scholarly journals Bradycardia in Accidental Severe Hypothermia in a Newborn: Treat or Don’t Touch? A case report

2021 ◽  
Author(s):  
Astrid Kuonen ◽  
Thomas Riva ◽  
Gabor Erdoes
Keyword(s):  
Body Temperature ◽  
Clinical Presentation ◽  
Prolonged Exposure ◽  
Accidental Hypothermia ◽  
Effective Measure ◽  
Heart Frequency ◽  
Mortality And Morbidity ◽  
Severe Hypothermia ◽  
Passive Rewarming ◽  
Accidental Severe Hypothermia

Abstract BackgroundHypothermia significantly affects mortality and morbidity of newborns. Literature about severe accidental hypothermia in neonates is limited. We present a case of a neonate suffering from severe accidental hypothermia. An understanding of the physiology of neonatal thermoregulation and hypothermia is important to decide on treatment.Case presentationWe report a case of severe accidental hypothermia (rectal temperature 25.7°C) in a hypothropic newborn due to prolonged exposure to low ambient temperature. The newborn presented bradycardic, bradypneic, lethargic, pale and cold. Bradycardia, bradypnea and consciousness were interpreted in the context of the measured body temperature. Therefore, no reanimation or intubation was initiated. The newborn was closely monitored and successfully treated only with active and passive rewarming. ConclusionClinical parameters such as heart frequency, blood pressure, respiration and consciousness must be interpreted in light of the measured body temperature. Medical treatment should be adapted to the clinical presentation. External rewarming can be a safe and effective measure in neonatal patients.

scholarly journals Bradycardia in a newborn with accidental severe hypothermia: treat or don’t touch? A case report

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Astrid Kuonen ◽  
Thomas Riva ◽  
Gabor Erdoes
Keyword(s):  
Body Temperature ◽  
Clinical Presentation ◽  
Prolonged Exposure ◽  
Accidental Hypothermia ◽  
Effective Measure ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Severe Hypothermia ◽  
Passive Rewarming ◽  
Accidental Severe Hypothermia

Abstract Background Hypothermia significantly affects mortality and morbidity of newborns. Literature about severe accidental hypothermia in neonates is limited. We report a case of a neonate suffering from severe accidental hypothermia. An understanding of the physiology of neonatal thermoregulation and hypothermia is important to decide on treatment. Case presentation A low-birth-weight newborn was found with severe accidental hypothermia (rectal temperature 25.7 °C) due to prolonged exposure to low ambient temperature. The newborn presented bradycardic, bradypnoeic, lethargic, pale and cold. Bradycardia, bradypnea and impaired consciousness were interpreted in the context of the measured body temperature. Therefore, no reanimation or intubation was initiated. The newborn was closely monitored and successfully treated only with active and passive rewarming. Conclusion Clinical parameters such as heart frequency, blood pressure, respiration and consciousness must be interpreted in light of the measured body temperature. Medical treatment should be adapted to the clinical presentation. External rewarming can be a safe and effective measure in neonatal patients.

Light-induced suppression of the rat circadian system

1995 ◽  
Vol 268 (5) ◽  
pp. R1111-R1116 ◽  
Author(s):  
P. Depres-Brummer ◽  
F. Levi ◽  
G. Metzger ◽  
Y. Touitou
Keyword(s):  
Locomotor Activity ◽  
Body Temperature ◽  
Circadian Rhythms ◽  
Prolonged Exposure ◽  
Light Exposure ◽  
Continuous Light ◽  
Circadian System ◽  
Short Exposure ◽  
Complete Suppression ◽  
Continuous Darkness

In a constant environment, circadian rhythms persist with slightly altered period lengths. Results of studies with continuous light exposure are less clear, because of short exposure durations and single-variable monitoring. This study sought to characterize properties of the oscillator(s) controlling the rat's circadian system by monitoring both body temperature and locomotor activity. We observed that prolonged exposure of male Sprague-Dawley rats to continuous light (LL) systematically induced complete suppression of body temperature and locomotor activity circadian rhythms and their replacement by ultradian rhythms. This was preceded by a transient loss of coupling between both functions. Continuous darkness (DD) restored circadian synchronization of temperature and activity circadian rhythms within 1 wk. The absence of circadian rhythms in LL coincided with a mean sixfold decrease in plasma melatonin and a marked dampening but no abolition of its circadian rhythmicity. Restoration of temperature and activity circadian rhythms in DD was associated with normalization of melatonin rhythm. These results demonstrated a transient internal desynchronization of two simultaneously monitored functions in the rat and suggested the existence of two or more circadian oscillators. Such a hypothesis was further strengthened by the observation of a circadian rhythm in melatonin, despite complete suppression of body temperature and locomotor activity rhythms. This rat model should be useful for investigating the physiology of the circadian timing system as well as to identify agents and schedules having specific pharmacological actions on this system.

