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[Acid-base equilibrium and nitrogen metabolism in rats in a state of artificial hibernation]

https://arctichealth.org/en/permalink/ahliterature57286
Source
Ukr Biokhim Zh. 1995 Jul-Aug;67(4):67-75
Publication Type
Article
Author
S D Mel'nychuk
S P Rohovs'kyi
D O Mel'nychuk
Source
Ukr Biokhim Zh. 1995 Jul-Aug;67(4):67-75
Language
Ukrainian
Publication Type
Article
Keywords
Acid-Base Equilibrium - physiology
Animals
Anoxia - metabolism
Arginase - metabolism
Bicarbonates - blood
Carbon Dioxide - blood
English Abstract
Glutamate Dehydrogenase - metabolism
Glutaminase - metabolism
Hypothermia, Induced
Male
Nitrogen - metabolism
Rats
Rats, Wistar
Abstract
Experiments on rats have shown an important role of hypercapnia in the development of condition of artificial hibernation in combination with influence of hypothermia, hypoxia and hypercapnia. It is proved that the joint action of hypothermia, hypoxia and hypercapnia has induced development of respiratory acidosis and hibernation in animals, while removal of the hypercapnia effect has induced development of acute metabolic acidosis and death of animals. It has been found that animals in the state of artificial hibernation have considerable changes in concentrations of main electrolytes (Na+, K+, Ca+, Mg2+, phosphates, Cl-) and metabolites (NH3, glutamine, urea) in blood as well as in activity of enzymes (glutamaldehydrogenase, glutaminase, arginase) in tissues of the liver and kidneys.
PubMed ID
8553476 View in PubMed
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Amplitude-integrated EEG (aEEG) predicts outcome after cardiac arrest and induced hypothermia.

https://arctichealth.org/en/permalink/ahliterature169206
Source
Intensive Care Med. 2006 Jun;32(6):836-42
Publication Type
Article
Date
Jun-2006
Author
Malin Rundgren
Ingmar Rosén
Hans Friberg
Author Affiliation
Lund University Hospital, Department of Anesthesia and Intensive Care, 221 85 Lund, Sweden. malin.rundgren@skane.se
Source
Intensive Care Med. 2006 Jun;32(6):836-42
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Coma
Electroencephalography - methods
Female
Heart Arrest
Humans
Hypothermia, Induced
Intensive Care Units
Male
Middle Aged
Outcome Assessment (Health Care) - methods
Sweden
Abstract
To evaluate the use of continuous amplitude-integrated EEG (aEEG) as a prognostic tool for survival and neurological outcome in cardiac arrest patients treated with hypothermia.
Prospective, observational study.
Multidisciplinary intensive care unit in a university hospital.
Comatose survivors of cardiac arrest were treated with induced hypothermia for 24 h. An aEEG recording was initiated upon arrival at the ICU and continued until the patient regained consciousness or, if the patient remained in coma, no longer than 120 h. The aEEG recording was not available to the ICU physician, and the aEEG tracings were interpreted by a neurophysiologist with no knowledge of the patient's clinical status. Only clinically visible seizures were treated.
Thirty-four consecutive hypothermia-treated cardiac arrest survivors were included. At normothermia (mean 37 h after cardiac arrest), the aEEG pattern was discriminative for outcome. All 20 patients with a continuous aEEG at this time regained consciousness, whereas 14 patients with pathological aEEG patterns (flat, suppression-burst or status epilepticus) did not regain consciousness and died in hospital. Patients were evaluated neurologically upon discharge from the ICU and after 6 months, using the Cerebral Performance Category (CPC) scale. Eighteen patients were alive with a good cerebral outcome (CPC 1--2) at 6-month follow-up.
A continuous aEEG pattern at the time of normothermia was discriminative for regaining consciousness. aEEG is an easily applied method in the ICU setting.
PubMed ID
16715325 View in PubMed
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[Anchor Fast endotracheal tube securing device for a pediatric patient during therapeutic hypothermia].

