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Hypothermia can be the first and only sign of sepsis in young infants, yet there is a paucity of standard recommendations for pediatric primary-care office management of those infants identified. The SMART aim of this study was to standardize the identification and care of infants age 0 to 49 days at risk of hypothermia in pediatric primary care by decreasing the percent of infants with temperatures ≤36.5°C from 24% to 10% within 2 years. Over the course of this project, variation in documented temperatures ≤36.5°C decreased from 24% to 7% of encounters. Temperatures ≤36.5°C were documented for 951 infants or 13.4% (1078 of 8020 encounters). Of the 951 infants with temperatures ≤36.5°C, 96.1% were rewarmed in the office. Thirty-one patients ultimately required hospitalization. Application of quality improvement in a primary-care office decreased low temperatures by standardizing care, empowering staff, and triaging at-risk infants to the most appropriate level of care. [ABSTRACT FROM AUTHOR]

The article focuses on the use of intravenous immunoglobulin (IVIg) in treating conditions like Kawasaki disease and multisystem inflammatory syndrome in children (MIS-C), highlighting its potential adverse effects including hypothermia, a rare occurrence. It presents cases of two children who developed hypothermia during IVIg infusion, prompting further discussion about this phenomenon, although the exact mechanism behind it remains unclear.

Aim: Hypothermia (HT) is a common and serious problem during anesthesia. As the ratio of skin surface area to body volume is higher in neonates than in adults, heat loss and ultimately HT are more common in the intraoperative period. This study aimed to determine the incidence and independent risk factors of HT in the neonatal period. Materials and Methods: This retrospective observational cohort study included 63 patients who underwent neonatal surgery within a one-year period. HT was defined as body temperature <36 °C and the patients were divided into two groups: Group I (body temperature <36 °C) and Group II (≥36 °C). Demographic data, ASA score, operative diagnosis, duration of surgery and anesthesia, amount of fluid, inotrope and vasopressor therapy, amount of bleeding, amount of blood transfusion, preoperative and postoperative temperatures, and the heating methods of the patients were recorded. Results: The median age of the patients was 5 days (0-28 days) and their mean weight was 2,792±782 grams. The esophageal method was used for temperature monitoring in 88.9% (56 patients) and the rectal method in 10.1% (7 patients). HT developed in 54% of the patients. Caps and socks were used to prevent HT in 96.8% of the patients, forced-air warming blankets in 95.2%, warming gel mattresses in 27%, and fluid and blood warming devices in 17.5%. In the logistic regression model, the operating room temperature was identified as the only independent risk factor associated with neonatal HT. Conclusion: Despite the use of active and passive warming methods, the incidence of HT in the neonatal period was found to be high. Cold operating rooms were found to be the only independent factor associated with neonatal HT. [ABSTRACT FROM AUTHOR]

Accidental perioperative hypothermia is a common but preventable surgical complication. This study aimed to review the risk factors for hypothermia in major abdominal surgery patients. Databases (CINAIL via EBSCO, Embase, Ovid MEDLINE, and Cochrane Center Register of Controlled Trials) were searched from inception to September 27, 2022. Meta-analyses were performed to calculate the pooled effects of risk factors. The Newcastle-Ottawa Scale was used to assess the quality of studies, and heterogeneity was examined by I-square tests. A total of 12 studies were involved in this review. The meta-analysis showed that hypothermia had an association with ASA (OR 0.48, 95% CI 0.30–0.77), mode of warming (OR 10.48, 95% CI 2.23–49.28), mode of presentation (OR 45.50, 95% CI 11.55–179.35), and baseline temperature (OR 5.54, 95% CI 2.30–13.25). Healthcare professionals should pay more attention to patients with these risk factors mentioned and reduce the risk of hypothermia. Besides, more evidence supported by high-quality studies is needed to explore the powers of the risk factors of hypothermia. [ABSTRACT FROM AUTHOR]

Purpose: To measure core temperature (Tcore) in open-water (OW) swimmers during a 25-km competition and identify the predictors of Tcore drop and hypothermia-related dropouts. Methods: Twenty-four national- and international-level OW swimmers participated in the study. Participants completed a personal questionnaire and a body fat/muscle mass assessment before the race. The average speed was calculated on each lap over a 2500-m course. Tcore was continuously recorded via an ingestible temperature sensor (e-Celsius, BodyCap). Hypothermia-related dropouts (H group) were compared with finishers (nH group). Results: Average prerace Tcore was 37.5°C (0.3°C) (N = 21). 7 participants dropped out due to hypothermia (H, n = 7) with a mean Tcore at dropout of 35.3°C (1.5°C). Multiple logistic regression analysis found that body fat percentage and initial Tcore were associated with hypothermia (G2 = 17.26, P <.001). Early Tcore drop ≤37.1°C at 2500 m was associated with a greater rate of hypothermia-related dropouts (71.4% vs 14.3%, P =.017). Multiple linear regression found that body fat percentage and previous participation were associated with Tcore drop (F = 4.95, P =.019). There was a positive correlation between the decrease in speed and Tcore drop (r =.462, P <.001). Conclusions: During an OW 25-km competition at 20°C to 21°C, lower initial Tcore and lower body fat, as well as premature Tcore drop, were associated with an increased risk of hypothermia-related dropout. Lower body fat and no previous participation, as well as decrease in swimming speed, were associated with Tcore drop. [ABSTRACT FROM AUTHOR]

The MARCH (Massive hemorrhage, Airway, Respirations, Circulation, and Hypothermia/Head injuries) algorithm taught to military medics includes interventions to prevent hypothermia. As possible sequelae from major trauma, hypothermia is associated with coagulopathy and lower survival. This paper sought to define hypothermia within our combat trauma population using an outcomes-based method, and determine clinical variables associated with hypothermia. This is a secondary analysis of a previously described dataset from the Department of Defense Trauma Registry focused on casualties who received prehospital care. A receiver operating curve was constructed and Youden's index was used to define hypothermia within the predetermined population based on mortality risk. A multivariable regression model was used to identify associations. There were 23,243 encounters that met the inclusion criteria for this study with patients having received prehospital care and documentation of at least one emergency department temperature. An optimal threshold of 36.2° C was found to predict mortality; 3,159 casualties had temperatures below this threshold (14%). Survival to discharge was lower among casualties with hypothermia (91% versus 98%). Hypothermic casualties were less likely to undergo blanket application (38% versus 40%). However, they had higher proportions with Hypothermia Prevention and Management Kit application (11% versus 7%) and radiant warming (2% versus 1%). On multivariable regression modeling, none of the hypothermia interventions were associated with a decreased likelihood of hypothermia. Non-hypothermia interventions associated with hypothermia included prehospital intubation (OR 1.57, 95% CI 1.45–1.69) and blood product administration. Hypothermia, including a single recorded low temperature in the patient care record, was associated with worse outcomes in this combat trauma population. Prehospital intubation was most strongly associated with developing hypothermia. Prehospital warming interventions were not associated with a reduction in hypothermia risk. Our dataset suggests that current methods for prehospital warming are inadequate. [ABSTRACT FROM AUTHOR]