scholarly journals Left ventricular noncompaction: Clinical-echocardiographic study

2012 ◽  
Vol 69 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Aleksandra Nikolic ◽  
Ljiljana Jovovic ◽  
Slobodan Tomic ◽  
Milan Vukovic
Keyword(s):  
Heart Failure ◽  
Clinical Presentation ◽  
Color Doppler ◽  
Neuromuscular Diseases ◽  
Left Ventricular ◽  
Left Ventricular Noncompaction ◽  
Ventricular Noncompaction ◽  
Mortality And Morbidity ◽  
Echocardiographic Examination ◽  
Myocardial Fibers

Background/Aim. Left ventricular noncompaction (LVNC) is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies) or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System). Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ? 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

The International Hypothermia Registry (IHR): Dieter's ESAO Winter Schools and Beat's International Hypothermia Registry

2017 ◽  
Vol 40 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Beat H. Walpoth ◽  
Marie Meyer ◽  
Christophe Gaudet-Blavignac ◽  
Philippe Baumann ◽  
Pierre Gilquin ◽  
...  
Keyword(s):  
Mild Hypothermia ◽  
Statistical Significance ◽  
Orphan Disease ◽  
Accidental Hypothermia ◽  
Evidence Based ◽  
Outcome Predictors ◽  
Severe Hypothermia ◽  
Life Threatening

Accidental hypothermia could be listed as an ‘orphan disease,’ since mild hypothermia is common but has no severe medical consequences, whereas severe hypothermia is rare and life-threatening. In order to increase our knowledge, find new outcome predictors, and propose better guidelines for the treatment of deep accidental hypothermia victims, we created the International Hypothermia Registry (IHR: https://www.hypothermia-registry.org ), which will allow us to gather a large number of cases in order to achieve statistical significance and issue evidence-based recommendations.

ELECTRIC BUNTING TO MAINTAIN BODY TEMPERATURE DURING EXCHANGE TRANSFUSION IN THE NEWBORN INFANT

PEDIATRICS ◽  
1951 ◽  
Vol 7 (2) ◽  
pp. 207-209
Author(s):  
P. VOGEL ◽  
R. E. ROSENFIELD ◽  
M. STEINBERG
Keyword(s):  
Body Temperature ◽  
Exchange Transfusion ◽  
Prolonged Exposure ◽  
Newborn Infants ◽  
Electric Heating ◽  
Hot Water ◽  
Maximum Temperature ◽  
Ideal Situation ◽  
The Many ◽  
Water Proof

THE maintenance of proper body temperature has been a serious problem in the performance of exchange transfusions on newborn infants suffering from hemolytic disease. Many of these infants are in such poor condition that extreme care in their handling is required, including incubation, oxygen and tracheal aspiration. The many procedures necessary create the hazard of prolonged exposure to room temperature, and a number of deaths may have resulted directly or indirectly from hypothermia. In the Children's Hospital in Boston, the entire exchange transfusion is carried out with the infant lying in a Hess bed; this is an ideal situation which undoubtedly is not readily available in most institutions where an exchange transfusion must be performed. The maintenance of body temperature with electric heating pads and/or hot water bottles has proved cumbersome and unsatisfactory, and has resulted in a number of burns, particularly about the buttocks. A washable electric blanket bunting has been designed (see Figs. and 2) to maintain the temperature of newborn infants throughout the procedure of an exchange transfusion, as well as for a period following the procedure, if a heated crib is not available. This bunting was constructed by the General Electric Company using water-proof washable material and employing the principles of the commercial electric blanket. The bunting can be regulated to any desired temperature although the maximum temperature obtainable is 42°C., which avoids the possibility of skin burns. The design of the bunting is simple: it is a bag with a zipper along one side to allow for easy insertion and removal of the baby, and a "U" shaped zippered flap which can be opened to provide a window at the approximate position of the umbilical cord.

scholarly journals The Importance of Changes in Body Temperature in Paediatric Surgery and Anaesthesia

1973 ◽  
Vol 1 (6) ◽  
pp. 480-485 ◽  
Author(s):  
Nerida M. Dilworth
Keyword(s):  
Body Temperature ◽  
Newborn Infant ◽  
Paediatric Anaesthesia ◽  
Considerable Importance ◽  
Accidental Hypothermia ◽  
Paediatric Surgery ◽  
Normal Body Temperature ◽  
Normal Body ◽  
The Subject

An understanding of the maintenance of normal body temperature, and the manner in which surgery, anaesthesia, and related procedures may disturb thermoregulation, is of considerable importance in paediatric anaesthesia. The subject of accidental hypothermia, with particular reference to the newborn infant, is reviewed; and hyperpyrexia is briefly discussed.

scholarly journals Can body temperature be maintained during aeromedical transport?

