• Title/Summary/Keyword: Hypothermia

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Early hypothermia improves outcomes of cardiopulmonary resuscitation after cardiac arrest in acute myocardial infarction rat models (급성심근경색 쥐 모델의 심정지 후 조기 저체온 치료가 심폐소생술 결과에 미치는 효과)

  • Park, Jeong-Hyun;Im, Hee-Kyung;Kim, Jee-Hee;Lee, Young-Il
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.2
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    • pp.7-19
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    • 2016
  • Purpose: To investigate the effect of early hypothermia on post-resuscitation myocardial recovery and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction(MI). Methods: Thoracotomies were performed in 10 male Sprague Dawley rats weighing 450-455g. Myocardial infarction was induced by ligation of the left anterior descending coronary artery. Ninety minutes after arterial ligation, ventricular fibrillation was induced, cardiopulmonary resuscitation was subsequently performed before defibrillation was attempted. Animals were randomized to control group and experimental group(acute MI-normothermia)($32^{\circ}C$ for 4 hours). Duration of survival was recorded. Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured using echocardiography. Results: Myocardial function was significantly better in hypothermia group than the control group during the first 4 hours post-resuscitation. The survival time of the experimental group was greater than that of the control group(p<.050). Conclusion: This study suggests that early hypothermia can attenuate post-resuscitation myocardial dysfunction after acute myocardial function, and may be a useful strategy in post-resuscitation care.

Evaluation of Thermal Insulation and Hypothermia for Development of Life Raft (해상 구명정의 단열성능평가 및 저체온증 예측 수치해석 연구)

  • Hwang, Se-Yun;Jang, Ho-Sang;Kim, Kyung-Woo;Lee, Jang-Hyun
    • Journal of Navigation and Port Research
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    • v.39 no.6
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    • pp.485-491
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    • 2015
  • The technology review about risk of hypothermia of victim according to heat transfer characteristic of life raft and sea state can use accident correspondence of standing and sinking of ship. This study studied heat transfer characteristics required for the design of life raft and thermal insulation property analysis and evaluation methods. In addition, it is study for comprehend the risk of hypothermia and suggest analysis result that is experiment of thermal insulation property and body temperature property for decide of prediction the body temperature decline Thermal Analysis apply the finite element analysis method is comprehended the property of heat conductivity, convective effect of sea water and properties changes according to property of insulation material. it measure the heat flux with attach temperature sensor on body in order to comprehend the variation of body temperature with boarding a life raft experiment on a human body. This study validate results by comparing variation of temperature measured from experiment on a body with variation of temperature from finite element analysis model. Also, the criteria of hypothermia was discussed through result of finite element analysis.

The Significance of Electroencephalography in the Hypothermic Circulatory Arrest in Human (인체에서 저체온 완전 순환 정지 시 뇌파검사의 의의)

  • 전양빈;이창하;나찬영;강정호
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.465-471
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    • 2001
  • Background: Hypothermia protects the brain by suppressing the cerebral metabolism and it is performed well enough before the total circulatory arrest(TCA) in the operation of aortic disease. Generally, TCA has been performed depending on the rectal or nasopharyngeal temperatures; however, there is no definite range of optimal temperature for TCA or an objective indicator determining the temperature for safe TCA. In this study, we tried to determine the optimal range of temperature for safe hypothermic circulatory arrest by using the intraoperative electroencephalogram(EEG), and studied the role of EEG as an indicator of optimal hypothermia. Material and Method: Between March, 1999 and August 31, 2000, 27 patients underwent graft replacement of the part of thoracic aorta using hypothermia and TCA with intraoperative EEG. The rectal and nasopharyngeal temperatures were monitored continuously from the time of anesthetic induction and the EEG was recorded with a ten-channel portable electroencephalography from the time of anesthetic induction to electrocerebral silence(ECS). Result: On ECS, the rectal and nasopharyngeal temperatures were not consistent but variable(rectal 11$^{\circ}C$ -$25^{\circ}C$, nasopharynx 7.7$^{\circ}C$ -23$^{\circ}C$). The correlation between two temperatures was not significant(p=0.171). The cooling time from the start of cardiopulmonary bypass to ECS was also variable(25-127min), but correlated with the body surface area(p=0.027). Conclusion: We have found that ECS appeared at various body temperatures, and thus, the use of rectal or nasopharyngeal temperature were not useful in identifying ECS. Conclusively, we can not fully assure cerebral protection during hypothermic circulatory arrest in regards to the body temperatures, and therefore, the intraoperative EEG is one of the necessary methods for determining the range of optimal hypothermia for safe circulatory arrest. :