https://arctichealth.org/en/permalink/ahliterature104928
Source
Masui. 2014 Jan;63(1):84-7
Publication Type
Article
Date
Jan-2014
Author
Takeshi Yano
Takeshi Miyazato
Masumi Nagahama
Tomohiro Koshida
Takehiko Nagano
Tetsu Yonaha
Mitsuo Oshikawa
Masahiko Taniguchi
Tetsuro Shirasaka
Isao Tsuneyoshi
Author Affiliation
Department of Anesthesiology and Critical Care, School of Medicine, University of Miyazaki, Miyazaki 889-1692.
Source
Masui. 2014 Jan;63(1):84-7
Date
Jan-2014
Language
Japanese
Publication Type
Article
Keywords
Child, Preschool
Female
Heart Arrest - etiology - therapy
Humans
Hypothermia, Induced - methods
Intubation, Intratracheal - instrumentation - methods
Near Drowning - complications
Nervous System Diseases - etiology - prevention & control
Resuscitation
Treatment Outcome
Abstract
A 5-year-old girl was admitted to our hospital after resuscitation from cardiac arrest due to near-drowning accident in a river. On admission, Glasgow Coma Scale score was 7; arterial blood pressure was 113/73 mm Hg; heart rate was 157 beats x min(-1), and percutaneous oxygen saturation was 99% on 10 l x min(-1) of oxygen. The patient was intubated with a 5.0 mm internal diameter endotracheal tube, and therapeutic hypothermia was started for neural protection. Hypothermia in the target temperature of 34 degrees C was maintained for 24 hours using Arctic Sun System. Although the patient had been sedated with fentanyl 0.6-1.2 microg x kg(-1) x hr(-1), midazolam 0.2-0.4 mg x kg(-1) x hr(-1) and dexmedetomidine 0.6-1.0 mirog x kg(-1) x hr(-1), agitation increased during the rewarming period following hypothermia. To avoid accidental extubation, we used Anchor Fast as a device for securing oral endotracheal tube. Anchor Fast kept the tube position properly even though the patient was turned or moved. Seventy-two hours later, she was rewarmed and extubated as scheduled. Ten days after admission, she was discharged without any neurological deficits.
PubMed ID
24558938 View in PubMed
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Apotransferrin, C1-esterase inhibitor, and alpha 1-acid glycoprotein for cerebral protection during experimental hypothermic circulatory arrest.

https://arctichealth.org/en/permalink/ahliterature57236
Source
Scand Cardiovasc J. 2004 Jun;38(3):178-86
Publication Type
Article
Date
Jun-2004
Author
Janne Heikkinen
Juha Koskenkari
Timo Kaakinen
Sebastian Dahlbacka
Kai Kiviluoma
Timo Salomäki
Päivi Laurila
Jorma Hirvonen
Fausto Biancari
Jaakko Parkkinen
Tatu Juvonen
Author Affiliation
Department of Surgery, University of Oulu and Oulu University Hospital, Oulu, Finland.
Source
Scand Cardiovasc J. 2004 Jun;38(3):178-86
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Animal Experimentation
Animals
Apoproteins - administration & dosage - pharmacology
Brain Infarction - etiology - prevention & control
Cerebrovascular Circulation - drug effects
Complement C1 Inactivator Proteins - administration & dosage - pharmacology
Female
Hemodynamic Processes - drug effects
Hypothermia, Induced
Neuroprotective Agents - administration & dosage - pharmacology
Orosomucoid - administration & dosage - pharmacology
Reperfusion Injury - complications - prevention & control
Research Support, Non-U.S. Gov't
Swine
Transferrin - administration & dosage - pharmacology
Abstract
BACKGROUND: Because of current limitations in improving metabolic support to the brain during hypothermic circulatory arrest (HCA), attenuation of ischemia-reperfusion injury remains an area of therapeutic intervention of relevance. Apotransferrin (Apo-Tf), alpha 1-acid glycoprotein (AGP), and C1-esterase inhibitor (C1-INH) have been herein evaluated as potential beneficial agents in reducing the ischemia-reperfusion injury in a surviving model of HCA. METHODS: Apo-Tf 100 mg/kg (n = 6), C1-INH 50 IU/kg (n = 6), AGP 100 mg/kg (n = 6), or NaCl 0.9% 2 ml/kg (n = 6) were randomly administered to 24 juvenile pigs after a 75-min period HCA at a brain temperature of 18 degrees C. RESULTS: Animals in the Apo-Tf group had a slightly better 7-day survival (66.7%) compared with the other study groups (50%), but such a difference was not statistically significant. Some favorable changes in the brain glucose metabolism parameters were observed in the AGP, C1-INH, and Apo-Tf groups, but these did not reach statistical significance. Semiquantitative analysis of the histopathological findings did not show any significant difference between the study groups. However, only two out of four surviving animals in the Apo-Tf group developed brain infarction, whereas all three survivors of the remaining study groups developed brain infarction. CONCLUSIONS: Although the small size of the study groups may affect the present findings, none of the metabolic and hemodynamic parameters as well as outcome endpoints indicate a substantial therapeutic efficacy of Apo-Tf, AGP, and C1-INH as neuroprotective agents after experimental HCA.
PubMed ID
15223717 View in PubMed
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Aprotinin to improve cerebral outcome after hypothermic circulatory arrest: a study in a surviving porcine model.

