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1.
Sci Rep ; 12(1): 18282, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36316356

RESUMO

Decreased heart rate variability (HRV) may be a biomarker of brain injury severity in neonatal hypoxic-ischemic encephalopathy for which therapeutic hypothermia is standard treatment. While therapeutic hypothermia may influence the degree of brain injury; hypothermia may also affect HRV per se and obscure a potential association between HRV and hypoxic-ischemic encephalopathy. Previous results are conflicting. This study aimed to investigate the effect of hypothermia on HRV in healthy, anaesthetised, newborn piglets. Six healthy newborn piglets were anaesthetised. Three piglets were first kept normothermic (38.5-39.0 °C) for 3 h, then exposed to hypothermia (33.5-34.5 °C) for 3 h. Three piglets were first exposed to hypothermia for 3 h, then rewarmed to normothermia for 3 h. Temperature and ECG were recorded continuously. HRV was calculated from the ECG in 5 min epochs and included time domain and frequency domain variables. The HRV variables were compared between hypothermia and normothermia. All assessed HRV variables were higher during hypothermia compared to normothermia. Heart rate was lower during hypothermia compared to normothermia and all HRV variables correlated with heart rate. Hypothermia was associated with an increase in HRV; this could be mediated by bradycardia during hypothermia.


Assuntos
Lesões Encefálicas , Hipotermia Induzida , Hipotermia , Hipóxia-Isquemia Encefálica , Animais , Suínos , Hipóxia-Isquemia Encefálica/terapia , Frequência Cardíaca , Animais Recém-Nascidos , Hipotermia Induzida/métodos , Lesões Encefálicas/terapia
2.
J Trauma Nurs ; 29(6): 319-324, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36350171

RESUMO

BACKGROUND: Handling livestock can be dangerous, and livestock-related injuries are increasing. CASE PRESENTATION: An 83-year-old man who was gored and thrown by a bison bull during feeding is presented. The traumatic event resulted in two major injuries: an abdominal laceration with intestinal evisceration and cervical fractures after being lifted and forcefully thrown. The patient's hospital course included emergent surgery using the damage control approach resulting in an open abdomen, postoperatively, intensive care unit placement, and physiological management of the lethal diamond (acidosis, coagulopathy, hypothermia, and hypocalcemia). Finally, the patient's injuries required repeated abdominoplasties, colostomy, and surgical cervical stabilization. Despite a complicated hospitalization, the patient returned to his previous lifestyle within 2 months. CONCLUSION: The geriatric population, despite multiple comorbidities, is active, and their dynamic lifestyle can result in severe injuries. Positive outcomes for this population are possible. Even if severely injured, the geriatric population has the propensity to rebound and survive with early aggressive management.


Assuntos
Bison , Hipotermia , Lesões do Pescoço , Fraturas da Coluna Vertebral , Idoso , Animais , Humanos , Unidades de Terapia Intensiva
3.
Medicine (Baltimore) ; 101(44): e31657, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36343089

RESUMO

Hypothermia has been shown to be associated with a high mortality rate among patients with sepsis. However, the relationship between hypothermia and body mass index (BMI) with respect to mortality remains to be elucidated. We conducted this study to assess the association between hypothermia and survival outcomes of patients with sepsis according to BMI categories. This secondary analysis of a prospective cohort study enrolled 1184 patients (aged ≥ 16 years) with sepsis hospitalized in 59 intensive care units in Japan. Patients were divided into 3 BMI categories (<18.5 [low], 18.5-24.9 [normal], >24.9 [high] kg/m2) and 2 body temperature (36 °C and ≥ 36 °C) groups. The primary outcome was in-hospital mortality rate. Associations between hypothermia and BMI categories with respect to in-hospital mortality were evaluated using multivariate logistic regression analysis. Of the 1089 patients, 223, 612, and 254 had low, normal, and high BMI values, respectively. Patients with body temperature < 36 °C (hypothermia) had a higher in-hospital mortality rate than that had by those without hypothermia in the normal BMI group (25/63, 39.7% vs. 107/549, 19.5%); however, this was not true for patients in the low or high BMI groups. A significant interaction was observed between hypothermia and normal BMI for in-hospital mortality (odds ratio, 1.56; 95% confidence interval, 1.00-3.41; P value for interaction = .04); however, such an interaction was not found between hypothermia and low or high BMIs. Patients with sepsis and hypothermia in the normal BMI subgroup may have a higher mortality risk than that of those in the low or high BMI subgroups and, therefore, require more attention.


