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1.
J Pediatr Urol ; 17(5): 750-752, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34736727

RESUMO

INTRODUCTION: Inadvertent perioperative hypothermia (a drop in core temperature to below 36 °C) occurs because of interference with normal temperature regulation by anaesthetic drugs, skin exposure for prolonged periods and the introduction of large volumes of intravenous and irrigation fluids. If the temperature of these fluids is below core body temperature, they can cause significant heat loss. Warming irrigation fluids might prevent some of this heat loss and subsequent hypothermia and that is the role of warming irrigation fluid systems. MATERIAL AND METHODS: The video describes prone ultra mini PCNL with suction-evacuation access sheath under warming irrigation fluid system in a 15 month-old boy with a 2 cm-600HU staghorn calculi and one stone of 7 mm-500HU in proximal ureter. RESULTS: The surgery was performed without intraoperative complications and perioperative hypothermia was prevented. The patient started the surgery at 35.4 °C and the final temperature was 36.3 °C in 90 min of procedure, in addition to being free of stones. CONCLUSIONS: The warming irrigation fluid system can be helpful in preventing inadvertent perioperative hypothermia in children, improving the safety of ultra mini PCNL with suction-evacuation access sheath and shows promising results with high stone-free rates and low complications.


Assuntos
Hipotermia , Cálculos Coraliformes , Criança , Humanos , Hipotermia/prevenção & controle , Lactente , Complicações Intraoperatórias/prevenção & controle , Masculino , Sucção , Temperatura
2.
Artigo em Inglês | MEDLINE | ID: mdl-34769999

RESUMO

Hypothermia in pediatrics is mainly about small body size. The key thermal factor here is the large surface-to-volume ratio. Although small mammals, including human infants and children, are adapted to higher heat losses through their elevated metabolic rate and thermogenic capacity, they are still at risk of hypothermia because of a small regulatory range and an impending metabolic exhaustion. However, some small mammalian species (hibernators) use reduced metabolic rates and lowered body temperatures as adaptations to impaired energy supply. Similar to nature, hypothermia has contradictory effects in clinical pediatrics as well: In neonates, it is a serious risk factor affecting respiratory adaptation in term and developmental outcome in preterm infants. On the other hand, it is an important self-protective response to neonatal hypoxia and an evidence-based treatment option for asphyxiated babies. In children, hypothermia first enabled the surgical repair of congenital heart defects and promotes favorable outcome after ice water drowning. Yet, it is also a major threat in various prehospital and clinical settings and has no proven therapeutic benefit in pediatric critical care. All in all, pediatric hypothermia is an ambiguous issue whose harmful or beneficial effects strongly depend on the particular circumstances.


Assuntos
Hipotermia , Pediatria , Animais , Temperatura Corporal , Regulação da Temperatura Corporal , Criança , Humanos , Hipotermia/prevenção & controle , Lactente , Recém-Nascido , Recém-Nascido Prematuro
4.
Ann Intern Med ; 174(11): JC126, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34724397

RESUMO

SOURCE CITATION: Dankiewicz J, Cronberg T, Lilja G, et al. Hypothermia versus normothermia after out-of-hospital cardiac arrest. N Engl J Med. 2021;384:2283-94. 34133859.


Assuntos
Hipotermia Induzida , Hipotermia , Parada Cardíaca Extra-Hospitalar , Adulto , Coma/terapia , Humanos , Parada Cardíaca Extra-Hospitalar/terapia
5.
A A Pract ; 15(11): e01546, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34807873

