• Journal of Korean Academy of Nursing
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• v.43 no.3
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• pp.352-360
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• 2013

Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1067-1073
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• 1990

To clarify the changes of left ventricular function under normothermia, the time interval between the onset of ischemia and the beginning of contracture of left ventricle[TIC] were recorded in newborn piglet. Myocardial performance was assessed using intraventricular balloon to determine compliance and systolic function after 5 to 10 minutes interval per-fusing normothermic substrate free Krebs solution as a perfusate. The time to onset TIC was 29.5\ulcorner1.7 minutes and peak ischemic contracture was 46.7\ulcorner4.0 minutes[p<0.01]. In myocardial performance, systolic function of left ventricle[defined as cardiac contractility] was kept until 25 minutes of perfusion, but was decreased abruptly after 30 minutes of perfusion[p<0.0018] and diastolic function of left ventricle[defined as diastolic compliance] was kept until 15 minutes of perfusion, but was decreased after 20 minutes of perfusion [p=0.00\ulcorner9]. This study demonstrated maximal time of the tolerance to normothermic global ischemia and functional changes of left ventricle using Krebs perfusate under the same condition.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.455-459
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• 1994

We experienced 20 cases of acquired aortic diseases during last 1 year [Sep. 1992-Aug. 1993] with newly developed surgical strategies. There were 13 cases[65%] of aortic dissections, 5 cases[25%] of aortic aneurysms and 2 cases of Takayasu arteritis with mean age of 56 + 16 years[range:5-78].In ten cases of patients requiring ascending aortic replacement, femoral artery and femoral vein &/or RA auricle were used as cannulation site. With deep hypothermic circulatory arrest and retrograde cerebral perfusion of cold oxygenated blood via SVC, we can replace the ascending aorta and part of arch if necessary. The mean duration of circulatory arrest was 30 minutes[17-45 min]. In 5 cases of patients who requiring descending and thoracoabdominal aorta replacement, we used simple aortic crossclamping under normothermia with no heparin. The mean duration of aortic crossclamping was 37 minutes[25-50 min].The results of operation were as follow:Operative mortality[2 cases, 10%], delayed cerebral infarct[1], low extremity weakness[1] and intraoperative myocardial infarct[1]. There are no delayed complication or mortality as yet.

• Journal of Korean Critical Care Nursing
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• v.10 no.3
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• pp.53-64
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• 2017

Purpose : This study investigated the effects of active warming using a Warm Touch warming system or a cotton blanket in postoperative patients after general anesthesia for abdominal surgery. Methods : This quasi-experimental study utilized two experimental groups and one control group: a cotton-blanket group (n = 25) were warmed with a cotton blanket and a sheet; a forced-air warming group (n = 24) were warmed with a Warm Touch warming system, a cotton blanket, and a sheet; and a control group (n = 25) were warmed with a sheet. Measurement variables were postoperative pain, body temperature, and thermal discomfort. Data were analyzed using a one-way ANOVA, ${\chi}^2-tests$, Fisher's exact test, and a repeated measures ANOVA. Results : The effects of active warming using a Warm Touch warming system and a cotton blanket on postoperative patients was significant in reducing pain (F = 13.91, p < .001) and increasing body temperature (F = 12.49, p < .001). Conclusion : Active warming made a significant difference in pain and body temperature changes. Active warming methods may help patients' postoperative recovery and prevent complications. Further research is needed to explore the effects and side effects of active warming on recovering normothermia.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.951-959
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• 1991

The level of serum potassium concentration is very important aspect in postoperative cardiac patients The postoperative cardiac arrhythmia and digitalis intoxication are known to be closely related with hypokalemia and also to cause the irreversible cardiac dysfunction. In this study, the changes of the level in serum and urine concentrations during, after extracorporeal circulation[EGG], Predict and Postdict periods are analyzed and compared statistically with postoperative cardiac patients 46 persons according to divided 8 groups. 1. There was no difference significantly in concentrations of serum and urine potassium in each period according to age, sex and disease types. 2. There was no difference significantly in concentrations of serum and urine potassium in each period according to the use of normothermia and hypothermia. 3. There was no difference significantly in concentrations of serum and urine potassium in each period according to the length of extracorporeal circulation time and aortic cross clamping time. 4. There was no difference significantly in concentrations of serum and urine potassium in each period according to the amount of the infused cardioplegic solution and level of Hct.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.797-799
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• 2001

Open heart surgery with hypothermia in patients with cold agglutinin can cause severe complications by hemolysis and hemagglutination of red blood cells. A 41 year-old male patient with mitral stenosis was admitted due to fever and cough. After antibiotics treatment, he was scheduled to undergo mitral valve replacement. In the operation room, we found agglutination of blood cardioplegia during lowering temperature of cardioplegia. And then, the cardioplegia was changed to warm cardioplegia and the operation was performed under normothermia due to the suspicion of the cold reactive protein. The operation was performed uneventfully. Postoperatively, cold agglutinin was confirmed by immunochemistry of the patient\`s serum.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.45-51
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• 2023

Andersen-Tawil syndrome (ATS) is a rare genetic disease characterized by a triad of episodic flaccid muscle weakness, ventricular arrhythmias, and physical anomalies. ATS patients have various cardiac arrhythmias that can cause sudden death. Implantation of an implantable cardioverter-defibrillator (ICD) is required when life-threatening cardiac arrhythmias do not respond to medical treatment. An 11-year-old girl underwent surgery for an ICD implantation. For general anesthesia in ATS patients, anesthesiologists should focus on the potentially difficult airway, serious cardiac arrhythmias, such as ventricular tachycardia (VT), and delayed recovery from neuromuscular blockade. We followed the difficult airway algorithm, avoided drugs that can precipitate QT prolongation and fatal cardiac arrhythmias, and tried to maintain normoxia, normocarbia, normothermia, normoglycemia, and pain control for prevention of sympathetic stimulation. We report the successful application of general anesthesia for ICD implantation in a pediatric patient with ATS and recurrent VT.