Assuntos
Hipotermia , Sepse , Humanos , Mortalidade Hospitalar , Índice de Massa Corporal , Temperatura Corporal , Estudos Prospectivos , Estudos Retrospectivos
4.
Ceska Slov Farm ; 71(5): 214-223, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36443026

RESUMO

NSAIDs are promising agents for preventing cold injury (frigoprotectors). The influence of prophylactic administration of the non-selective COX inhibitor diclofenac sodium (7 mg/kg) and the highly selective COX-2 inhibitor etoricoxib (5 mg/kg) on cyclooxygenase pathway biomarkers was studied on the model of acute general cooling (air hypothermia at -18 °С for 2 hours). Diclofenac completely prevented a decrease in body temperature, surpassing etoricoxib. In the liver of the rats immediately after cold exposure, the content of COX-1 was increased moderately and the content of COX-2 highly significantly. Very significantly, the level of PGE2 decreased, and the levels of PGF2α, especially PGI2 and TXB2, were elevated. In the blood serum, the level of COX-1 was decreased, and the changes in COX-2 and prostaglandins levels were similar to those in the liver. Diclofenac exerted a moderate effect towards the normalization of both COX isoforms in the liver, moderately increased the content of PGE2, and decreased - PGF2α and TXB2 without changing the level of PGI2. In serum, diclofenac reduced COX-1 level to subnormal values, and its effect on other biomarkers was similar to that in the liver, except for a moderate decrease in PGI2. Thus, diclofenac was inferior to etoricoxib, which normalized COX-1, COX-2, PGE2, and PGI2 in the liver and reduced the content of PGF2α and TXB2 in the liver to subnormal values. At the same time, in the blood serum, it decreased COX-1, COX-2, and PGE2 to subnormal values, normalized PGF2α, and PGI2, and significantly reduced TXB2. The opposite degree of intensity of the influence of diclofenac and etoricoxib on the cyclooxygenase pathway and body temperature indicates a dissociation of anti-inflammatory and frigoprotective activity. Inhibition of oxidative stress is not determinative for the frigoprotective activity of NSAIDs since diclofenac, despite the weaker influence on the content of 8-isoprostane in the liver, still exerts the maximum frigoprotective activity.


Assuntos
Hipotermia , Ratos , Animais , Temperatura Corporal , Ácido Araquidônico , Diclofenaco/farmacologia , Etoricoxib , Ciclo-Oxigenase 2 , Dinoprosta , Dinoprostona , Anti-Inflamatórios não Esteroides/farmacologia
5.
Int J Mol Sci ; 23(21)2022 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-36361819

RESUMO

Renal ischemia in the peri-transplant period causes a number of changes that adversely affect the initiation of normal vital functions in grafts after transplantation. To minimise the extent of ischemic damage, organs are stored in preservation fluid. The components of the fluid are supposed to ensure stabilisation of the cell cytoskeleton, protect against oxygen free radicals, reduce cell swelling, and ensure endothelial cell integrity. The aim of this study was to analyse the protective effect of Cu2+, as a component of Biolasol preservative fluid, in the prevention of nephron damage occurring during the graft storage period. Analyses of the effectiveness of copper in the presence of prolactin added to Biolasol fluid were also carried out. Forty isolated pig slaughter kidneys were used in the study, avoiding the use of laboratory animals. The kidneys were stored using simple hypothermia. After 2 h and 48 h of graft storage, selected biochemical indicators of renal function were determined in the collected perfusates. The addition of Cu2+ at a dose of 1 µg/L to the composition of Biolasol fluid was found to affect the generation of ischemic damage in the isolated pig kidney. The intensity of the occurrence of these processes is exacerbated by the presence of prolactin at a dose of 0.1 µg/L.