RESUMO

Malignant hyperthermia (MH) is a life-threatening hypermetabolic disorder triggered by volatile anesthetics and/or succinylcholine. We report a case of a 58-year-old patient with a type-A aortic dissection. After induction of general anesthesia, a hypermetabolic reaction was successfully treated by deep hypothermia using cardiopulmonary bypass. Dantrolene became available in theater after the hypermetabolism was already treated successfully by hypothermia. Because of a low suspicion of MH, dantrolene was not administered when it became available. The patient fully recovered, and MH susceptibility was confirmed. Cardiopulmonary bypass should be considered to treat MH in case dantrolene and conservative therapy are unavailable or insufficient.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Hipotermia , Hipertermia Maligna , Ponte Cardiopulmonar , Humanos , Hipertermia , Hipotermia/terapia , Hipertermia Maligna/tratamento farmacológico , Pessoa de Meia-Idade
6.
Artigo em Inglês | MEDLINE | ID: mdl-34769877

RESUMO

PURPOSE: Historically, studies suggested that intraoperative hypothermia (IH) could result in significant resource consumption, but more recent studies have found the opposite. The purpose of this study is to estimate the value of active warming devices for IH prevention based on synthesized evidence. METHODS: A cost-benefit analysis was conducted using the effect of active warming versus passive warming devices for intraoperative hypothermia from a meta-analysis. The item-based aggregated treatment cost approach was adopted to estimate the cost of each adverse event, which was then weighted to calculate the total cost of IH. RESULTS: IH was associated with higher risks of bleeding, surgical site infection, and shivering compared with normothermia. The cost of one case of IH was $363.80, and the use of active warming devices might save $152.80. Extra investment in active warming (e.g., $291.00) might only be cost-beneficial when the minimum willingness-to-pay is $150.00. CONCLUSIONS: Synthesized evidence showed that the cost of IH might be overestimated. Furthermore, the value of using active warming devices remains uncertain because the willingness to pay may vary between decision-makers. As not enough awareness of hypothermia prevention in some countries, further research into the clinical use of active warming devices during major surgeries is warranted.


Assuntos
Hipotermia , Temperatura Corporal , Análise Custo-Benefício , Hemorragia , Humanos , Hipotermia/prevenção & controle , Tremor por Sensação de Frio , Infecção da Ferida Cirúrgica
7.
Medicina (Kaunas) ; 57(11)2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34833473

RESUMO

Background and Objectives: Female reproductive hormones may affect core body temperature. This study aimed to investigate the effects of female reproductive hormones on inadvertent intraoperative hypothermia in patients who underwent laparoscopic gynecologic surgery under general anesthesia. Materials and Methods: This retrospective study included 660 menstruating and menopausal female patients aged 19-65 years. The patients were divided into two groups according to the occurrence of inadvertent intraoperative hypothermia: non-hypothermia group (N = 472) and hypothermia group (N = 188). After propensity score matching, 312 patients (N = 156 in each group) were analyzed to investigate the association between intraoperative hypothermia and female reproductive hormones. As potential predictors of inadvertent hypothermia, the levels of female reproductive hormones were analyzed using binary logistic regression. Results: The association of estradiol (r = -0.218, p = 0.000) and progesterone (r = -0.235, p = 0.000) levels with inadvertent intraoperative hypothermia was significant but weakly negative before matching; however, it was significant and moderately negative after matching (r = -0.326, p = 0.000 and r = -0.485, p = 0.000, respectively). In a binary logistic analysis, the odds ratio for estradiol was 0.995 (p = 0.014, 0.993 < 95% confidence interval [CI] < 0.998) before matching and 0.993 (p = 0.000, 0.862 < 95% CI < 0.930) after matching, and that for progesterone was 0.895 (p = 0.000, 0.862 < 95% CI < 0.930) before matching and 0.833 (p = 0.014, 0.990 < 95% CI < 0.996) after matching. Conclusions: Estradiol and progesterone levels were associated with inadvertent intraoperative hypothermia. However, the odds ratio for female reproductive hormone levels was close to 1. Therefore, female reproductive hormones may not be a risk factor for hypothermia during gynecologic surgery under general anesthesia. However, a small sample size in this study limits the generalizability of the results.