Aims: To construct and validate an intraoperative hypothermia risk prediction model for elderly patients undergoing total hip arthroplasty (THA). Methods: We collected data from 718 patients undergoing THA in a tertiary hospital from January 2021 to December 2022. Of these patients, 512 were assigned to the modeling group from January 2021 to April 2022, and 206 participants were assigned to the validation group from May 2022 to December 2022. A logistic regression analysis was performed to construct the model. The area under the curve (AUC) was used to test the model's predictive ability. Results: The incidence rate of intraoperative hypothermia was 51.67%. The risk factors entered into the risk prediction model were age, preoperative hemoglobin level, intraoperative blood loss, postoperative hemoglobin level, and postoperative systolic blood pressure. The model was constructed as follows: logit (P) = − 10.118 + 0.174 × age + 1.366 × 1 (preoperative hemoglobin level) + 0.555 × 1 (postoperative hemoglobin level) + 0.009 × 1 (intraoperative blood loss) + 0.066 × 1 (postoperative systolic blood pressure). Using the Hosmer–Lemeshow test, the P value was 0.676 (AUC, 0.867). The Youden index, sensitivity, and specificity were 0.602, 0.790, and 0.812, respectively. The incidence rates of intraoperative hypothermia in the modeling and validation groups were 53.15% and 48.06%, respectively. The correct practical application rate was 89.81%. This model had good application potential. Conclusions: This risk prediction model has good predictive value and can accurately predict the occurrence of intraoperative hypothermia in patients who undergo THA, which provides reliable guidance for clinical work and has good clinical application value. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to understand the research hotspots, research trends and research frontiers for hypothermia in surgical patients and provide a reference for developing effective measures to reduce the incidence of hypothermia in these patients. Design: Using CiteSpace software, a visual analysis of 1288 included articles related to hypothermia in surgical patients was performed. Methods: CiteSpace software is a Java application that supports knowledge research, data visualization and analysis of literature databases. The following data were retrieved: title, abstract, year, keywords, author, academic institution, journal and citations. The included literature was analysed using CiteSpace visualization software, knowledge mapping, collaborative network analysis, cluster analysis and highlighting keywords for visualization. Results: A total of 1288 articles related to hypothermia in surgical patients were included, with the largest number of articles published in the United States (448), followed by in Germany (104) and China (102). The top three institutions, journals and authors were from the United States. The most common keywords were perioperative 'hypothermia', 'risk factors' and 'anesthesia'. [ABSTRACT FROM AUTHOR]

Background: The surgical nurse should identify patients at high risk of hypothermia. Considering the complications that hypothermia may cause; preventive measures should be taken before, during, and after surgery to prevent the development of inadvertent hypothermia. Objective: To determine the knowledge and applications of nurses to prevent the development of hypothermia related to the perioperative period. Method: This descriptive study consisted of 153 surgical nurses working in the surgical wards of a university hospital. Data collection form in the research; it consisted of questions that determined the demographic characteristics of nurses, their knowledge and applications to prevent hypothermia development during the perioperative period. Descriptive statistics, chi-square, independent samples t-test, repeated measures analysis of variance (ANOVA), Pearson correlation coefficient were used in data analysis. Results: In the study, nurses reported that seven of the 20 high-risk patient groups with a high risk of hypothermia were at risk. The nurses stated that they knew and applied the methods of covering the patient, putting on socks and warming the bed among passive heating methods and the method of using a blanket with hot air blowing among active heating methods. In the study, a positive correlation was found between the preoperative, intraoperative, postoperative period and general knowledge score and the preoperative, intraoperative, postoperative and general practice score of the nurses (p<0.001). Conclusion: The research showed that nurses do not know the majority of patients with high risk of hypothermia, and passive methods are known and applied more than active methods in the prevention of hypothermia. At the same time, the research revealed that with the increase in nurses' knowledge about the prevention of hypothermia, their practices also increased. As a result of this research, it is recommended that organize to training programs for the prevention of hypothermia in the perioperative process. [ABSTRACT FROM AUTHOR]

Background & Problems: Post-operation hypothermia tends to induce complications. Sixty percent of robotic-assisted mitral valve surgery patients experienced hypothermia while admitted to our intensive care unit (ICU), resulting in prolonged ICU stays and 57% (eight) of those patients with hypothermia also experiencing cardiac arrhythmia. The causes of hypothermia in our ICU included low temperature in the operating room, delayed initiation of blanket coverage after surgery, and lack of postoperative thermal blankets, insufficient cardiopulmonary bypass rewarming time, cold ICU beds, lack of in-service training for hypothermia, and lack of procedure auditing. Purpose: This intervention was designed to reduce the incidence of hypothermia in ICU patients undergoing robotic-assisted mitral valve surgery upon ICU admission from 60% to 36% and the one-hour hypothermia rate from 43.3% to 26%. Resolutions: We implemented several measures including increasing the room temperature, pre-heating the ICU bed, achieving team consensus regarding prolonging the rewarming time after cardiopulmonary bypass, establishing a blanket warming area for postoperative patient use, and holding in-service training to enhance the awareness of the nurses were implemented. Result: The incidence of hypothermia in ICU patients receiving robotic-assisted mitral valve surgery upon ICU admission decreased from 60% to 19.4%, while the one-hour hypothermia rate decreased from 43.3% to 19.4%. Conclusions: Using systemic interprofessional collaboration, combined thermal care can be achieved to significantly reduce the incidence of postoperative hypothermia in patients undergoing robotic-assisted mitral valve surgeries resulting in higher patient care quality and shorter ICU stays. We recommend applying this combined method to improve the quality of perioperative care for long-duration and major surgical procedures that involve large postoperative wounds and for patients who may require wider exposure during their operation. [ABSTRACT FROM AUTHOR]