Assuntos
Hipotermia , Preservação de Órgãos , Suínos , Animais , Cobre/farmacologia , Prolactina/farmacologia , Rim/fisiologia , Isquemia , Perfusão
6.
BMC Pregnancy Childbirth ; 22(1): 860, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36411419

RESUMO

BACKGROUND: Postnatal care (PNC) is an important tool for reducing maternal and neonatal morbidity and mortality. However, what predicts receipt and maintenance in PNC, particularly events during pregnancy and the peripartum period, is not well understood. We hypothesized that fever or hypothermia during delivery would engender greater health consciousness among those attending antenatal care, leading to greater PNC engagement after hospital discharge and our objective was to evaluate this relationship. METHODS: Women were prospectively enrolled immediately postpartum at Mbarara Regional Referral Hospital (MRRH). We collected postpartum vital signs and surveyed women by telephone about PNC receipt, fever, and infection at two and six weeks postpartum. Our outcome of interest was receipt of PNC post-discharge, defined as whether a participant visited a health facility and/or was hospitalized in the postpartum period. Our explanatory variables were whether a participant was ever febrile (> 38.0˚C) or hypothermic (< 36.0˚C) during delivery stay and whether a participant attended at least 4 antenatal care (ANC) visits. We used logistic regressions to estimate the association between ANC and fever/hypothermia with PNC, including an interaction term between ANC and fever/hypothermia to determine whether there was a modifying relationship between variables on PNC. Regression models were adjusted for age, marital status, parity, HIV serostatus, Mbarara residency, and whether the participant was referred to MRRH, RESULTS: Of the 1,541 women, 86 (5.6%) reported visiting a health facility and/or hospitalization and 186 (12.0%) had an abnormal temperature recorded during delivery stay. Of those who reported at least one visit, 59/86 (68.6%) delivered by cesarean, 37/86 (43.0%) reported post-discharge fever, and 44/86 (51.2%) reported post-discharge infection. Neither ANC attendance, abnormal temperature after delivery, nor their interaction term, were significantly associated with post-discharge PNC. The included covariates were not significantly associated with the outcome. CONCLUSIONS: While the overall proportion of women reporting post-discharge PNC was low, those who reported visiting a health facility and/or hospitalization had high proportions of post-discharge fever, post-discharge infection, and cesarean delivery, which suggests that these visits may have been related to problem-focused care. No significant associations between ANC and PNC were observed in this cohort. Further research assessing ANC quality and PNC visit focus is needed to ensure ANC and PNC are optimized to reduce morbidity and mortality.


Assuntos
Hipotermia , Cuidado Pré-Natal , Recém-Nascido , Feminino , Humanos , Gravidez , Cuidado Pós-Natal , Estudos Prospectivos , Uganda , Assistência ao Convalescente , Temperatura , Alta do Paciente , Paridade , Febre
7.
Sci Adv ; 8(47): eabq4882, 2022 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-36427309

RESUMO

Patients with glioblastoma (GBM) have limited options and require novel approaches to treatment. Here, we studied and deployed nonfreezing "cytostatic" hypothermia to stunt GBM growth. This growth-halting method contrasts with ablative, cryogenic hypothermia that kills both neoplastic and infiltrated healthy tissue. We investigated degrees of hypothermia in vitro and identified a cytostatic window of 20° to 25°C. For some lines, 18 hours/day of cytostatic hypothermia was sufficient to halt division in vitro. Next, we fabricated an experimental tool to test local cytostatic hypothermia in two rodent GBM models. Hypothermia more than doubled median survival, and all rats that successfully received cytostatic hypothermia survived their study period. Unlike targeted therapeutics that are successful in preclinical models but fail in clinical trials, cytostatic hypothermia leverages fundamental physics that influences biology broadly. It is a previously unexplored approach that could provide an additional option to patients with GBM by halting tumor growth.


Assuntos
Citostáticos , Glioblastoma , Hipotermia Induzida , Hipotermia , Ratos , Animais , Ratos Sprague-Dawley , Hipotermia Induzida/métodos
8.
Crit Care ; 26(1): 361, 2022 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-36434649