Assuntos
Hipotermia , Laparoscopia , Temperatura Corporal , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Hormônios , Humanos , Hipotermia/epidemiologia , Hipotermia/etiologia , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/etiologia , Estudos Retrospectivos
8.
BMJ Open ; 11(10): e052200, 2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34711600

RESUMO

INTRODUCTION: Accidental hypothermia (AH) is a rare but critical disease, leading to death in severe cases. In recent decades, extracorporeal membrane oxygenation (ECMO) has been successfully used to rewarm hypothermic patients with cardiac arrest or circulation instability. However, data on the efficacy of rewarming using ECMO for patients with AH are limited. Therefore, a large-scale, multicentre, prospective study is warranted. The primary objective of this study will be to clarify the effectiveness of rewarming using ECMO for patients with AH. Our secondary objectives will be to compare the incidence of adverse effects between ECMO rewarming and non-ECMO rewarming and to identify the most appropriate management of ECMO for AH. METHODS AND ANALYSES: The Intensive Care with ExtraCorporeal membrane oxygenation Rewarming in Accidentally Severe Hypothermia study is taking place in 35 tertiary emergency medical facilities in Japan. The inclusion criteria are patients ≥18 years old with a body temperature ≤32°C. We will include patients with AH who present to the emergency department from December 2019 to March 2022. The research personnel at each hospital will collect several variables, including patient demographics, rewarming method, ECMO data and complications. Our primary outcome is to compare the 28-day survival rate between the ECMO and non-ECMO (other treatments) groups among patients with severe AH. Our secondary outcomes are to compare the following values between the ECMO and non-ECMO groups: length of stay in the intensive-care unit and complications. Furthermore, in patients with cardiac arrest, the Cerebral Performance Category score at discharge will be compared between both groups. ETHICS AND DISSEMINATION: This study received research ethics approval from Asahikawa Medical University (18194 and 19115). The study was approved by the institutional review board of each hospital, and the requirement for informed consent was waived due to the observational nature of the study. TRIAL REGISTRATION NUMBER: UMIN000036132.


Assuntos
Oxigenação por Membrana Extracorpórea , Hipotermia , Acidentes , Adolescente , Adulto , Cuidados Críticos , Humanos , Hipotermia/terapia , Japão , Estudos Multicêntricos como Assunto , Estudos Observacionais como Assunto , Estudos Prospectivos , Reaquecimento
9.
Artigo em Inglês | MEDLINE | ID: mdl-34639535

RESUMO

Avalanche accidents are common in mountain regions and approximately 100 fatalities are counted in Europe each year. The average mortality rate is about 25% and survival chances are mainly determined by the degree and duration of avalanche burial, the patency of the airway, the presence of an air pocket, snow characteristics, and the severity of traumatic injuries. The most common cause of death in completely buried avalanche victims is asphyxia followed by trauma. Hypothermia accounts for a minority of deaths; however, hypothermic cardiac arrest has a favorable prognosis and prolonged resuscitation and extracorporeal rewarming are indicated. In this article, we give an overview on the pathophysiology and on-site management of avalanche victims.


Assuntos
Avalanches , Parada Cardíaca , Hipotermia , Asfixia/terapia , Parada Cardíaca/terapia , Humanos , Hipotermia/terapia , Reaquecimento
10.
Ann Palliat Med ; 10(9): 9564-9571, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628882

