OBJECTIVE To compare the effectiveness of arteriovenous anastomosis (AVA) vs heated intravenous fluid (IVF) rewarming in hypothermic subjects. Additionally, we sought to develop a novel method of hypothermia induction. METHODS Eight subjects underwent 3 cooling trials each to a core temperature of 34.8±0.6 (32.7 to 36.3°C [mean±SD with range]) by 14°C water immersion for 30 minutes, followed ...

We measured afterdrop and peripheral tissue temperature distribution in eight patients cooled to approximately 17°C during cardiopulmonary bypass and subsequently rewarmed to 36.5°C. A nasopharyngeal probe evaluated trunk and head temperature and heat content. Peripheral tissue temperature (arm and leg temperature) and heat content were estimated using fourth-order regressions and integration o...

BACKGROUND Selective cerebral perfusion (SCP) is used for extending the period during which surgical procedures can be safely performed. We sought to determine the direct effects of pH management on cerebral microcirculation and metabolism during SCP. METHODS An experimental SCP porcine model was created by selectively allowing cold perfusate only into the bicarotid brachiocephalic trunk duri...

BACKGROUND AND PURPOSE Moderate hypothermia decreases ischemic damage in experimental stroke models. This multicenter study was performed to evaluate (1) the safety and feasibility of moderate hypothermia and (2) its potential to reduce intracranial hypertension in acute stroke patients. METHODS Fifty prospective patients with cerebral infarction involving at least the complete middle cerebra...

BACKGROUND Neurodevelopmental disabilities persist in survivors of neonatal hypoxic-ischemic encephalopathy (HIE) despite treatment with therapeutic hypothermia. Cerebrovascular autoregulation, the mechanism that maintains cerebral perfusion during changes in blood pressure, may influence outcomes. Our objective was to describe the relationship between acute autoregulatory vasoreactivity during...

In humans, the relative importance of oxidative fuels for sustaining shivering during passive hypothermic recovery or rewarming is still unclear. The main goals of this study were 1) to quantify the respective contributions of lipids and carbohydrates (CHO) during passive rewarming and 2) to determine the effects of precooling exercise on the pattern of fuel utilization. With indirect calorimet...

Background: To evaluate the incidence of Acute Kidney Injury (AKI) during therapeutic hypothermia (TH) and rewarming in comatose patients resuscitated from Cardiac Arrest (CA). Methods: We have performed a pilot study of consecutive comatose patients resuscitated from CA and admitted to our Intensive Care Unit (ICU) from January 2013 to March 2015. The surface cooling devices used were: 1) Arct...

INTRODUCTION Whole-body ischemia and reperfusion trigger a systemic inflammatory response. In this study, we analyzed the effect of temperature on the inflammatory response in patients treated with prolonged mild hypothermia after cardiac arrest. METHODS Ten comatose patients with return of spontaneous circulation after pulseless electrical activity/asystole or prolonged ventricular fibrillat...

Isolated primary hepatocytes, which are widely used for pharmacological and clinical purposes, usually undergo certain periods of cold storage in suspension during processing. While adherent hepatocytes were shown previously to suffer iron-dependent cell death during cold (4 °C) storage and early rewarming, we previously found little iron-dependent hepatocyte death in suspension but severely de...