RESUMO

Most of the patients who die after cardiac arrest do so because of hypoxic-ischemic brain injury (HIBI). Experimental evidence shows that temperature control targeted at hypothermia mitigates HIBI. In 2002, one randomized trial and one quasi-randomized trial showed that temperature control targeted at 32-34 °C improved neurological outcome and mortality in patients who are comatose after cardiac arrest. However, following the publication of these trials, other studies have questioned the neuroprotective effects of hypothermia. In 2021, the largest study conducted so far on temperature control (the TTM-2 trial) including 1900 adults comatose after resuscitation showed no effect of temperature control targeted at 33 °C compared with normothermia or fever control. A systematic review of 32 trials published between 2001 and 2021 concluded that temperature control with a target of 32-34 °C compared with fever prevention did not result in an improvement in survival (RR 1.08; 95% CI 0.89-1.30) or favorable functional outcome (RR 1.21; 95% CI 0.91-1.61) at 90-180 days after resuscitation. There was substantial heterogeneity across the trials, and the certainty of the evidence was low. Based on these results, the International Liaison Committee on Resuscitation currently recommends monitoring core temperature and actively preventing fever (37.7 °C) for at least 72 h in patients who are comatose after resuscitation from cardiac arrest. Future studies are needed to identify potential patient subgroups who may benefit from temperature control aimed at hypothermia. There are no trials comparing normothermia or fever control with no temperature control after cardiac arrest.


Assuntos
Reanimação Cardiopulmonar , Parada Cardíaca , Hipotermia Induzida , Hipotermia , Adulto , Humanos , Hipotermia Induzida/métodos , Coma/etiologia , Coma/terapia , Parada Cardíaca/complicações , Parada Cardíaca/terapia , Reanimação Cardiopulmonar/métodos , Febre
10.
Nat Commun ; 13(1): 6890, 2022 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371436

RESUMO

Therapeutic hypothermia at 32-34 °C during or after cerebral ischaemia is neuroprotective. However, peripheral cold sensor-triggered hypothermia is ineffective and evokes vigorous counteractive shivering thermogenesis and complications that are difficult to tolerate in awake patients. Here, we show in mice that deep brain stimulation (DBS) of warm-sensitive neurones (WSNs) in the medial preoptic nucleus (MPN) produces tolerable hypothermia. In contrast to surface cooling-evoked hypothermia, DBS mice exhibit a torpor-like state without counteractive shivering. Like hypothermia evoked by chemogenetic activation of WSNs, DBS in free-moving mice elicits a rapid lowering of the core body temperature to 32-34 °C, which confers significant brain protection and motor function reservation. Mechanistically, activation of WSNs contributes to DBS-evoked hypothermia. Inhibition of WSNs prevents DBS-evoked hypothermia. Maintaining the core body temperature at normothermia during DBS abolishes DBS-mediated brain protection. Thus, the MPN is a DBS target to evoke tolerable therapeutic hypothermia for stroke treatment.


Assuntos
Hipotermia , Animais , Camundongos , Área Pré-Óptica/fisiologia , Tremor por Sensação de Frio/fisiologia , Encéfalo , Modelos Animais de Doenças , Isquemia
11.
Medicina (Kaunas) ; 58(11)2022 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-36363464

RESUMO

Background and Objectives: The post-mortem diagnosis of hypothermia is challenging in forensics. The aim of our study was to detect the kidney and heart histopathological changes that occurred in a group of hypothermia-related fatalities. Materials and Methods: The cohort included 107 cases identified in the database of our department between 2007 and 2021, which have been associated with extreme cold stress. Demographic and clinicopathological data were collected from the medico-legal reports. Archived tissue samples were evaluated to identify the histopathological features, in routine haematoxylin-eosin (H&E), Periodic acid-Schiff (PAS), and Masson's trichrome stainings, while cardiac sirtuin1 (SIRT1) and renal ubiquitin (Ub) immunostaining have been performed. Results: The majority of cases exposed to low temperatures were males (76%) from rural regions (68.2%) during the cold season. Paradoxical undressing was documented in 9.3% of cases. The common comorbidities included alcoholism (50.5%), neuropsychiatric diseases (10.3%), diabetes mellitus (3.7%), and lung tuberculosis (4.7%). The microscopic heart exam revealed areas of myocardial degeneration (100%), contraction bands (95.3%), fatty change (13.1%) and focal wavy contractile myocardial cells. Basal vacuolisation of renal tubular epithelial cells (Armanni-Ebstein lesions) (21.5%), focal tubular necrosis (7.5%), tubular renal cysts (7.5%), interstitial haemorrhages (5.6%), diabetic kidney disease (3.7%), background benign nephroangiosclerosis (42.1%), variable thickening of tubules and corpuscles basement membranes, capsular space amorphous material, and intratubular casts were identified in kidney tissue samples. Myocardial cells displayed SIRT1 weak expression, with a loss of immunopositivity correlated with areas with contraction bands, while a variable Ub expression was observed in renal corpuscles capsules, proximal, distal, and collecting renal tubules, Henle's loops, urothelium, and intratubular casts. Conclusions: In the context of the current concept that death associated with hypothermia is still a diagnosis of exclusion, our findings suggest that the microscopic exam provides relevant data that support the diagnosis of hypothermia-related fatalities in appropriate circumstances of death. A deeper insight into the histopathologic findings in hypothermic patients may lead to new therapeutic approaches in these cases.