• Clinical and Experimental Pediatrics
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• v.57 no.5
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• pp.222-225
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• 2014

Purpose: A recent study analyzing several cytokines reported that long cardiopulmonary bypass (CPB) time and long aortic cross clamp (ACC) time were accompanied by enhanced postoperative inflammation, which contrasted with the modest influence of the degree of hypothermia. In this present study, we aimed to examine the effect of CPB temperature on the clinical outcome in infants undergoing repair of isolated ventricular septal defect (VSD). Methods: Of the 212 infants with isolated VSD who underwent open heart surgery (OHS) between January 2001 and December 2010, 43 infants were enrolled. They were classified into 2 groups: group 1, infants undergoing hypothermic CPB ($26^{\circ}C-28^{\circ}C$; n=19) and group 2, infants undergoing near-normothermic CPB ($34^{\circ}C-36^{\circ}C$; n=24). Results: The age at the time of the OHS, and number of infants aged<3 months showed no significant differences between the groups. The CPB time and ACC time in group 1 were longer than those in group 2 (88 minutes vs. 59 minutes, P =0.002, and 54 minutes vs. 37 minutes, P =0.006 respectively). The duration of postoperative mechanical ventilation was 1.6 days in group 1 and 1.8 days in group 2. None of the infants showed postoperative neurological and developmental abnormalities. Moreover, no postoperative differences in the white blood cell count and C-reactive protein levels were noted between two groups. Conclusion: This study revealed that hypothermic and near-normothermic CPB were associated with similar clinical outcomes and inflammatory reactions in neonates and infants treated for simple congenital heart disease.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.643-654
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• 1987

The effect of prostacyclin[PGI, ] on myocardial preservation during global ischemia was studied in the isolating working rabbit heart model. Forty hearts underwent a 15 minute period of retrograde nonworking perfusion with Krebs-Henseleit buffer solution [37*C] and were switched over to the working mode for 15 minutes. After baseline measurement of heart rate, peak aortic pressure, aortic flow, and coronary flow, all hearts were subjected to 60 minutes of ischemic arrest at 10*C induced with St. Thomas Hospital cardioplegic solution: Group I had single dose cardioplegia, Croup II double dose, Croup III oxygenated double dose, and Group IV single dose with PCI, infusion [10ng/min./gm heart weight]. Hearts were then revived with 15 minute period of nonworking reperfusion at normothermia, followed by 30 minutes of working perfusion. Repeat measurements of cardiac function were obtained and expressed as a percent of the preischemic baseline values. Oxygen content of arterial perfusate and coronary effluent was measured by designed time interval. Leakage of creatine kinase was determined during post-ischemic reperfusion period. Finally wet hearts were weighed and placed in 120*C oven for 36 hours for measurement of dry weight. In the PGI, treated group [IV], heart rate increased consistently throughout the period of reperfusion from 100*5.0% [p<0.001] to 107*6.2% [p<0.001]. The percent recovery of aortic flow showed 95*5.7% [p<0.001] at the first 3 minute and full recovery through the subsequent time. Coronary flow was augmented significantly in the 3 minute [96*6.2%, p<0.001] and then sustained above baseline values. Among the Croup I, II, and III, all hemodynamic values were significantly below preischemic levels. PGI2 relatively increased oxygen delivery [1.22*0.19ml/min, p<0.001] and myocardial oxygen consumption [0.90*0.13ml/min, p<0.001] during reperfusion period. Leakage of creatine kinase in the PGI2 group was 9.3*1.58IU/15min [p<0.001]. This was significantly lower than Group I [33.0*2.68 IU/15min]. The water content of PCI2 treated hearts [81*0.9%, p<0.001] was also lower than the other groups.

• Proceedings of the KAIS Fall Conference
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• 2011.12a
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• pp.170-173
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• 2011

Therapeutic hypothermia(TH) improves neurological outcomes and reduces mortality among survivors of out-of-hospital cardiac arrest. Animal and human studies have shown that TH results in improved salvage of the myocardium, reduced infarct size, reduced left ventricular remodeling and better long-term left ventricular function in settings of regional myocardial ischemia. This study is to investigate the effect of TH on post-resuscitation myocardial dysfunction and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction (MI). Thoracotomies were performed in 10 Male Sprague-Dawley rats weighing 450-550 g. MI was induced by ligation of the left anterior descending coronary artery (LAD). Ninety min after LAD ligation, ventricular fibrillation induction and subsequent cardiopulmonary resuscitation was performed before defibrillation attempts. Animals were randomized to two groups: a) Acute MI-Normothermia b) Acute MI-Hypothermia ($32^{\circ}C$ for 4 h). Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured echocardiographically together with duration of survival. Ejection fraction, cardiac output and myocardial performance index were $54.74{\pm}9.16$, $89.00{\pm}8.89$, $1.30{\pm}0.09$ respectively and significantly better in the TH group than those of the normothermic group at the first 4 h after resuscitation($32.20{\pm}1.85$,$41.60{\pm}8.62$,$1.77{\pm}0.19$)(p=0.00). The survival time of the hypothermic group ($31.8{\pm}14.8$ h) was greater than that of the normothermic group($12.3{\pm}6.5$ h, p<0.05). This study suggested that TH attenuated post resuscitation myocardial dysfunction in acute MI and would be a potential strategy in post resuscitation care.