and behavioral responses involved in the febrile process, it is possible to have timely solutions to serious problem situations. For this reason, the present review aims to analyze the new findings in pathophysiological mechanisms of the febrile process, the heat-loss mechanisms in an animal with fever, thermoregulation, the adverse effects of fever, and recent scientific findings related to different pathologies in farm animals through the use of IRT.

scholarly journals Effect of Hypothermia in the Emergency Department on the Outcome of Trauma Patients: A Cross-Sectional Analysis

2018 ◽  
Vol 15 (8) ◽  
pp. 1769 ◽  
Author(s):  
Ting-Min Hsieh ◽  
Pao-Jen Kuo ◽  
Shiun-Yuan Hsu ◽  
Peng-Chen Chien ◽  
Hsiao-Yun Hsieh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Body Temperature ◽  
Propensity Score ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Trauma Patients ◽  
Body Temperatures ◽  
Multivariate Logistic Regression ◽  
Mortality Outcome

This study aimed to assess whether hypothermia is an independent predictor of mortality in trauma patients in the condition of defining hypothermia as body temperatures of <36 °C. Data of all hospitalized adult trauma patients recorded in the Trauma Registry System at a level I trauma center between 1 January 2009 and 12 December 2015 were retrospectively reviewed. A multivariate logistic regression analysis was performed in order to identify factors related to mortality. In addition, hypothermia and normothermia were defined as temperatures <36 °C and from 36 °C to 38 °C, respectively. Propensity score-matched study groups of hypothermia and normothermia patients in a 1:1 ratio were grouped for mortality assessment after adjusting for potential confounders such as age, sex, preexisting comorbidities, and injury severity score (ISS). Of 23,705 enrolled patients, a total of 401 hypothermic patients and 13,368 normothermic patients were included in this study. Only 3.0% of patients had hypothermia upon arrival at the emergency department (ED). Compared to normothermic patients, hypothermic patients had a significantly higher rate of abbreviated injury scale (AIS) scores of ≥3 in the head/neck, thorax, and abdomen and higher ISS. The mortality rate in hypothermic patients was significantly higher than that in normothermic patients (13.5% vs. 2.3%, odds ratio (OR): 6.6, 95% confidence interval (CI): 4.86–9.01, p < 0.001). Of the 399 well-balanced propensity score-matched pairs, there was no significant difference in mortality (13.0% vs. 9.3%, OR: 1.5, 95% CI: 0.94–2.29, p = 0.115). However, multivariate logistic regression analysis revealed that patients with low body temperature were significantly associated with the mortality outcome. This study revealed that low body temperature is associated with the mortality outcome in the multivariate logistic regression analysis but not in the propensity score matching (PSM) model that compared patients with hypothermia defined as body temperatures of <36 °C to those who had normothermia. These contradicting observations indicated the limitation of the traditional definition of body temperature for the diagnosis of hypothermia. Prospective randomized control trials are needed to determine the relationship between hypothermia following trauma and the clinical outcome.

scholarly journals Comparison of Tympanic and Tail Temperatures in Angus and Brahman Steers

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Dikmen S ◽  
Davila KMS ◽  
Rodriquez E ◽  
Scheffler TL ◽  
Oltenacu PA ◽  
...  
Keyword(s):  
Body Temperature ◽  
Repeated Measures ◽  
Core Body Temperature ◽  
The Body ◽  
Tympanic Temperature ◽  
Repeated Measure ◽  
Important Indicator ◽  
Significant Difference ◽  
Brahman Steers ◽  
Core Body

In cattle, core body temperature can be used as an important indicator of heat stress level. However, accurately recording core body temperature can be difficult and labor intensive. The objectives of the current study were 1) to compare the recorded tympanic and tail body temperature measurements in steers and 2) to determine the body temperature change of Angus and Brahman steers in a hot and humid environment. Data was analyzed using a repeated measure model where repeated measures were hourly tympanic and tail temperatures and their difference for individual steers during the day of the experiment. There was a significant breed effect (P=0.01), hour (P<0.0001) and breed by hour interaction (P<0.0001) for the tympanic temperature. Brahman steers, which are known to have superior thermotolerance, maintained a lower body temperature than the Angus steers during the afternoon under grazing conditions. In the Brahman steers there was only a minimal increase in the body temperature throughout the day, an evidence of the thermotolerance ability of the breed. In the Angus steers, which experienced an increase in their body temperature from hour to hour with a peak around 1600 hour; there was a significant difference between the tympanic and tail temperature during the times when the body temperature as measured by the tympanic recordings was the highest (1300 to 1700 hour). Our results indicate that the tympanic temperature can be used to accurately and continuously monitor core body temperature in a natural environment for up to several days and without disturbing the animal.

scholarly journals A Case Report on Osborn Waves of Hypothermia Induced LV Systolic Dysfunction

2021 ◽  
Vol 70 (2) ◽  
Author(s):  
Rajnandini Singha ◽  
Amazing Grace Siangshai ◽  
Jashlyn Lijo
Keyword(s):  
Body Temperature ◽  
Sinus Bradycardia ◽  
Core Body Temperature ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
The Body ◽  
Qrs Complex ◽  
Pr Interval ◽  
Gradual Expansion ◽  
Core Body