Assuntos
Hipotermia , Masculino , Humanos , Feminino , Sirtuína 1 , Rim/patologia , Túbulos Renais/patologia , Túbulos Renais/ultraestrutura , Miocárdio/patologia
13.
Crit Care ; 26(1): 356, 2022 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-36380332

RESUMO

BACKGROUND: Targeted temperature management (TTM) is recommended following cardiac arrest; however, time to target temperature varies in clinical practice. We hypothesised the effects of a target temperature of 33 °C when compared to normothermia would differ based on average time to hypothermia and those patients achieving hypothermia fastest would have more favorable outcomes. METHODS: In this post-hoc analysis of the TTM-2 trial, patients after out of hospital cardiac arrest were randomized to targeted hypothermia (33 °C), followed by controlled re-warming, or normothermia with early treatment of fever (body temperature, ≥ 37.8 °C). The average temperature at 4 h (240 min) after return of spontaneous circulation (ROSC) was calculated for participating sites. Primary outcome was death from any cause at 6 months. Secondary outcome was poor functional outcome at 6 months (score of 4-6 on modified Rankin scale). RESULTS: A total of 1592 participants were evaluated for the primary outcome. We found no evidence of heterogeneity of intervention effect based on the average time to target temperature on mortality (p = 0.17). Of patients allocated to hypothermia at the fastest sites, 71 of 145 (49%) had died compared to 68 of 148 (46%) of the normothermia group (relative risk with hypothermia, 1.07; 95% confidence interval 0.84-1.36). Poor functional outcome was reported in 74/144 (51%) patients in the hypothermia group, and 75/147 (51%) patients in the normothermia group (relative risk with hypothermia 1.01 (95% CI 0.80-1.26). CONCLUSIONS: Using a hospital's average time to hypothermia did not significantly alter the effect of TTM of 33 °C compared to normothermia and early treatment of fever.


Assuntos
Reanimação Cardiopulmonar , Hipotermia Induzida , Hipotermia , Parada Cardíaca Extra-Hospitalar , Humanos , Parada Cardíaca Extra-Hospitalar/terapia , Temperatura Baixa , Febre/terapia , Resultado do Tratamento
14.
Int J Clin Pract ; 2022: 6806225, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36187909

RESUMO

Objectives: There have been no fully validated tools for the rapid identification of surgical patients at risk of intraoperative hypothermia. The objective of this study was to validate the performance of a previously established prediction model in estimating the risk of intraoperative hypothermia in a prospective cohort. Methods: In this observational study, consecutive adults scheduled for elective surgery under general anesthesia were enrolled prospectively at a tertiary hospital between September 4, 2020, and December 28, 2020. An intraoperative hypothermia risk score was calculated by a mobile application of the prediction model. A wireless axillary thermometer was used to continuously measure perioperative core temperature as the reference standard. The discrimination and calibration of the model were assessed, using the area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow goodness-of-fit test, and Brier score. Results: Among 227 participants, 99 (43.6%) developed intraoperative hypothermia, and 10 (4.6%) received intraoperative active warming with forced-air warming. The model had an AUC of 0.700 (95% confidence interval [CI], 0.632-0.768) in the overall cohort with adequate calibration (Hosmer-Lemeshow χ 2 = 13.8, P=0.087; Brier score = 0.33 [95% CI, 0.29-0.37]). We categorized the risk scores into low-risk, moderate-risk, and high-risk groups, in which the incidence of intraoperative hypothermia was 23.0% (95% CI, 12.4-33.5), 43.4% (95% CI, 33.7-53.2), and 62.7% (95% CI, 51.5-74.3), respectively (P for trend <0.001). Conclusions: The intraoperative hypothermia prediction model demonstrated possibly helpful discrimination and adequate calibration in our prospective validation. These findings suggest that the risk screening model could facilitate future perioperative temperature management.