RESUMO

BACKGROUND: Systemic therapeutic hypothermia is commonly used in patients with craniocerebral injury, cardiopulmonary resuscitation, and high fever, but its effect is still controversial that some reported hypothermia is helpful for thrombosis while someothers thought it had limited effects on thrombosis. In order to explore the effect of intraoperative hypothermia on patients, we analyzed the role of hypothermia in promoting thrombosis, in order to guide the implementation of corresponding countermeasures and timely intervention. METHODS: The databases of PubMed, Embase, Cochrane database, and China National Knowledge Infrastructure (CKNI) were used to retrieve relevant studies. The selected literatures were evaluated with Review Manager 5.2. Forest plots, sensitivity analysis, and bias analysis were used to analyze the included studies. RESULTS: A total of 2,053 patients in 8 trials (762 patients were randomly divided into hypothermia group and 1,191 patients in normothermia group) were included in the meta-analysis. High quality randomized evidence suggested that therapeutic hypothermia is associated with thrombosis and high mortality in critically ill patients. Although therapeutic hypothermia may still be beneficial in specific environments, it is best to avoid the routine application of therapeutic hypothermia outside the circumstances specified in the international guidelines (adult cardiac arrest and neonatal hypoxic ischemic encephalopathy). DISCUSSION: This study shows that intraoperative hypothermia is more likely to cause thrombosis, massive hemorrhage, and even death in comparison to routine nursing.


Assuntos
Parada Cardíaca , Hipotermia Induzida , Hipotermia , Trombose , Adulto , Bases de Dados Factuais , Parada Cardíaca/terapia , Humanos , Recém-Nascido , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Medicine (Baltimore) ; 100(39): e27339, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34596139

RESUMO

ABSTRACT: The effect of hypothermia as a mortality risk factor at 30 days in the elderly who had hip fracture (HF) surgery is still controversial because it may be due to a set of poorly identified factors. In this study, we aim to determine if exposure to intra and immediate postoperative hypothermia increases the incidence of mortality at 30 days in elderly patients who had HF surgery.Survival study in the elderly who had HF surgery with and without exposure to hypothermia. Sociodemographic, anesthetic and surgical factors were collected. The temperature of the rectum was measured at the end of the surgery and in the recovery room. The effect of hypothermia was analyzed by the incidence of mortality at 30 days. Other results were considered, such as, surgical site infection (SSI), blood transfusions, and influence of implants used in the 30-day mortality.Three hundred eighty five subjects were eligible, to include 300. Inadvertent hypothermia was 12%, the 30-day overall mortality was 9% and in subjects with hypothermia it was 25% (P = .002). Subjects with hypothermia had a higher risk of SSI (relative risk 4.2, 95% confidence interval 1.3-13.6, P = .03) and receive more transfusions (relative risk 3.6, 95% confidence interval 2.0-6.5, P < .001).Elderly subjects with HF exposed to hypothermia who undergo hip hemiarthroplasty and who receive 2 or more blood transfusions during their treatment, are at greater risk of dying after 30 days of the surgery. Hypothermia, as a possible causative factor of mortality, should continue to be studied.


Assuntos
Hemiartroplastia/mortalidade , Hemiartroplastia/métodos , Fraturas do Quadril/mortalidade , Fraturas do Quadril/cirurgia , Hipotermia/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue/estatística & dados numéricos , Temperatura Corporal , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Infecção da Ferida Cirúrgica/epidemiologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-34574562

RESUMO

BACKGROUND: Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C. METHODS: This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021. RESULTS: From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5-2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9-3.0) and intermittent (1.9 °C/h; 95% CI 1.5-2.3) methods (p > 0.9). CONCLUSIONS: Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines.


Assuntos
Hipotermia , Humanos , Hipotermia/terapia , Diálise Renal , Reaquecimento , Revisões Sistemáticas como Assunto , Fatores de Tempo
13.
Artigo em Inglês | MEDLINE | ID: mdl-34574690