Hypothermia, described as a core body temperature of < 95%, is associated with ECG alteration abnormalities. Sinus bradycardia occurs when the body temperature drops below 90°F, and is correlated with gradual prolongation of the PR interval, QRS complex, QT interval. It can progress to ventricular and atrial fibrillation at a temperature reaching 89°F, which can lead to left ventricular dysfunction. Hypothermia is connected to the osborn waves, which at the end of the QRS complex consist of additional deflection. The inferior and lateral precordial leads are seen by Osborn waves, also known as J waves, Camel hump waves and hypothermic waves. As the body temperature decreases, it becomes more pronounced and a gradual expansion of the QRS complex raises the likelihood of ventricular fibrillation causing ventricle dysfunction.

Effect of postprandial thermogenesis on the cutaneous vasodilatory response during exercise

2014 ◽  
Vol 39 (8) ◽  
pp. 920-926 ◽  
Author(s):  
Keiji Hayashi ◽  
Nozomi Ito ◽  
Yoko Ichikawa ◽  
Yuichi Suzuki
Keyword(s):  
Regression Analysis ◽  
Food Intake ◽  
Body Temperature ◽  
Oxygen Uptake ◽  
The Body ◽  
Temperature Threshold ◽  
Doppler Flowmetry ◽  
Cutaneous Vasodilation ◽  
Vasodilatory Response ◽  
Postprandial Thermogenesis

To examine the effect of postprandial thermogenesis on the cutaneous vasodilatory response, 10 healthy male subjects exercised for 30 min on a cycle ergometer at 50% of peak oxygen uptake, with and without food intake. Mean skin temperature, mean body temperature ([Formula: see text]), heart rate, oxygen uptake, carbon dioxide elimination, and respiratory quotient were all significantly higher at baseline in the session with food intake than in the session without food intake. To evaluate the cutaneous vasodilatory response, relative laser Doppler flowmetry values were plotted against esophageal temperature (Tes) and [Formula: see text]. Regression analysis revealed that the [Formula: see text] threshold for cutaneous vasodilation tended to be higher with food intake than without it, but there were no significant differences in the sensitivity. To clarify the effect of postprandial thermogenesis on the threshold for cutaneous vasodilation, the between-session difference in the Tes threshold and the [Formula: see text] threshold were plotted against the between-session difference in baseline Tes and baseline [Formula: see text], respectively. Linear regression analysis of the resultant plot showed significant positive linear relationships (Tes: r = 0.85, P < 0.01; [Formula: see text]: r = 0.67, P < 0.05). These results suggest that postprandial thermogenesis increases baseline body temperature, which raises the body temperature threshold for cutaneous vasodilation during exercise.

scholarly journals The Effects of Hyperbaric Exposure on Immediate and Delayed Changes in Core Temperature and Its Circadian Fluctuations

2017 ◽  
Vol 60 (3) ◽  
pp. 19-25
Author(s):  
Sławomir Kujawski ◽  
Joanna Słomko ◽  
Monika Zawadka-Kunikowska ◽  
Mariusz Kozakiewicz ◽  
Jacek J. Klawe ◽  
...  
Keyword(s):  
Body Temperature ◽  
Core Temperature ◽  
Core Body Temperature ◽  
The Body ◽  
Physiological Adaptation ◽  
Deep Body Temperature ◽  
Delayed Effects ◽  
Hyperbaric Exposure ◽  
Core Body ◽  
Deep Body

Abstract Changes observed in the core body temperature of divers are the result of a multifaceted response from the body to the change of the external environment. In response to repeated activities, there may be a chronic, physiological adaptation of the body’s response system. This is observed in the physiology of experienced divers while diving. The purpose of this study is to determine the immediate and delayed effects of hyperbaric exposure on core temperature, as well as its circadian changes in a group of three experienced divers. During compression at 30 and 60 meters, deep body temperature values tended to increase. Subsequently, deep body temperature values showed a tendency to decrease during decompression. All differences in core temperature values obtained by the group of divers at individual time points in this study were not statistically significant.

scholarly journals Association of body temperature with in-hospital mortality among paediatric trauma patients: an analysis of a nationwide observational trauma database in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e033822
Author(s):  
Asami Okada ◽  
Yohei Okada ◽  
Hiromichi Narumiya ◽  
Wataru Ishii ◽  
Tetsuhisa Kitamura ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Body Temperature ◽  
Hospital Mortality ◽  
Multivariate Logistic Regression Analysis ◽  
Data Bank ◽  
Trauma Patients ◽  
Multivariate Logistic Regression ◽  
Hospital Arrival ◽  
Paediatric Trauma ◽  
Japan Trauma Data Bank