CJEM ◽  
2002 ◽  
Vol 4 (03) ◽  
pp. 172-177 ◽  
Author(s):  
Sunil M. Sookram ◽  
Samantha Barker ◽  
Karen D. Kelly ◽  
William Patton ◽  
Terry Sosnowski ◽  
...  
Keyword(s):  
Body Temperature ◽  
Core Temperature ◽  
Mild Hypothermia ◽  
Severely Injured ◽  
Severe Hypothermia ◽  
Northern Areas ◽  
Aeromedical Transport ◽  
Regional Hospitals ◽  
Rotary Wing ◽  
Northern Alberta

ABSTRACTBackground:Aeromedical transport in northern areas may be associated with hypothermia. The objective of this study was to determine whether significant hypothermia (core temperature <35ºC) occurs in severely injured or ill intubated patients during transport by rotary wing aircraft.Methods:In this prospective cohort study, all intubated patients over 16 years of age who were transported by rotary wing aircraft from rural hospitals or trauma scenes in northern Alberta to regional hospitals in Edmonton were eligible for study. Esophageal thermometers were used to measure core temperature at 10-minute intervals during transport.Results:Of 133 potentially eligible patients, 116 were enrolled; 69 (59%) had esophageal thermometers inserted, and 47 (41%) had other temperature measurements. Severe hypothermia occurred in only 1% to 2% of cases, but 28% to 39% of patients met criteria for mild hypothermia prior to transport. Core temperatures did not fall during transport, despite the fact that warming techniques were documented in only 38% of cases.Conclusions:During brief (<225 km) rotary wing aeromedical transport of severely injured or ill patients, significant hypothermia is uncommon and body temperature is generally well maintained with the use of simple passive measures. These findings do not justify recommendations for more aggressive core temperature monitoring during this type of aeromedical transport.

scholarly journals Severe Hypothermia: Challenging Normal Physiology

2005 ◽  
Vol 33 (5) ◽  
pp. 662-664 ◽  
Author(s):  
J. Brieva ◽  
B. Mcfadyen ◽  
M. Rowley
Keyword(s):  
Cause Of Death ◽  
Core Temperature ◽  
Accidental Hypothermia ◽  
Severe Hypothermia

Accidental hypothermia is not a frequent cause of death in Australia. Moreover it is rare to have an admission to hospital with a core temperature below 32°C. Among the cases described in the literature, it is clear that temperature and prognosis are related. Our patient presented with severe accidental hypothermia and even though the admission core temperature was below 26 degrees she was successfully discharged from hospital after active re-warming with three different devices. She had laboratory and ECG findings associated with severe hypothermia.

scholarly journals Effect of chronic hypercapnia on body temperature regulation

1975 ◽  
Vol 38 (5) ◽  
pp. 900-906 ◽  
Author(s):  
K. E. Schaefer ◽  
A. A. Messier ◽  
C. Morgan ◽  
G. T. Baker
Keyword(s):  
Body Temperature ◽  
Guinea Pigs ◽  
Time Course ◽  
Prolonged Exposure ◽  
Respiratory Acidosis ◽  
Serotonin Content ◽  
Regulatory Processes ◽  
Transient Rise ◽  
Acid Base Status ◽  
Partial Compensation

Guinea pigs and rats exposed to 15% CO2 for 7 days showed a parallel time course of changes in pH, body temperature (TB), and oxygen consumption (VO2). Between 1 and 6 h of exposure the maximal drop in actual pH occurred in guinea pigs simultaneously with the maximal fall in TB and VO2. During the subsequent period pH TB, VO2 rose again. Skin blood content (heat loss) also exhibited a biphasic pH-dependent time course. Animals showing no partial compensation of respiratory acidosis during 3 days exposure also failed in raising their TB back to normal in this time. The behavior of TB was found to be a good indicator of the acid-base status and adaptive potential of the animals to hypercapnia. Similar results were obtained in rats. Thermo-regulatory processes in the hypothalamus were affected during exposure to 15% CO2. Both guinea pigs and rats showed a decrease in norepinephrine content of the hypothalamus during the first part of exposure reaching a maximal fall at the end of 24 h. The serotonin content increased slightly during this period. During prolonged exposure to 3% CO2 for 7 days, TB showed a transient rise, and VO2 was slightly elevated.

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