Assuntos
Hipotermia , Adulto , Anestesia Geral/efeitos adversos , Humanos , Hipotermia/diagnóstico , Hipotermia/epidemiologia , Hipotermia/etiologia , Incidência , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/etiologia , Fatores de Risco
15.
Crit Care ; 26(1): 323, 2022 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-36271410

RESUMO

BACKGROUND: Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO2) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO2 with patients' outcome. METHODS: Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO2 < 60 mmHg and severe hyperoxemia as PaO2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. RESULTS: 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93-1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95-1.06). The time exposure, i.e., the area under the curve (PaO2-AUC), for hyperoxemia was significantly associated with mortality (p = 0.003). CONCLUSIONS: In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. TRIAL REGISTRATION: clinicaltrials.gov NCT02908308 , Registered September 20, 2016.


Assuntos
Hipotermia , Parada Cardíaca Extra-Hospitalar , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hipotermia/complicações , Hipóxia/complicações , Parada Cardíaca Extra-Hospitalar/complicações , Oxigênio , Pressão Parcial
17.
Leg Med (Tokyo) ; 59: 102150, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36198254

RESUMO

Forensic diagnosis of fatal hypothermia is considered difficult because no specific findings, such as molecular markers, have been identified. Therefore, determining the molecular mechanism in hypothermia and identifying novel molecular markers to assist in diagnosing fatal hypothermia are important. This study aimed to investigate microRNA (miRNA) and mRNA expression in iliopsoas muscle, which plays a role in homeostasis in mammals, to resolve the molecular mechanism in hypothermia. We generated rat models of mild, moderate, and severe hypothermia, then performed body temperature-dependent miRNA and mRNA expression analysis of the iliopsoas muscle using microarray and next-generation sequencing. Analysis showed that rno-miR-203a-3p expression was lower with decreasing body temperature, while Socs3 expression was significantly increased only by severe hypothermia. Luciferase reporter assays suggested that Socs3 expression is regulated by rno-miR-203a-3p. Socs3 and Mex3B small interfering RNA-mediated knockdown showed that suppressing Mex3B could induce the activation of Socs3, followed by a change in caspase 3/7 activity and adenosine triphosphate levels in iliopsoas muscle cells. These findings indicate that rno-miR-203a-3p and Mex3B are deactivated by a decrease in body temperature, whereby it contributes to suppressing apoptosis by accelerating Socs3. Accordingly, the rno-miR-203a-3p-Socs3-Casp3 or Mex3B-Socs3-Casp3 axis may be the part of the biological defense response to maintain homeostasis under extreme hypothermia.


Assuntos
Hipotermia , MicroRNAs , Músculo Esquelético , Proteínas de Ligação a RNA , Animais , Ratos , Trifosfato de Adenosina/metabolismo , Caspase 3/genética , Caspase 3/metabolismo , Sobrevivência Celular/genética , Hipotermia/genética , Hipotermia/metabolismo , Luciferases/metabolismo , Mamíferos/genética , Mamíferos/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Músculo Esquelético/metabolismo , RNA Mensageiro/metabolismo , RNA Interferente Pequeno/metabolismo , Proteína 3 Supressora da Sinalização de Citocinas/genética , Proteína 3 Supressora da Sinalização de Citocinas/metabolismo , Proteínas de Ligação a RNA/genética , Proteínas de Ligação a RNA/metabolismo
18.
Anaesthesiol Intensive Ther ; 54(3): 226-233, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36189905