RESUMO

BACKGROUND: While ECLS is a highly invasive procedure, the identification of patients with a potentially good prognosis is of high importance. The aim of this study was to analyse changes in the acid-base balance parameters and lactate kinetics during the early stages of ECLS rewarming to determine predictors of clinical outcome. METHODS: This single-centre retrospective study was conducted at the Severe Hypothermia Treatment Centre at John Paul II Hospital in Krakow, Poland. Patients ≥18 years old who had a core temperature (Tc) < 30 °C and were rewarmed with ECLS between December 2013 and August 2018 were included. Acid-base balance parameters were measured at ECLS implantation, at Tc 30 °C, and at 2 and 4 h after Tc 30 °C. The alteration in blood lactate kinetics was calculated as the percent change in serum lactate concentration relative to the baseline. RESULTS: We included 50 patients, of which 36 (72%) were in cardiac arrest. The mean age was 56 ± 15 years old, and the mean Tc was 24.5 ± 12.6 °C. Twenty-one patients (42%) died. Lactate concentrations in the survivors group were significantly lower than in the non-survivors at all time points. In the survivors group, the mean lactate concentration decreased -2.42 ± 4.49 mmol/L from time of ECLS implantation until 4 h after reaching Tc 30 °C, while in the non-survivors' group (p = 0.024), it increased 1.44 ± 6.41 mmol/L. CONCLUSIONS: Our results indicate that high lactate concentration is associated with a poor prognosis for hypothermic patients undergoing ECLS rewarming. A decreased value of lactate kinetics at 4 h after reaching 30 °C is also associated with a poor prognosis.


Assuntos
Oxigenação por Membrana Extracorpórea , Hipotermia , Adolescente , Adulto , Idoso , Humanos , Ácido Láctico , Pessoa de Meia-Idade , Estudos Retrospectivos , Reaquecimento
14.
Rev Bras Enferm ; 75(1): e20200940, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34495128

RESUMO

OBJECTIVE: to discuss in the scientific literature the strategies used to prevent hypothermia in newborns undergoing surgical procedures. METHODS: this is an integrative literature review, with structured search in April and May 2020 in 08 databases, using the descriptors: Hypothermia; Surgical Procedures, Operative; Infant, Newborn; Protocols. Four primary studies were selected and analyzed using three instruments to assess the methodological quality of the Joanna Briggs Institute and content analysis. RESULTS: Among the strategies used, the following stand out: room temperature control; establishment of humidification and quality of air conditioning cleanliness; use of a heated incubator or cradle; use of thermal mattress; use of caps and blanket; heated fluids; temperature monitoring and abdominal organ coverage. CONCLUSION: good hypothermia prevention strategies were identified, despite the small number of publications on this topic; thus, it points out the need for research with strong evidence.


Assuntos
Hipotermia , Temperatura Alta , Humanos , Hipotermia/prevenção & controle , Recém-Nascido
15.
BMC Geriatr ; 21(1): 507, 2021 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-34563118

RESUMO

BACKGROUND: Frailty has been associated with a risk of adverse outcomes, and mortality in patients with various conditions. However, there have been few studies on whether or not frailty is associated with mortality in patients with accidental hypothermia (AH). In this study, we aim to determine this association in patients with AH using Japan's nationwide registry data. METHODS: The data from the Hypothermia STUDY 2018&19, which included patients of ≥18 years of age with a body temperature of ≤35 °C, were obtained from a multicenter registry for AH conducted at 120 institutions throughout Japan, collected from December 2018 to February 2019 and December 2019 to February 2020. The clinical frailty scale (CFS) score was used to determine the presence and degree of frailty. The primary outcome was the comparison of mortality between the frail and non-frail patient groups. RESULTS: In total, 1363 patients were included in the study, of which 920 were eligible for the analysis. The 920 patients were divided into the frail patient group (N = 221) and non-frail patient group (N = 699). After 30-days of hospitalization, 32.6% of frail patients and 20.6% of non-frail patients had died (p < 0.001). Frail patients had a significantly higher risk of 90-day mortality (Hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.25-2.17; p < 0.001). Based on the Cox proportional hazards analysis using multiple imputation, after adjustment for age, potassium level, lactate level, pH value, sex, CPK level, heart rate, platelet count, location of hypothermia incidence, and rate of tracheal intubation, the HR was 1.69 (95% CI, 1.25-2.29; p < 0.001). CONCLUSIONS: This study showed that frailty was associated with mortality in patients with AH. Preventive interventions for frailty may help to avoid death caused by AH.