Aim: To construct and validate a postoperative hypothermia prediction model for patients undergoing joint replacement surgery. Background: Postoperative hypothermia is one of the harmful perioperative complications in patients undergoing joint replacement surgery. The previous studies mainly focused on intraoperative hypothermia prediction models. The prediction model for postoperative hypothermia in patients with joint replacement surgery was understudied. Design: Cohort study. Methods: We collected data from 503 participants undergoing joint replacement surgery in a tertiary hospital from January 2019 to December 2021. Of those, 404 cases were assigned to the modelling and 99 to the validation groups. Logistic regression was used to construct the model. The AUC was used to test the predictive effect of the model. Finally, 99 cases were used to verify the application effect of the model. A TRIPOD checklist was used to guide the reporting of this study. Results: The factors entered into the prediction model were age, intraoperative hypothermia, BMI, heat preservation measures and platelet (PLT). The model was constructed as follows: Logit (P) =.537 + 3.669 × 1 (intraoperative hypothermia) +.030 × age −.289 × BMI + 2.857 × 1 (intraoperative insulation measures) +.003 × PLT. Hosmer–Lemeshow test, p =.608, the area under the receiver operating characteristic curve (AUC) was.861. The Youden index was.530, the sensitivity was.599 and the specificity was.93. The incidence of postoperative hypothermia in the modelling group was 42.93% (173/404), and that in the verification group was 43.43% (43/99), χ2 =.012, p =.912. The correct practical application rate was 87.88%. This model has a good application effect. Conclusion: The current prediction model provided a reference for clinical screening of patients with high‐risk hypothermia after joint replacement surgery. Relevance to clinical practice: Clinical nurses can use the developed prediction model to predict the occurrence of postoperative hypothermia and provide a reference for the preventive measure. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Early diagnosis, control and management of hypothermia are decisive in the outcome of burns. Various factors play a role in creating or aggravating accidental hypothermia in these patients. This study was conducted with the aim of determining accidental hypothermia prevalence and related factors among burned patients referred to Shahid Motahhari Hospital in Tehran, Iran in 2021. MATERIAL AND METHODS: In this prospective observational study, 151 burn patients who were transferred to the emergency department by EMS were selected through available sampling from February 2021 to August 2021. Data was collected and recorded in three areas (pre-hospital, emergency ward, and burn center) through observation and interview of patients and their relations and review of records from admission to discharge. The ambient temperature and core body temperature (CBT) of the patients was measured by a calibrated tympanic thermometer at the time of arrival. Individual, clinical, environmental, and care variables were investigated as factors related to hypothermia. The research data were analyzed using descriptive and inferential statistics such as Pearson correlation, chi-score, and multiple linear regression by SPSS software version 22. A significance level of less than 0.05 was considered. RESULTS: Forty-seven percent of patients had a CBT of less than 36 degrees Celsius at arrival. Through multiple linear regression, 15 independent variables were entered with the backward model. Only the kind of airway management (ß = -0.296, p < 0.001), and volume of fluids received (ß = 0.144, p = 0.082) were as predicting factors for accidental hypothermia in burn patients. CONCLUSIONS: About half of the patients were hypothermic at the time of admission. Optimizing care in pre-hospital and burn departments and empowering the healthcare team in the assessment of burn patients, and early detection, prevention, and proper management of accidental hypothermia are highly expected. [ABSTRACT FROM AUTHOR]

Background: Inadvertent perioperative hypothermia is an unintentional drop in core body temperature to less than 36 °C perioperatively and is associated with many negative outcomes such as infection, a prolonged stay in a recovery room, and decreased patient comfort. Objective: To determine the incidence of postoperative hypothermia and to identify the associated factors with postoperative hypothermia in patients undergoing head, neck, breast, general, urology, and vascular surgery. The incidences of pre- and intraoperative hypothermia were examined as the intermediate outcomes. Materials and methods: A retrospective chart review was conducted in adult patients undergoing surgery at a university hospital in a developing country for two months (October to November 2019). Temperatures below 36 °C were defined as hypothermia. Univariate and multivariate analyses were used to identify factors associated with postoperative hypothermia. Results: A total of 742 patients were analyzed, the incidence of postoperative hypothermia was 11.9% (95% CI 9.7%-14.3%), and preoperative hypothermia was 0.4% (95% CI 0.08%-1.2%). Of the 117 patients with intraoperative core temperature monitoring, the incidence of intraoperative hypothermia was 73.5% (95% CI 58.8–90.8%), and hypothermia occurred most commonly after anesthesia induction. Associated factors of postoperative hypothermia were ASA physical status III-IV (OR = 1.78, 95%CI 1.08–2.93, p = 0.023) and preoperative hypothermia (OR = 17.99, 95%CI = 1.57-206.89, p = 0.020). Patients with postoperative hypothermia had a significantly longer stay in the PACU (100 min vs. 90 min, p = 0.047) and a lower temperature when discharged from PACU (36.2 °C vs. 36.5 °C, p < 0.001) than those without hypothermia. Conclusion: This study confirms that perioperative hypothermia remains a common problem, especially in the intraoperative and postoperative periods. High ASA physical status and preoperative hypothermia were associated factors of postoperative hypothermia. In order to minimize the incidence of perioperative hypothermia and enhance patient outcomes, appropriate temperature management should be emphasized in patients at high risk. Registration: Clinical Trials.gov (NCT04307095) (13/03/2020). [ABSTRACT FROM AUTHOR]

INTRODUCTION: Hypothermia is highly prevalent among trauma patients. If hypothermia is diagnosed and managed early, complications from hypothermia can be reduced. This study aimed to determine the prevalence of accidental hypothermia and related factors in prehospital trauma patients. MATERIAL AND METHODS: This is a single-center prospective observational study. From 2 to 16 November 2018, 132 trauma patients were selected by convenience sampling. To collect data, the patient's core body temperature (CBT) and the temperature of the ambulance cabin were measured as the patient left the ambulance. A combination of observation and emergency medical technician records was used to identify factors influencing hypothermia onset or exacerbation. SPSS 16 was used to analyze the data using descriptive statistics and multiple logistic regression. A significance level of 5% was considered. RESULTS: It was calculated that 44.1% of prehospital trauma patients had accidental hypothermia. The predicting variables for accidental hypothermia in trauma patients were found to be level of consciousness (OR = 2.19, p < 0.049), pulse rate (OR = 1.04, p < 0.02), and ambient cabin temperature (OR = 1.32, p < 0.015). CONCLUSIONS: At the time of hospital admission, a significant number of trauma patients were hypothermic. This study emphasizes the need for identifying unintentional hypothermia in trauma patients early on during the pre-hospital stage. [ABSTRACT FROM AUTHOR]