https://arctichealth.org/en/permalink/ahliterature81429
Source
Heart Surg Forum. 2006;9(4):E719-24
Publication Type
Article
Date
2006
Author
Heikkinen Janne
Kaakinen Timo
Dahlbacka Sebastian
Kiviluoma Kai
Salomäki Timo
Laurila Päivi
Biancari Fausto
Tuominen Hannu
Anttila Vesa
Juvonen Tatu
Author Affiliation
Department of Surgery, University of Oulu and Oulu University Hospital, Oulu, Finland.
Source
Heart Surg Forum. 2006;9(4):E719-24
Date
2006
Language
English
Publication Type
Article
Keywords
Animals
Aprotinin - administration & dosage
Brain Diseases, Metabolic - chemically induced - prevention & control
Cerebral Infarction - etiology - prevention & control
Circulatory Arrest, Deep Hypothermia Induced - adverse effects
Neuroprotective Agents - administration & dosage
Serine Proteinase Inhibitors - administration & dosage
Swine
Treatment Outcome
Abstract
BACKGROUND: Aprotinin is a serine protease inhibitor, which is usually used during cardiac surgery to reduce blood loss. There is evidence that aprotinin has neuroprotective effects during ischemia. We planned this study to evaluate its potential neuroprotective efficacy during hypothermic circulatory arrest (HCA). METHODS: Twenty piglets with a median weight of 25.7 kg (interquartile range, 23.9-26.6) were randomly assigned to receive aprotinin or placebo prior to a 75-minute period of HCA at 18 degrees C. Brain microdialysis parameters and neurological and histological scores were the primary outcome measures. RESULTS: Changes in brain metabolic parameters and histopathological findings were favorable in the aprotinin group. Brain lactate concentrations were significantly lower in the aprotinin group during the experiment (P = .02) along with blood lactate concentrations in the aprotinin group (P = .023). Brain glucose was significantly higher during the experiment (P = 0.02). Intracranial pressure tended to be higher in the control group. Two of 10 animals in the aprotinin group and 4 of 10 in the control group failed to reach full recovery on the seventh postoperative day. Four animals of 10 in the aprotinin group and 6 animals of 10 in the control group had brain infarction (P = .40). CONCLUSIONS: The present data suggest that aprotinin mitigates cerebral damage and improves neurological outcome following a period of HCA.
PubMed ID
16844627 View in PubMed
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Arrhythmias and heart rate variability during and after therapeutic hypothermia for cardiac arrest.