Assuntos
Fragilidade , Hipotermia , Idoso , Idoso Fragilizado , Fragilidade/diagnóstico , Hospitalização , Humanos , Hipotermia/diagnóstico , Japão/epidemiologia
16.
BMC Vet Res ; 17(1): 302, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503510

RESUMO

BACKGROUND: Diseases of the central nervous system are a well-recognized cause of morbidity and mortality in equine. Collection and analysis of cerebrospinal fluid (CSF) give information about the type and stage of degenerative and inflammatory diseases in central nervous system (CNS). The present research aimed to assess the clinical complications of CSF collections and to establish range values of cytological and biochemical parameters of CSF in adult healthy donkeys (Equus asinus). The CSF samples were collected from fifty healthy donkeys at the lumbosacral (LS) and atlanto-occipital (AO) sites. RESULTS: Hypothermia, tachycardia, ataxia and recumbency may develop post-puncture. Erythrocytes were noticed in 35 of 50 CSF samples. Total nucleated cell counts ranged from 0 to 6 cells/µL, and lymphocytes predominated the cells (61%). The concentration of glucose (1.2 to 5.3 mmol/L) was lower than that of serum (P < 0.05). The CSF sodium concentration (123 to 160 mmol/L) was approximately like that of serum, but potassium (1.5-3 mmol/L) was lower than that of serum (P < 0.01). Urea concentrations (1.1-2.9 mmol/L) were markedly lower than serum (P < 0.001). Concentrations of CSF total proteins, and albumin ranged from 0.1 to 0.6 g/dL, and from 0.002 to 0.013 g/dL, respectively. The albumin quotient ranged from 0.06 to 0.56. CONCLUSIONS: Transient hypothermia, tachycardia, ataxia and recumbency may develop as clinical complications of CSF puncture procedures. The collection site has no impact on the constituents in CSF. Furthermore, this study presented the range values for normal cytological and biochemical constituents of CSF in donkeys (Equus asinus) that can provide a basis in comparison when evaluating CSF from donkeys with neurologic diseases.


Assuntos
Ataxia/veterinária , Líquido Cefalorraquidiano/química , Líquido Cefalorraquidiano/citologia , Equidae/líquido cefalorraquidiano , Hipotermia/veterinária , Punção Espinal/veterinária , Taquicardia/veterinária , Animais , Ataxia/etiologia , Contagem de Células , Hipotermia/etiologia , Valores de Referência , Punção Espinal/efeitos adversos , Taquicardia/etiologia
17.
PLoS One ; 16(9): e0257816, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34555101

RESUMO

BACKGROUND: Inadvertent intraoperative hypothermia is frequent during open surgeries; however, few studies on hypothermia during laparoscopic abdominal surgery have been reported. We aimed to investigate the incidence and risk factors for hypothermia in patients undergoing laparoscopic abdominal surgery. METHODS: This single-center prospective cohort observational study involved patients undergoing laparoscopic surgery between October 2018 and June 2019. Data on core body temperature and potential variables were collected. A multivariate logistic regression analysis was performed to identify the risk factors associated with hypothermia. A Cox regression analysis was used to verify the sensitivity of the results. RESULTS: In total, 690 patients were included in the analysis, of whom 200 (29.0%, 95% CI: 26%-32%) had a core temperature < 36°C. The core temperature decreased over time, and the incident hypothermia increased gradually. In the multivariate logistic regression analysis, age (OR = 1.017, 95% CI: 1.000-1.034, P = 0.050), BMI (OR = 0.938, 95% CI: 0.880-1.000; P = 0.049), baseline body temperature (OR = 0.025, 95% CI: 0.010-0.060; P < 0.001), volume of irrigation fluids (OR = 1.001, 95% CI: 1.000-1.001, P = 0.001), volume of urine (OR = 1.001, 95% CI: 1.000-1.003, P = 0.070), and duration of surgery (OR = 1.010, 95% CI: 1.006-1.015, P < 0.001) were significantly associated with hypothermia. In the Cox analysis, variables in the final model were age, BMI, baseline body temperature, volume of irrigation fluids, blood loss, and duration of surgery. CONCLUSIONS: Inadvertent intraoperative hypothermia is evident in patients undergoing laparoscopic surgeries. Age, BMI, baseline body temperature, volume of irrigation fluids, and duration of surgery are significantly associated with intraoperative hypothermia.