RESUMO

INTRODUCTION: Patients with major burn injury are prone to hypothermia, potentially resulting in an increase in mortality and length of hospital stay. Our study comprehensively evaluates the practicalities of physiological thermoregulation and temperature control in the largest cohort of critically ill adult burn patients to date. MATERIAL AND METHODS: This retrospective study of routinely collected patient data from the Intensive Care Unit (ICU) of the West Midlands Burn Centre was conducted over a three-year period (2016-2019). Data were analysed to assess temperature control against local and International Society for Burn Injury (ISBI) standards. RESULTS: Thirty-one patients with significant burn injuries, requiring active critical care treatment for more than 48 hours were included (total body surface area [TBSA] mean = 42.7%, SD = 18.1%; revised Baux score [rBaux] = 99, SD = 25). The majority were male (77.29%) with an average age of 44 years (17-77 years). The patients were cared for in the ICU for a total of 15 119 hours. Hypothermia, defined as core temperature below 36.0°C, was recorded for 251 hours (2% of total stay). Only 27 patients (87%) had their temperature ≥ 36°C for more than 95% of their admission. Non-survivors were more prone to hypothermia during their stay in ICU. There was an association between rBaux score and post-opera-tive temperature, with a 0.12°C decrease per 10 points increase in rBaux score (P = 0.04). CONCLUSIONS: We have observed a high variability of temperature control between individual patients, especially in non-survivors, and have demonstrated an association between high rBaux score and poor temperature control, specifically during the postoperative period.


Assuntos
Queimaduras , Hipotermia , Adulto , Queimaduras/terapia , Estudos de Coortes , Cuidados Críticos , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Estudos Retrospectivos , Temperatura , Reino Unido
19.
J Cardiothorac Vasc Anesth ; 36(12): 4320-4326, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36216686

RESUMO

OBJECTIVE: Perioperative hypothermia (core temperature <36°C) occurs in 50%-to-80% of patients recovering from thoracic aortic surgery, though its effects have not been described fully in this context. The authors, therefore, sought to characterize the incidence of perioperative hypothermia and its association with time from procedure end to extubation in endovascular aortic surgical patients. DESIGN: A retrospective cohort study. SETTING: At a single academic tertiary center. PARTICIPANTS: Patients recovering from thoracic aortic surgery with lumbar drains. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 196 patients were included in this study, 55 of whom were hypothermic with temperatures <35.0°C at the end of surgery. Though the unadjusted time to extubation was not statistically different in the hypothermic group (median 8 minutes, IQR 5-13.5 minutes) compared to the normothermic group (median 7 minutes, IQR 4-12 minutes; p = 0.062), multivariate predictors of increased time from procedure end to extubation included hypothermia (p = 0.011), age (p = 0.009), diabetes (p = 0.015), history of carotid disease (p = 0.040), and crystalloid volume (p = 0.019). CONCLUSIONS: Hypothermia in patients recovering from endovascular aortic surgery was associated with prolonged time from procedure end to extubation. Because of the retrospective observational nature of the authors' analysis, it was not possible to determine the extent to which prolonged mechanical ventilation was influenced by low temperature.


Assuntos
Hipotermia Induzida , Hipotermia , Procedimentos Cirúrgicos Torácicos , Humanos , Hipotermia/etiologia , Estudos Retrospectivos , Hipotermia Induzida/métodos , Aorta , Procedimentos Cirúrgicos Torácicos/efeitos adversos
20.
Neurosci Lett ; 791: 136911, 2022 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-36243204

RESUMO

Traumatic brain injury (TBI) has high morbidity, mortality and disability. Cell death runs through its occurrence and development. Necroptosis is a recently discovered mode of cell death. Its mechanism still has not been fully resolved. Studies which researcher published before showed that: pramipexole could play a neuroprotective role by inducing hypothermia; receptor interacting protein 1 (RIP1) could play a neuroprotective role by regulating necroptosis. On this basis, we carried out the experiments and it was observed that we could establish a hypothermia model of SD rats safely and effectively via pramipexole. Meanwhile, necroptosis and expression of RIP1 and its related proteins did change. As a result, the prognosis of TBI rats did improve. In brief, we found that pramipexole could play a protective role after TBI by inhibiting necroptosis. We hope our investigation would provide new theoretical basis to improve the outcome of clinical TBI patients.


Assuntos
Lesões Encefálicas Traumáticas , Hipotermia , Animais , Ratos , Necroptose , Pramipexol , Apoptose/fisiologia , Ratos Sprague-Dawley , Proteína Serina-Treonina Quinases de Interação com Receptores/metabolismo , Lesões Encefálicas Traumáticas/tratamento farmacológico
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