Background: Perioperative hypothermia and shivering are common and can cause adverse outcomes. The aim of this study was to investigate the incidence of postoperative hypothermia and shivering and their risk factors in patients undergoing malignant tumor surgery. Methods: This retrospective study collected data from patients with American Society of Anesthesiologists physical status (ASA) I or II who underwent scheduled surgery from November 2020 to March 2021 at Fudan University Shanghai Cancer Center. Each patient's core body temperature was measured at three time points: time point 1 (arrival at the postanesthesia care unit (PACU)), time point 2 (after 30-min care in the PACU), and time point 3 (at discharge from the PACU). At time point 1, if the patient's body temperature was below 36 ℃, we provided an active forced-air warmer. At time point 2, if it was still below 36 ℃, the forced-air warmer was still applied until the patient was discharged from the PACU. If it reached 36 ℃, the forced-air warmer would be switched off. Univariate and multivariate logistic regression combined with stepwise methods and linear regression were used to explore risk factors for postoperative hypothermia and shivering. Results: The numbers (percentage) of 202 patients who developed postoperative hypothermia at the different time points were 52 (25.7%), 37 (18.3%) and 28 (13.9%). Eight patients (4.0%) experienced shivering. Multivariate logistic regression showed that high weight (OR = 0.923, 95% CI: 0.884 to 0.964, P = 0.0003) and low estimated blood loss (OR = 0.252, 95% CI: 0.115 to 0.550, P = 0.0005) were protective factors against hypothermia, while long surgical duration (OR = 3.339, 95% CI: 1.675 to 6.655, P = 0.0006) was an independent risk factor for hypothermia at time point 1. There was no risk factor associated with the occurrence of shivering (P > 0.05). There was a significant difference between the hypothermia and normothermia groups in the median length of stay in the PACU (59.0 vs. 49.0 min, P = 0.0123). Conclusions: Postoperative hypothermia occurred frequently. Weight, estimated blood loss and surgical duration were significantly associated with hypothermia on arrival at the PACU. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hypothermia is a common clinical issue during the perioperative period. The patients with perioperative inadvertent hypothermia are associated with higher risk of postoperative complications and higher hospitalisation costs. Aims: The aim of this study is to explore the prevalence of and predictors for hypothermia in patients entering postanaesthesia care unit. Design: Retrospective cohort study. Methods: A rigorous retrospective cohort study was conducted according to the STROBE reporting checklist. A total of 7216 patients were enrolled in this study. The perioperative variables potentially related to hypothermia were collected. Univariate analysis and multivariate logistic regression analysis were performed to investigate the contributing factors. Results: The overall prevalence of inadvertent hypothermia in postanaesthesia care unit was 21.3% (n = 1505). The multivariate logistic regression analysis showed that age >65 (OR = 1.561, 95% CI 1.371–1.778, p <.001), non‐supine position [lateral decubitus position (OR = 1.341, 95% CI 1.133–1.586, p =.001), lithotomy position (OR = 1.639, 95% CI 1.295–2.075, p <.001)], non‐superficial surgery (OR = 2.195, 95% CI 1.566–3.077, p <.001), non‐open surgery [laparoscopic surgery (OR = 1.205, 95% CI 1.020–1.423, p =.029), endoscopic surgery (OR = 1.430, 95%CI 1.084–1.887, p =.011)], the volume of intravenous infusion fluid >1000 ml (OR = 1.814, 95% CI 1.500–2.194, p <.001), blood transfusion (OR = 1.552, 95% CI 1.159–2.078, p =.003), operation performed in the summer or fall (OR = 1.874, 95%CI 1.656–2.122, p <.001) and use of dexmedetomidine (OR = 1.147, 95%CI 1.015–1.296, p =.028) were associated with increased risk of hypothermia. In contrast, our finding showed that body mass index ≥25 kg/m2 (OR = 0.556, 95%CI 0.491–0.630, p <.001), higher baseline body temperature (OR = 0.641, 95%CI 0.541–0.761, p <.001) and duration of fasting ≥18 h (OR = 0.487, 95%CI 0.345–0.689, p <.001) were associated with decreased risk of hypothermia. Compared with non‐hypothermic patients, patients with hypothermia were associated with prolonged length of hospital days (5 vs. 4 days, p <.001). Conclusion: For patients admitted to postanaesthesia care unit after elective procedures, old age, non‐supine position, non‐open surgery, non‐superficial surgery, large volume of intravenous infusion fluid, dexmedetomidine, blood transfusion and Summer or Fall operative season were associated with increased risk of hypothermia, whereas high body mass index, high baseline body temperature and long fasting duration were associated with decreased risk of hypothermia. Relevance to clinical practice: The outcomes of this study will raise the concerns of perioperative care team on hypothermia in surgical patients. Measures should be taken to improve perioperative hypothermia and clinical outcome. [ABSTRACT FROM AUTHOR]

Although hypothermia and cold injuries are rare in children and young people in the UK, the risk is persistent and requires urgent medical management when it does occur. This article outlines some considerations for professionals who may be caring for hypothermic patients or those at risk of becoming hypothermic. [ABSTRACT FROM AUTHOR]

Background & Aims: Accidental hypothermia is a common complication in trauma patients. Hospitalization of these patients in the Operating Room (OR) can greatly affect the prevalence of inadvertent hypothermia. Due to the negative patient's outcomes, the aim of this study was to investigate its prevalence and related risk factors among trauma patients in the OR. Methods: This prospective observational study was conducted on trauma patients who underwent surgery in the OR department of the Educational and Treatment Center of Mousavi in Zanjan. In this study, 59 eligible patients were selected using convenience sampling method in December 2017. Individual, clinical, environmental and care variables related to hypothermia were collected by a researcher and recorded in a researcher-made data sheet. Results: The majority of patients (66.1%) were men. The mean and standard deviation of their age was 46.8 (17.7) years. The most common mechanism of trauma was blunt trauma (66.1%) and the main cause of trauma was motor vehicle crash (45.8%). The prevalence of accidental hypothermia in the OR was 67.8%. Eighteen independent variables were entered into the logistic regression model as factors related to accidental hypothermia, and in the final step of the model, low systolic blood pressure (OR=1.141, P=0.022), low blood oxygen saturation (OR=2.229, P=0.009), and inadequate clothing and coverage of patients (OR=8.354, P=0.039) were identified as risk factors. High OR ambient temperature (OR=0.126, P=0.035) and short duration of surgery (OR=0.086, P=0.016) also acted as protective factors. Conclusion: In the current study, a significant part of surgical patients was hypothermic during operation and factors such as surgery time, systolic blood pressure, blood oxygen saturation, ambient temperature of the OR, and the condition of the patients' clothing were found to be effective in its development. This study has aimed to emphasize the need for early identification of hypothermia and effective management of related factors in order to prevent unwanted consequences. [ABSTRACT FROM AUTHOR]