Assuntos
Hipotermia/epidemiologia , Complicações Intraoperatórias/epidemiologia , Laparoscopia/efeitos adversos , Adulto , Índice de Massa Corporal , Feminino , Humanos , Hipotermia/etiologia , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
18.
Transplant Proc ; 53(8): 2509-2511, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34521542

RESUMO

BACKGROUND: The donor shortage poses a major limitation to use of heart transplantation. Novel strategies such as use of expanded-criteria donors with prolonged ischemia times are being employed to address this need. Recent developments in static hypothermia have allowed for the safe use of cardiac allografts with prolonged ischemic times. CASE REPORT: We present the case of a 68-year-old woman with valvular cardiomyopathy refractory to medical therapy who underwent orthotopic heart transplantation with a cardiac allograft exposed to elevated ischemic times. This was achieved through use of the federally approved SherpaPak Cardiac Transport System for transportation of the allograft. This method of static hypothermic organ preservation allowed for a 330-minute total ischemic time, including 283 minutes of storage within the preservation system. The patient tolerated the procedure well and was discharged on postoperative day 10, with excellent graft function and no evidence of rejection 3 months postoperatively. CONCLUSIONS: Though traditionally ischemic times of 240 minutes or less are recommended for cardiac allografts, we demonstrate, to our knowledge, the longest reported ischemic time of 330 minutes via use of a novel method of static hypothermia for organ preservation. The recipient had an excellent outcome postoperatively, demonstrating the potential for this new organ preservation system to expand the donor pool and improve access and use of heart transplantation.


Assuntos
Transplante de Coração , Hipotermia , Idoso , Feminino , Transplante de Coração/efeitos adversos , Humanos , Isquemia , Preservação de Órgãos , Doadores de Tecidos
19.
Pan Afr Med J ; 38: 364, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34367443

RESUMO

Introduction: approximately 1 million children die each year due to complications of preterm birth with the major contributor to mortality being hypothermia. Kangaroo mother care (KMC) is an effective and low-cost technique which prevents neonate from hypothermia. The mother uses her body temperature to keep the infant warm thereby preventing demise from cold injury. Not much is known about the perception and practice of this simple and easy method of caring for preterm infants among post-natal mothers in Nigeria. This study aimed to determine the knowledge, attitude and practice of kangaroo mother care among mothers in the neonatal wards of a tertiary care center in Nigeria. Methods: this study was a hospital-based descriptive cross-sectional survey of sixty mothers selected from the Neonatal ward of the Lagos University Teaching Hospital (LUTH), Idi-Araba using convenient sampling technique. Data was collected with the use of a questionnaire and analyzed using descriptive statistics. Frequency and percentages were presented in tables and chi-square was used to test associations between categorical variables; p-value <0.05 was considered significant. Results: the findings revealed that 80% of respondents had heard of kangaroo mother care with 66.6% having good knowledge. Two-thirds (65%) of the respondents had a good attitude towards the use of KMC with 71.7% feeling happy when their baby is in kangaroo position. The knowledge of mothers significantly influenced their attitude and practice of KMC, p <0.05. Conclusion: the knowledge of KMC among mothers whose babies were admitted into the newborn wards of LUTH was high and they believe that KMC is helpful to their babies and were happy practicing it.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hipotermia/prevenção & controle , Recém-Nascido Prematuro , Método Canguru/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Recém-Nascido , Mães/psicologia , Nigéria , Estudos Prospectivos , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
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