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Extended Application of Total Circulatory Arrest in Non-cardiac Diease (완전순환정지술의 심장질환 이외의 임상적 적용)

  • Won, Yong-Sun;Baek, Wan-Ki;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.854-857
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    • 1994
  • Hypothermia and circulatory arrest is efficatious adjunct in the surgical treatment of conventionally difficult or otherwise inoperable lesion. This technique was utilized in 5 patients, 3 with membraneous obstruction of inferior vena cava[MOVC] and 1 with giant middle cerebral artery aneurysm and 1 with renal cell carcinoma invading inferior vena cava. All membraneous obstruction of inferior vena cava patients had excellent results but the others died of operative complications. The rationale for the use of complete cardiac arrest with hypothermia is reviewed and the use of these technique in selected patients is warrented.

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Effect of Topical Hypothermia on Myocardial Protection from Ischemia - Experimental study using isolated rat heart perfusion technique- (흰쥐의 적출된 작업성 심장에서 허혈성 심정지시 국소냉각법이 심근보호에 미치는 영향)

  • 최종범
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.231-239
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    • 1988
  • Currently numerous methods are in use for myocardial hypothermia as a myocardial preservation modality for cardiac operation. During cardiac ischemia after crystalloid cardioplegia[4C GIK solution], topical cold saline[Group I, a=9], topical ice slush[Group II, n=9] and topical ice chip[Group III, a=10] have been compared for myocardial surface cooling in the isolated rat heart model of cardiopulmonary bypass. During postischemic period, hemodynamic functions[aortic flow, coronary flow, peak aortic pressure and heart rate], biochemical enzymatic activities and cellular injuries with electron microscope were evaluated in this isolated rat heart perfusion model. Postischemic aortic flow, cardiac output and peak aortic pressure in Group I and Group II recovered better than Group III.[p< 0.05] Postischemic creatine kinase and lactate dehydrogenase leakages in Group II and Group III increased more than Group l and postischemic mitochondrial swelling in Group III was more severe than Group I, and Group II.[p< 0.05] These results suggest that topical cold saline was the better method than topical ice slush or topical ice chip as a myocardial preservation modality in the isolated rat heart model of cardiopulmonary bypass.

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Surgical Correction of Obstruction of the Inferior Vena Cava using Profound Hypothermia and Total Circulatory Arrest - A Case Report - (초 저체온법과 전혈류 정지술을 이용한 하공정맥 폐쇄증의 수술 치험: 1례 보고)

  • 유재현
    • Journal of Chest Surgery
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    • v.24 no.7
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    • pp.732-738
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    • 1991
  • Membranous obstruction of the inferior vena cava[IVC] is a rare congenital anomaly that may present clinical features of Budd-Chiari syndrome caused by chronic obstruction of hepatic drain. We have experienced a case of IVC obstruction caused by hour-glass constriction and membrane in its center. Operative correction was accomplished using profound hypothermia [20%] and total circulatory arrest of 26 minutes. This technique permitted resection of membrane with direct vision and removal of thrombus of IVC and hepatic vein. After then constricted IVC was repaired with autologous pericardial patch. Total circulatory arrest was used intermittently for good visual field. Postoperative course was smooth and postoperative angiography showed unobstructed flow through the IVC in spite of slight constriction of cavoatrial junction and nearly complete disappearance of collateral vessels.

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Phrenic Nerve Paralysis Complicating Topical Cardiac Hypothermia During Open Heart Surgery - A Report of 4 Cases- (개심술후 합병되는 횡경신경 손상 -4례 보고-)

  • 이종욱
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.772-777
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    • 1988
  • Because of increasing myocardial damage by normothermic arrest, most of cardiac surgeons now uses many kinds of method reducing myocardial injury, such as systemic hypothermia, topical cooling and cold cardioplegic solutions. And phrenic nerve paralysis has been reported with the use of iced slush for topical cooling. So we reviewed the preoperative and postoperative chest X-rays of 54 patients undergoing open heart surgery with the use of iced slush for topical cooling to find phrenic nerve paralysis. Four of 54 patients were known to have phrenic nerve paralysis. The first time known to develop phrenic nerve paralysis was from POD 4 1 day to POD 4 3 day and the phrenic nerve paralysis resolved within a month postoperatively except one. A patient have had phrenic nerve paralysis persistently over 7 months. And the effect of unilateral phrenic nerve paralysis was of no clinical significance.

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