ObjectivesTo examine the association between body temperature (BT) on hospital arrival and in-hospital mortality among paediatric trauma patients.DesignA retrospective cohort study.SettingJapan Trauma Data Bank (JTDB, which is a nationwide, prospective, observational trauma registry with data from 235 hospitals).ParticipantsPaediatric trauma patients <16 years old who were transferred directly from the scene of injury to the hospital and registered in the JTDB from January 2004 to December 2017 were included. We excluded patients >16 years old and those who developed cardiac arrest before or on hospital arrival.Primary outcomeThe association between BT on hospital arrival and in-hospital mortality. We conducted multivariate logistic regression analyses to calculate the adjusted ORs, with their 95% CIs, of the association between BT and in-hospital mortality.ResultsA total of 9012 patients were included (median age: 9 years (IQR, 6.0–13.0 years), mortality: 2.5% (mortality number was 226 in total 9012 patients)). In the multivariate logistic regression analysis, the corresponding adjusted ORs of BT <36.0°C and BT ≥37.0°C, relative to a BT of 36°C–36.9°C, for in-hospital mortality were 2.83 (95% CI: 1.85 to 4.33) and 0.93 (95% CI: 0.53 to 1.63), respectively.ConclusionsIn paediatric patients with hypothermia (BT <36.0°C) on hospital arrival, a clear association with in-hospital mortality was observed; no such association was observed between higher BT values (≥37.0°C) and outcomes.

Stagnation of treatment times over a decade: results of a pooled analysis from the MERCI registry, MERCI, TREVO, and TREVO 2 trials

2015 ◽  
Vol 8 (5) ◽  
pp. 453-456 ◽  
Author(s):  
Rishi Gupta ◽  
Bin Xiang ◽  
Sijian Ge ◽  
Chung-Huan J Sun ◽  
Albert J Yoo ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Scale Score ◽  
Systems Of Care ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Information ◽  
Multivariate Regression Analysis ◽  
Pooled Analysis ◽  
Pooled Data ◽  
Procedure Duration ◽  
Stroke Systems Of Care

BackgroundThere has been a growing interest in improving systems of care for the endovascular treatment of acute ischemic stroke. We analyzed data from previous registries and studies to determine if there has been an improvement in times to reperfusion with increasing experience.MethodsWe analyzed the pooled data from the Multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI), MERCI Registry and Thrombectomy Revascularization of Large Vessel Occlusions (TREVO), and TREVO 2 trials and assessed times from last known normal to puncture, from hospital arrival to puncture, and procedure duration by year to determine if there has been a reduction in times. Demographic, radiographic, and clinical information were also assessed in a multivariate regression analysis to determine the predictors of good outcomes defined as a modified Rankin Scale score of 0–2 at 3 months.Results1248 patients of mean age 68±14 years and median NIH Stroke Scale score 18 were analyzed from 2001 to 2011. Procedure times showed a significant improvement while last known normal to puncture times remained static. In multivariate logistic regression analysis, longer last known normal to puncture time and longer procedure duration were associated with a decreased chance of a good outcome (OR 0.84, 95% CI 0.76 to 0.92, p=0.0004 and OR 0.75, 95% CI 0.61 to 0.91, p=0.0040, respectively).ConclusionsDespite a reduction in procedure times, there has not been a corresponding improvement in overall last known normal to puncture times over a 10-year period. The current study shows that there are many opportunities to create more efficient endovascular stroke systems of care in trials.

Perioperative Temperature Regulation

2004 ◽  
Vol 5 (2) ◽  
pp. 27-30
Author(s):  
J. Hegarty
Keyword(s):  
Body Temperature ◽  
Heat Loss ◽  
Core Body Temperature ◽  
The Body ◽  
Surgical Patients ◽  
Temperature Management ◽  
Perioperative Nurses ◽  
Anaesthetic Care ◽  
Life Threatening ◽  
Patient At Risk

The regulation of body temperature is one of a variety of mechanisms, which play a part in maintaining a stable internal environment in the body thus enabling the body to function optimally. It is crucial that the core body temperature is maintained within a narrow (36–37.5°C) range [Luckmann, 1997]. Thermoregulation in the operating theatre and post anaesthetic care unit is often an underemphasized concern for surgical patients. Anaesthesia and surgery commonly cause substantial alterations in the temperature of surgical patients.Unnecessary heat loss, hypothermia, the typical variation, results from a combination of anaesthetic-induced impairment of thermoregulatory control, a cool, operating room environment and other factors exclusive to surgery and anaesthesia. Estimates of the incidence of inadvertent perioperative hypothermia range from 60% to 90% of all surgical cases [Bernthal, 1999, Litwack, 1995], when this condition is defined as a body temperature below 36°C (degrees Celsius) 96.8°F (degrees Fahrenheit) (Arndt, 1999). Hypothermia apart from causing a very unpleasant sensation of cold, places the patient at risk of developing life-threatening events, which include altered cardiac performance, delayed emergence from anaesthesia and increased rates of morbidity and mortality. Although the aim of temperature management by intraoperative medical and nursing staff is prevention of heat loss, the objective of post anaesthetic recovery room staff is usually the restoration of normothermia. Thus, perioperative nurses need to be aware of the need to monitor patient's temperature, be familiar with different patient warming/rewarming methods and be alert for potential problems that can arise from hypothermia.

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