Objective: Perioperative hypothermia occurs in the pediatric age group in the perioperative period at a high rate. In this study, it is aimed to reveal the incidence of perioperative hypothermia and the risk factors that play a role in its development in pediatric circumcision cases that have a brief operation duration. Materials and Methods: This prospective observational cohort study included 100 children who underwent circumcision under general anesthesia. All patients were heated with a passive heater and hypothermia was interpreted as a drop in body temperature below <36°C. The patients were divided into 2 groups: group 1 (patients with body temperature <36°C) and group 2 (≥36°C). Demographic data, the American Society of Anesthesiologists' Classification of Physical Health Score, premedication method, operation time, fluid amount, preoperative and postoperative temperature of patients as tympanic were recorded. Results: The average age of the patients was 70 ± 40 months (median: 84) and 93% were ASA I. In 71% of patients, a decrease in body temperature and hypothermia developed in 39% compared to baseline. The duration of operation was longer in the group with hypothermia (30 min [15-70] vs. 25 min [15-60], P < .001). Only the duration of operation was determined as the independent risk factor associated with hypothermia (odds ratio: 1.103 [1.017-1.197], P = .018). Conclusion: In this study, it was found that high rates of hypothermia developed even in minor operations such as pediatric circumcision. The risk of hypothermia increases with the prolongation of surgery. [ABSTRACT FROM AUTHOR]

Introduction: Hypothermia at admission in trauma patients has been significantly associated with worse outcomes and increased blood usage. Previous studies have found variably significant associations between ambient temperatures and incidence of hypothermia in trauma patients. Methods: The trauma quality improvement registry was queried for data on trauma patients admitted direct from the scene over a 5-year period. This database was matched to daily weather data taken from the nearest National Oceanic and Atmospheric Administration land-based climate monitoring center, and further combined with blood usage data from the laboratory information system. Results: Multivariate logistic regression models predicted significant associations between ambient temperature and patient admission temperature for severely injured patients. No significant direct associations were predicted between ambient temperature and in-hospital mortality or blood usage. Models predicted a significant association between decreased admission temperature and increased likelihood of both blood transfusion and mortality for a severely injured subgroup. Conclusions: Ambient temperature is a significant contributor to the rate of admission hypothermia in trauma patients. Most of the variability in admission temperatures for severely injured trauma patients remains unaccounted for by models using standard markers of anatomic and physiologic severity. Decreasing admission temperature is significantly associated with increased mortality and likelihood of blood transfusion for severely injured patients. [ABSTRACT FROM AUTHOR]

A case study of a 62‑year man presented with weakness of the right hand6 months earlier as electromyography had shown extensive denervation and reinnervation all the segments. Topics include Oculomotor abnormalities (OMA) are smooth pursuit and saccadic abnormalities followed by supranuclear ophthalmoplegia and total external ophthalmoplegia; and severe muscle loss precluded endothermic muscular heat generation necessary to maintain normothermia in a cold environment.

Purpose: The research is conducted in order to determine the incidence of involuntary hypothermia developed at the patients after abdominal surgery in the postoperative period and the factors affecting the development of the undesired hypothermia. Methodology: In this research that is conducted in descriptive and sectional style, 189 patients who had abdominal surgery in the general surgery and urology clinics of a university hospital in between 2nd of May -- 2nd of October 2019, who are in preoperative period with body temperature 36°C and above. These data are collected via patient identification forms and hypothermia evaluation form and individuals with body temperature below 36°C are considered as in hypothermia. In the evaluation of the data average, percentage distribution and chi-square test are used. Findings: The ratios of incidence in the postoperative period are determined as 62.4% in 0th postop hour, 42.9% at 1st postop hour, 33.9% at 2nd postop hour, 22.2% at postop 3rd hour and 13.2% at 4th postop hour. The lowest body temperature is measured as (35.69±0.66) at 0th postop hour. In patients with operation time our two hours and in risk classification II and above of the American Society of Anesthesiologists, the ratios of incidence of hypothermia are determined to be significantly higher (p<0.05). Results: In this study, it is determined that the hypothermia incidence in the postoperative period of the patients who had abdominal surgery is high, in the patients with long operation time and who are over risk classification II and above of the American Anesthesiologists Association, the hypothermia is seen more frequently. [ABSTRACT FROM AUTHOR]

Introduction: The sensation to cold, shake occurrence and shivering are events that are commonly developed following general anesthesia administration postoperatively. Hypothermia has been considered as the most frequent outcome of surgery underwent by anesthesia. Inadvertent hypothermia has been taken into account as common side effect in the postoperative period immediately and it is related to wide impairments and anomalies of different body organs. Concentration on predictive factors of hypothermia would be important to reduce the incidence rate and correct preventable unnecessary risks for patients in the health settings following surgical operations. The aim of study is to assess the magnitude and associated factors of postoperative hypothermia recovery room in patients underwent general anesthesia. Methods: A hospital-based prospective cross-sectional study was conducted on200patients with different age groups of both genders who underwent a scheduled non-cardiac surgery and general anesthesia consecutively during the period between the October 1stand the November1st2016. Results: The study revealed that the overall core hypothermia in the study sample was31%. The study showed that the post-operative temperatures decreased statistically significantly in all study patients and separately in adults, children, males, or females P<0.001. The study also revealed that the operation duration(p=0.045) and pre-operative temperature P<0.001were predictors of post-operative hypothermia in study sample. Conclusions: The incidence of hypothermia among study sample was not so high. A significant reduction in core body temperature of patients between pre and post-operation times was found. Those patients with longer operation duration, lower room temperature, and lower pre-operative temperature were at more risk of post-operative hypothermia. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Total joint arthroplasty (TJA) usually leads to substantial blood loss, which may cause allogenic blood transfusion. Hypothermia occurring during operation has been reported to increase blood loss and transfusion rates in nonorthopedic cohorts. However, the relationship between intraoperative hypothermia and blood loss remains controversial in patients undergoing orthopedic surgeries. The aims of this study were to investigate the incidence of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty (TKA and THA, respectively). Methods. This retrospective study enrolled 616 consecutive patients, who underwent primary unilateral TKA or THA at our institution during the period from April 2012 to July 2014. The occurrence of a temperature below 36°C during the operation was documented to identify the incidence of hypothermia. Univariate analysis was performed to find the risk factors for hypothermia. Multiple regression analysis and multivariate logistic regression analysis were employed to explore the association of intraoperative temperature and hypothermia with intraoperative blood loss and perioperative blood transfusion. Results. The incidence of intraoperative hypothermia was 13.5%, 14.0%, and 13.1% in TJA, TKA, and THA, respectively. Intraoperative temperature (P = 0.045 , P = 0.006) and hypothermia (P = 0.042 , P < 0.001) were associated with intraoperative blood loss and perioperative transfusion in TKA. Intraoperative temperature (P = 0.002) was negatively related to the amount of blood loss, and hypothermia (P = 0.031) was the independent risk factor for transfusion in THA. Conclusion. Intraoperative hypothermia is associated with increased blood loss and transfusion rates in TJA. Efforts should be made to maintain normothermia during operation in these patients. [ABSTRACT FROM AUTHOR]

