BACKGROUND This study aimed to assess cardiac and pulmonary pathophysiological responses during cooling and extracorporeal life support (ECLS) rewarming in a porcine model of deep hypothermic cardiac arrest (DHCA). In addition, we evaluated whether providing a lower flow rate of ECLS during the rewarming phase might attenuate cardiopulmonary injuries. METHODS Twenty pigs were cannulated for E...

INTRODUCTION Treatment with hypothermia has been shown to improve outcome after cardiac arrest (CA). Current consensus is to rewarm at 0.25-0.5 °C/h and avoid fever. The aim of this study was to investigate whether active rewarming, the rate of rewarming or development of fever after treatment with hypothermia after CA was correlated with poor outcome. METHODS This retrospective cohort study ...

OBJECTIVE Deep hypothermia is used as a neuroprotectant during cardiac surgery utilizing deep hypothermic circulatory arrest (DHCA), although the ideal rewarming strategy is not known yet. Some of the neuroprotective properties of hypothermia seem to be mediated by Nuclear Factor Kappa B (NFκB) as an important transcription factor. The current study was designed to investigate the effect of the...

OBJECTIVE Triggering of tissue factor (TF)-mediated blood coagulation leads to the development of disseminated intravascular coagulation during rewarming from hypothermia. We studied post-rewarming TF levels, activity, and surface redistribution, along with the regulation of TF gene transcription in mononuclear cells (MNCs) obtained from an in vivo rat model. METHODS AND RESULTS Rewarming aft...

Accidental hypothermia is an acute medical emergency with a high mortality rate. Physiologic derangements include hypoxemia, hypotension, acidosis, and arrhythmias. Management consists of careful monitoring rewarming, vigorous supportive care, and treatment of underlying and complicating disorders. Active core rewarming is recommended for hypothermia with associated cardiovascular insufficiency...

Rewarming from accidental hypothermia is often complicated by "rewarming shock," characterized by low cardiac output (CO) and a sudden fall in peripheral arterial pressure. In this study, we tested whether epinephrine (Epi) is able to prevent rewarming shock when given intravenously during rewarming from experimental hypothermia in doses tested to elevate CO and induce vasodilation, or lack of ...

To examine the changes in breathing that occur during progressive hypothermia and rewarming in neonatal rats, we cooled and rewarmed rat pups during the first 6 days of life. During cooling, breathing stopped when rectal temperature (Tr) fell below 10.7+/-0.24 degrees C, and recovered spontaneously during rewarming when Tr reached 13.3+/-0.38 degrees C, regardless of age. During cooling, breath...

The consequences of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy are poorly understood. Adverse effects from suboptimal rewarming could diminish neuroprotection from hypothermia. Therefore, we tested whether rewarming is associated with apoptosis. Piglets underwent hypoxia-asphyxia followed by normothermic or hypothermic recovery at 2 hours. Hypothermic groups were divid...

Objectives: Temperature management during cardiopulmonary bypass (CPB) has an established influence on surgical outcomes. The purpose of this study was to examine the relationship of the minimum temperature, duration of hypothermia, rewarming rate and peak rewarming temperature to post-surgical outcomes. Methods: Analysis of 2259 patients undergoing isolated on-pump CABG. Outcomes included 30da...