https://arctichealth.org/en/permalink/ahliterature153443
Source
Crit Care Med. 2009 Feb;37(2):403-9
Publication Type
Article
Date
Feb-2009
Author
Marjaana Tiainen
Hannu J Parikka
Markku A Mäkijärvi
Olli S Takkunen
Seppo J Sarna
Risto O Roine
Author Affiliation
Departments of Neurology, Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Finland.
Source
Crit Care Med. 2009 Feb;37(2):403-9
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Arrhythmias, Cardiac - therapy
Electrocardiography
Electrocardiography, Ambulatory
Female
Finland
Heart Arrest - physiopathology - therapy
Heart Rate - physiology
Humans
Hypothermia, Induced
Intensive Care Units
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Young Adult
Abstract
To evaluate the effects of therapeutic hypothermia (HT) of 33 degrees C after cardiac arrest (CA) on cardiac arrhythmias, heart rate variability (HRV), and their prognostic value.
Prospective, comparative substudy of a randomized controlled trial of mild HT after out-of-hospital CA, the European Hypothermia After Cardiac Arrest study.
Intensive care unit of a tertiary referral hospital (Helsinki University Hospital).
Seventy consecutive adult patients resuscitated from out-of-hospital ventricular fibrillation were randomly assigned either to therapeutic HT of 33 degrees C or normothermia.
Patients randomized to HT were cooled with an external cooling device for 24 hours and then allowed to rewarm slowly during 12 hours. In the normothermia group, the core temperature was kept 100 msec of the 24-48-hour recording in the HT group (p = 0.018) predicted good outcome.
The use of therapeutic HT of 33 degrees C for 24 hours after CA was not associated with an increase in clinically significant arrhythmias. Preserved 24 to 48-hour HRV may be a predictor of favorable outcome in patients with CA treated with HT.
Notes
Comment In: Crit Care Med. 2009 Feb;37(2):735-619325360
PubMed ID
19114905 View in PubMed
Less detail

[Blood coagulation system after blood loss in rabbits, subjected to the effect of low temperature]

https://arctichealth.org/en/permalink/ahliterature57339
Source
Fiziol Zh. 1969 Sep-Oct;15(5):631-5
Publication Type
Article
Author
N K Kazimirko
Source
Fiziol Zh. 1969 Sep-Oct;15(5):631-5
Language
Ukrainian
Publication Type
Article
Keywords
Animals
Blood Coagulation
Fibrinogen - metabolism
Hemorrhage - blood
Hypothermia, Induced
Rabbits
PubMed ID
5396375 View in PubMed
Less detail

Bradycardia during therapeutic hypothermia is associated with good neurologic outcome in comatose survivors of out-of-hospital cardiac arrest.

https://arctichealth.org/en/permalink/ahliterature258786
Source
Crit Care Med. 2014 Nov;42(11):2401-8
Publication Type
Article
Date
Nov-2014
Author
Henrik Stær-Jensen
Kjetil Sunde
Theresa M Olasveengen
Dag Jacobsen
Tomas Drægni
Espen Rostrup Nakstad
Jan Eritsland
Geir Øystein Andersen
Source
Crit Care Med. 2014 Nov;42(11):2401-8
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Bradycardia - diagnosis
Cardiopulmonary Resuscitation - methods
Cohort Studies
Coma - mortality - therapy
Confidence Intervals
Electrocardiography
Female
Glasgow Coma Scale
Hospital Mortality
Hospitals, University
Humans
Hypothermia, Induced - methods
Logistic Models
Male
Multivariate Analysis
Nervous System Diseases - epidemiology - physiopathology
Norway
Odds Ratio
Out-of-Hospital Cardiac Arrest - mortality - therapy
Patient Discharge - statistics & numerical data
Prognosis
Retrospective Studies
Survival Rate
Survivors
Treatment Outcome
Abstract
Comatose patients resuscitated after out-of-hospital cardiac arrest receive therapeutic hypothermia. Bradycardia is frequent during therapeutic hypothermia, but its impact on outcome remains unclear. We explore a possible association between bradycardia during therapeutic hypothermia and neurologic outcome in comatose survivors of out-of-hospital cardiac arrest.
Retrospective cohort study, from January 2009 to January 2011.
University hospital medical and cardiac ICUs.
One hundred eleven consecutive comatose out-of-hospital cardiac arrest patients treated with therapeutic hypothermia.
Patients treated with standardized treatment protocol after cardiac arrest.
All out-of-hospital cardiac arrest patients' records were reviewed. Hemodynamic data were obtained every fourth hour during the first days. The patients were in temperature target range (32-34°C) 8 hours after out-of-hospital cardiac arrest and dichotomized into bradycardia and nonbradycardia groups depending on their actual heart rate less than or equal to 60 beats/min or more than 60 beats/min at that time. Primary endpoint was Cerebral Performance Category score at hospital discharge. More nonbradycardia group patients received epinephrine during resuscitation and epinephrine and norepinephrine in the early in-hospital period. They also had lower base excess at admission. Survival rate with favorable outcome was significantly higher in the bradycardia than the nonbradycardia group (60% vs 37%, respectively, p = 0.03). For further heart rate quantification, patients were divided into quartiles: less than or equal to 49 beats/min, 50-63 beats/min, 64-77 beats/min, and more than or equal to 78 beats/min, with respective proportions of patients with good outcome at discharge of 18 of 27 (67%), 14 of 25 (56%), 12 of 28 (43%), and 7 of 27 (26%) (p = 0.002). Patients in the lowest quartile had significantly better outcome than the higher groups (p = 0.027), whereas patients in the highest quartile had significantly worse outcome than the lower three groups (p = 0.013).
Bradycardia during therapeutic hypothermia was associated with good neurologic outcome at hospital discharge. Our data indicate that bradycardia should not be aggressively treated in this period if mean arterial pressure, lactate clearance, and diuresis are maintained at acceptable levels. Studies, both experimental and clinical, are warranted.
Notes
Comment In: Crit Care Med. 2014 Nov;42(11):2452-425319912
PubMed ID
25072762 View in PubMed
Less detail
Source
Lakartidningen. 2008 Nov 26-Dec 9;105(48-49):3547-52
Publication Type
Article
Author
Sommar Pehr
Huss Fredrik
Author Affiliation
Kliniken för rekonstruktiv plastikkirurgi, Karolinska Universitetssjukhuset Solna. pehr.sommar@karolinska.se
Source
Lakartidningen. 2008 Nov 26-Dec 9;105(48-49):3547-52
Language
Swedish
Publication Type
Article
Keywords
Adolescent
Adult
Burns - diagnosis - pathology - therapy
Child
Child, Preschool
Consensus
Emergency medical services
Emergency Treatment - methods
Fluid Therapy
Humans
Hypothermia, Induced
Infant
Practice Guidelines as Topic
Prognosis
Sweden
Young Adult
PubMed ID
19133583 View in PubMed
Less detail