Background: Inadvertent intraoperative hypothermia increases the risk of adverse events, but its related risk factors have not been defined in video-assisted thoracoscopic surgery (VATS). This study aimed at analyzing the prevalence and factors related to inadvertent intraoperative hypothermia in adults undergoing elective VATS under general anesthesia. Methods: This was a retrospective study using data from the Peking University People's Hospital from January through December, 2018. Data were collected on age, sex, height, weight, American Society of Anesthesiologists physical status, the duration of preparation and surgery, timing of surgery, surgery types, anesthesia types, intraoperative core temperature and the length of stay (LOS) in the hospital from the electronic database in our center. Patients were covered with a cotton blanket preoperatively and the surgical draping during the operation. A circulation-water warming mattress set to 38 °C were placed under the body of the patients. Inadvertent intraoperative hypothermia was identified as a core temperature monitored in nasopharynx < 36 °C. Multivariate logistic regression analysis was used to identify independent risk factors of hypothermia. Results: We found that 72.7% (95% CI 70.5 to 75.0%) of 1467 adult patients who underwent VATS suffered hypothermia during surgery. The factors associated with inadvertent intraoperative hypothermia included age (OR = 1.23, 95% CI 1.11 to 1.36, p < 0.001), BMI (OR = 1.83, 95% CI 1.43 to 2.35, p < 0.001), the duration of preparation (OR = 1.01, 95% CI 1.00 to 1.02, p = 0.014), the duration of surgery (OR = 2.10, 95% CI 1.63 to 2.70, p < 0.001), timing of surgery (OR = 1.64, 95% CI 1.28 to 2.12, p < 0.001), ambient temperature in the operating room (OR = 0.67, 95% CI 0.53 to 0.85, p = 0.001) and general anesthesia combined with paravertebral block after induction of anesthesia (OR = 2.30, 95% CI 1.31 to 4.03, p = 0.004). The average LOS in the hospital in the hypothermia group and the normothemic group was 9 days and 8 days, respectively (p < 0.001). Conclusions: We highlight the high prevalence of inadvertent intraoperative hypothermia during elective VATS and identify key risk factors including age, duration of surgery more than 2 h, surgery in the morning and general anesthesia combined with paravertebral block (PVB) after intubation. We also find that hypothermia did prolong the LOS in the hospital. [ABSTRACT FROM AUTHOR]

Background: Postanesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication. The main purpose of this meta-analysis was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering. Methods: We searched the following databases: Medline, Embase, and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome observed was the difference of the incidence rate of postanesthetic shivering between ketamine group and placebo group. The secondary outcomes were the sedation score and incidence of the side effects caused by ketamine and any other drugs utilized in the studies. Results: In this meta-analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P<0.01). Regarding side effects, there was no evident variability of the incidence of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo. Hallucinations were more frequently observed in patients who received higher doses of ketamine. No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions. Conclusions: Ketamine can prevent postanesthetic shivering without severe side effects. However, ketamine shows no advantage over other anti-shivering drugs. [ABSTRACT FROM AUTHOR]

Background and purpose — Periprosthetic joint infection (PJI) remains a devastating complication following total knee or total hip arthroplasty (TKA/THA). Nowadays, many studies focus on preventive strategies regarding PJI; however, the potential role of anesthesia in the development of PJI remains unclear. Patients and methods — All consecutive patients undergoing elective primary unilateral TKA or THA from January 2014 through December 2017 were included. Exclusion criteria included femoral fractures as the indication for surgery and previously performed osteosynthesis or hardware removal on the affected joint. Age, sex, BMI, ASA classification, type of arthroplasty surgery, type of anesthesia, duration of surgery, smoking status, and intraoperative hypothermia were recorded. Propensity score-matched univariable logistic regression analysis was used to control for allocation bias. Results — 3,909 procedures consisting of 54% THAs and 46% TKAs were available for analysis. 42% arthroplasties were performed under general anesthesia and 58% under spinal anesthesia. Early PJIs were observed in 1.7% of the general anesthesia group and in 0.8% in the spinal anesthesia group. The multivariable logistic regression model demonstrated an odds ratio for PJI of 2.0 (95% CI 1.0–3.7) after general anesthesia relative to the propensity score-matched patients who received spinal anesthesia. Interpretation — These results suggest a potential association between general anesthesia and early PJI. Future research using large-scale data is required to further elucidate this clinically relevant association. [ABSTRACT FROM AUTHOR]

Objective: Operative hysteroscopy is considered a minimally invasive and effective treatment approach for submucosal uterine leiomyoma, endometrial polyps, Müllerian anomalies, and other conditions that result in abnormal uterine bleeding and/or infertility. Given the systemic absorption inherent in resectoscopic surgery, the primary aim of this study was to determine if warming distention-fluid medium during operative hysteroscopy performed under intravenous (IV) sedation with monitored anesthesia care would affect patients' perioperative core body temperatures, and secondarily, to assess patients' postoperative self-rated pain scores. Materials and Methods: For this single-blinded, 3-armed, stratified randomized trial (Level 2b Oxford Centre for Evidence-based Medicine Levels of Evidence 2009), 96 patients from a minimally invasive gynecologic surgery clinic in an academic-affiliated community hospital were enrolled. A computer-generated randomization sequence was used to allocate patients randomly to 3 groups. Group 1 had normal saline-distention medium-fluid bags at room temperature, defined as 22°C (71.6°F). Group 2 had fluid bags pulled from a warming-cabinet set at 40°C (104°F) as standardized by the Joint Commission on National Quality Approval. Group 3 had continuously warmed fluid by an automated fluid-management system with a function that warms the distention medium to 40°C (104°F) continually. Randomization was stratified by procedure type (myomectomy and nonmyomectomy), so that 50% of the cases for each fluid-temperature category included resections of submucosal leiomyomas. Pre- and postoperative near-core body temperatures and pain scores; operative times; and hysteroscopic fluid temperatures, pressures, and fluid deficits were recorded. Intention-to-treat analysis was performed. Results: There was no statistically significant differences among the 3 arms of the trial for the primary outcome of near-core body temperature or for the secondary outcome of self-rated pain scores. However, when comparing patients undergoing hysteroscopic myomectomy with patients undergoing nonmyomectomy hysteroscopic procedures, there were higher fluid deficits and operative times in the hysteroscopic myomectomy patients in groups 1 and 2 (room-temperature fluid and passively warmed fluid, respectively), but not in group 3 (continuously warmed fluid). Group 3 had no statistically significant differences in average fluid deficit, when comparing hysteroscopic myomectomy to all other procedure types. This finding held true although there was no statistically significant differences in total procedure times between the myomectomy procedures and all other surgical procedure types within group 3. Conclusions: Warming hysteroscopic distention media did not affect near-core body temperature or postoperative pain scores. Use of continuously warmed hysteroscopic fluid in hysteroscopic myomectomy might decrease operative times as well as volume of hysteroscopic fluid deficits. Use of an automated fluid-management system that has the capacity to warm fluid-distention medium continuously can be advantageous to gynecologic surgeons, as this intervention is simple, low-cost, and safe. Further studies to assess the relationship between the temperature of distention medium and surgical outcomes are recommended, specifically surrounding the relationship between operative times and fluid absorption. [ABSTRACT FROM AUTHOR]

Introduction: Data on management of severe accidental hypothermia published from an established high-volume extracorporeal membrane oxygenation centre are scarce. Methods: A total of 28 patients with intravesical temperature lower than 28°C on admission were either treated with veno-arterial extracorporeal membrane oxygenation or rewarmed conservatively. Results: A total of 10 patients rewarmed on veno-arterial extracorporeal membrane oxygenation (age: 37 ± 12.6 years) and 18 conservatively (age: 55.2 ± 11.2 years) were collected over a course of 5 years. The dominant cause was alcohol intoxication with exposure to cold (39%), 12 patients were resuscitated prior to admission. The admission temperature in the extracorporeal membrane oxygenation group (23.8 ± 2.6°C) was lower than in the non–extracorporeal membrane oxygenation group (26.0 ± 1.5°C, p = 0.01). The peripheral percutaneous veno-arterial extracorporeal membrane oxygenation was always cannulated in malignant arrhythmias causing refractory cardiac arrest. The typical extracorporeal membrane oxygenation blood flow was 3-4 L/minute and sweep gas flow 2 L/minute, the median extracorporeal membrane oxygenation duration was 48.3 (28.1-86.7) hours. The median rates of rewarming did not differ (0.41 (0.35-0.7)°C/hour in extracorporeal membrane oxygenation and 0.77 (0.54-0.98)°C/hour in non–extracorporeal membrane oxygenation, p = 0.46) as well as the admission arterial lactate, pH and potassium. Their development was not different between the groups except for higher pH between the third and ninth hour of rewarming in the extracorporeal membrane oxygenation group. The hospital mortality was 10% in the extracorporeal membrane oxygenation group and 11.1% in the non–extracorporeal membrane oxygenation group with the median last Glasgow Coma Scale 15 and Cerebral Performance Score 1. Conclusion: Veno-arterial extracorporeal membrane oxygenation for severe hypothermia shows promising outcome data collected in an extracorporeal membrane oxygenation/extracorporeal cardiopulmonary resuscitation centre located in a European urban area. Except for presence of refractory cardiac arrest, the established hypothermia-related prognostic indicators did not differ between patients in need for extracorporeal membrane oxygenation and those rewarmed without extracorporeal membrane oxygenation. [ABSTRACT FROM AUTHOR]

Hypothermia is associated with a higher risk of perioperative complications and occurs frequently after total joint arthroplasty (TJA). The incidence of hypothermia following total joint arthroplasty was assessed with its risk factors and its correlation with PJI. Correlation of hypothermia with age, gender, BMI, type of arthroplasty surgery, type of anesthesia, operation time, blood loss, date of surgery and PJI was evaluated in 2600 patients. Female gender and spinal anesthesia increased the risk for hypothermia whereas an increased BMI and surgery duration correlated decreased the risk of hypothermia. The incidence of hypothermia decreased over time without a correlation with PJI. [ABSTRACT FROM AUTHOR]

General anaesthesia disrupts thermoregulation in mammals, which can cause hypothermia. Decreases in core body temperature of 1℃ cause significant postoperative complications in humans, and peri-anaesthetic hypothermia in mice increases data variability, which can potentially increase animal use. In rats, the impact of different temperature management strategies on the incidence and severity of hypothermia, and the accuracy of different temperature measurement methods, is unknown. Eighteen adult male and female SD rats were block-randomized to one of three treatment groups: no-warming (NW), limited-warming (LW, heat pad during anaesthesia), and pre-warming (PW, warm air exposure before anaesthesia, followed by heat pad). Anaesthesia (isoflurane) duration was for 40 min. Core body temperature (intra-abdominal telemetric temperature capsule) was recorded during anaesthesia and recovery. During anaesthesia, rectal, skin, and tail temperatures were also recorded. In the PW group, core temperature was maintained during anaesthesia and recovery. By contrast, the NW group was hypothermic (11% temperature decrease) during anaesthesia. The LW group showed a decrease in temperature during recovery. Recovery to sternal recumbency was significantly faster in the PW (125 [70–186] s, P = 0.0003) and the LW (188 [169–420] s, P = 0.04) groups than in the NW group (525 [229–652] s). Rectal temperature underestimated core temperature (bias −0.90℃, 95% limits of agreement −0.1 to 1.9℃). Skin and tail temperatures showed wide 95% limits of agreement, spanning 6 to 15℃, respectively. The novel strategy of PW was effective at maintaining core temperature during and after anaesthesia. Rectal temperature provided an acceptable proxy for core body temperature. [ABSTRACT FROM AUTHOR]

Temperature monitoring is a critically important aspect of patient care; however, hypothermia may not always be detected at initial onset due to a lack of temperature monitoring and implemented guidelines. The following study aimed to identify potential risk factors and patterns in the development of hyperthermia postoperatively and whether differences exist between the use of axilla and tympanic thermometers. Immediate recognition and intervention of hypothermia is critical in the Post Anaesthetic Care Unit (PACU) as it can lead to serious post-operative complications, a longer PACU stay and increased hospital costs (Connor & Wren, 2000). [ABSTRACT FROM AUTHOR]