Capillary leakage in post-cardiac arrest survivors during therapeutic hypothermia - a prospective, randomised study.

https://arctichealth.org/en/permalink/ahliterature143311
Source
Scand J Trauma Resusc Emerg Med. 2010;18:29
Publication Type
Article
Date
2010
Author
Bård E Heradstveit
Anne Berit Guttormsen
Jørund Langørgen
Stig-Morten Hammersborg
Tore Wentzel-Larsen
Rune Fanebust
Elna-Marie Larsson
Jon-Kenneth Heltne
Author Affiliation
Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. baard.heradstveit@helse-bergen.no
Source
Scand J Trauma Resusc Emerg Med. 2010;18:29
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Capillary Leak Syndrome - diagnosis - etiology
Heart Arrest - therapy
Humans
Hypothermia, Induced
Intensive Care - methods
Isotonic Solutions - adverse effects - pharmacology - therapeutic use
Middle Aged
Norway
Outcome Assessment (Health Care) - methods
Prospective Studies
Saline Solution, Hypertonic - adverse effects - pharmacology - therapeutic use
Survivors
Young Adult
Abstract
Fluids are often given liberally after the return of spontaneous circulation. However, the optimal fluid regimen in survivors of cardiac arrest is unknown. Recent studies indicate an increased fluid requirement in post-cardiac arrest patients. During hypothermia, animal studies report extravasation in several organs, including the brain. We investigated two fluid strategies to determine whether the choice of fluid would influence fluid requirements, capillary leakage and oedema formation.
19 survivors with witnessed cardiac arrest of primary cardiac origin were allocated to either 7.2% hypertonic saline with 6% poly (O-2-hydroxyethyl) starch solution (HH) or standard fluid therapy (Ringer's Acetate and saline 9 mg/ml) (control). The patients were treated with the randomised fluid immediately after admission and continued for 24 hours of therapeutic hypothermia.
During the first 24 hours, the HH patients required significantly less i.v. fluid than the control patients (4750 ml versus 8010 ml, p = 0.019) with comparable use of vasopressors. Systemic vascular resistance was significantly reduced from 0 to 24 hours (p = 0.014), with no difference between the groups. Colloid osmotic pressure (COP) in serum and interstitial fluid (p
Notes
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PubMed ID
20500876 View in PubMed
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170 records – page 1 of 17.