Copyright of Journal of Raptor Research is the property of Raptor Research Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of high-risk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia. Methods: A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth. Results: A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia. Conclusion: Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants. [ABSTRACT FROM AUTHOR]

Background: Hypothermia is a rare, but potentially fatal adverse effect of antipsychotic drug (APD) use. Although the opposite condition, hyperthermia, has been researched extensively in the context of the malignant antipsychotic syndrome, little is known about hypothermia due to APDs. Objective: This study aimed to review the literature on hypothermia in the context of APD use, and formulate implications for research and clinical care. Methods: A systematic search was made in PubMed and Ovid Medline. Results: The literature search yielded 433 articles, including 57 original case descriptions of hypothermia developed during APD use with non-toxic plasma levels. All cases together indicate that the risk of developing hypothermia is highest during the 7 days following initiation, or increase in dosage, of APDs, especially in the presence of additional predisposing factors, such as advanced age, exposure to cold, adjuvant use of benzodiazepines, and (subclinical) hypothyroidism. In addition, data derived from drug-monitoring agencies suggest that the prevalence of APD-related hypothermia is at least 10 times higher than suggested by the literature. Conclusion: We conclude that health-care professionals need to monitor the body temperature of patients starting with (an increased dose of) APDs for a duration of 7–10 days to prevent hypothermia, especially in the presence of multiple risk factors. Moreover, systematic studies are needed to establish the actual prevalence of APD-related hypothermia as well as the relative risk for individual APDs. [ABSTRACT FROM AUTHOR]

The postmortem diagnosis of hypothermia remains problematic even in the era of molecular and digital diagnostic advances. Gross hemorrhages in iliopsoas muscles have been regarded as a helpful diagnostic sign in hypothermia fatalities; nevertheless, they have received marginal attention since their original description. The present study attempts to fill that void by examining occurrence, localization, and diagnostic significance of the bleeding into the core muscles as evidence of death due to hypothermia in a series comprising 51 consecutive hypothermia autopsy cases. Hemorrhages into the core muscles were identified in 33 cases of fatal hypothermia (65%). Hemorrhages were present in iliopsoas muscles (19 cases; 37%), deep back muscles (18 cases; 35%), and in other core muscular groups such as the diaphragm, cervical, pectoral, and intercostal muscles (11 cases; 22%). The results of the study offer an attractive diagnostic opportunity and reaffirm the potential of the careful core muscle dissection for the clarification of hypothermic deaths. Centers lacking high-end imaging technologies and molecular postmortem programs may especially benefit, which may have implications in broader autopsy practice. [ABSTRACT FROM AUTHOR]

In cases of death caused by hypothermia, histological analysis can be used to determine the cause of death. Certain histological alterations of the pituitary glands in hypothermia have been reported in the literature, including haemorrhage, hyperaemia and cellular vacuolization of cells in the anterior lobe. In the present study, the validity of these morphological alterations as markers for fatal accidental hypothermia was investigated in autopsy material. A total of 34 pituitary glands in cases of verified fatal accidental hypothermia were examined histologically (haematoxylin and eosin, ferric, azan) and immunohistochemically (LCA, ACTH, C5b-9). The findings were compared with 61 cases in a control group. Hyperaemia was found in 50.0% of the study group cases and 59.0% of the control group cases. Cellular vacuolization was observed in one case (2.9%) in the study group and one case (1.6%) in the control group. Acute or recent haemorrhage in the glandular tissue was never detected. In our study, the histopathological characteristics described in the literature as pathognomonic for hypothermia could not be confirmed. Furthermore, histological differences in the pituitary glands between fatal hypothermia cases and control group cases were not observed. [ABSTRACT FROM PUBLISHER]

Shortly after the injury process, a swelling of the soft skin tissue in the fracture area is formed, often preventing an immediate operation of the fracture. Our work aims for reducing the swelling and to accelerate the swelling decline. This is achieved by considering the spatial distribution of inflammation and applying mild local hyperthermia. Therefore it is necessary to investigate how the inflammation has spread out nearby the fracture tissue. In order to locate the focus of inflammation, a time-dependent monitoring with a temperature sensor mat is necessary. Temperature sensors should be arranged in a netlike style in order to measure a skin area as large as possible under the support bandage. The spatially optimal necessary distance between the sensors is determined by analyzing and evaluating temperature gradients on infrared images of ankle fractures. [ABSTRACT FROM AUTHOR]

Background: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. Methods: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications. Information regarding hemodynamic alterations, temperature variability, fluid-electrolyte imbalance, coagulation abnormalities and alterations in the anesthesia course was specifically noted. Results: Among the important complications observed were aneurysm rupture (2.5%), vasospasm (6.67%), thromboembolism (4.16%), contrast reactions, hemodynamic alterations, electrolyte abnormalities, hypothermia, delayed emergence from anesthesia, groin hematomas and early postoperative mortality (5.14%). Conclusion: Awareness of the unique challenges of endovascular neurosurgery and prompt and appropriate management of the associated complications by an experienced neuroanesthesiologist is vital to the outcome of these procedures. [ABSTRACT FROM AUTHOR]

Background and Objective: Correct interhospital transfer of neonates is an important factor in reducing their mortality. This study aimed at determining the prevalence and factors affecting the clinical complications of infants transferred to the Neonatal Intensive Care Unit of Besat Hospital within a year. Methodology: This cross-sectional study included all newborns transferred from the province cities to our center from October 2012 to September 2013 for 1 year. The clinical conditions were recorded during the transfer until arrival to the ward and the collected data were analyzed to determine the factors associated with clinical complications. Results: A total of 100 infants were enrolled in the study. The mean gestational age and the mean birth weight were 37.5 ± 1.8 weeks and 2800 ± 605 g, respectively. The reasons for neonate transfer were respiratory diseases (58%), need for surgery (21%), central nervous system diseases (9%), acute kidney injury (4%), fulminant sepsis (6%), and pathologic jaundice (2%). The mean time of transfer was 84 ± 42 min, being more than 120 min in 17% of the infants. Clinical complications occurred in 32% of the newborns with hypotension (18%) and hypothermia (9%) as the most common clinical complications and acidosis and hypercapnia as the most common laboratory abnormalities caused by transfer. Univariate analysis to evaluate the risk factors associated with complications revealed that gestational age of <37 weeks (preterm), mean birth weight, and intubation before transfer had a significant association with transfer complications. Conclusion: Interhospital transfer of neonates can increase the risk of complications, and since identification of infants requiring transfer is not possible before birth in all cases, it is necessary to develop an appropriate caring strategy and the transfer should be performed by an experienced team with adequate equipment. [ABSTRACT FROM AUTHOR]