Retrospective Analysis of Esophageal Heat Transfer for Active Temperature Management in Post-cardiac Arrest, Refractory Fever, and Burn Patients.

Retrospective Analysis of Esophageal Heat Transfer for Active Temperature Management in Post-cardiac Arrest, Refractory Fever, and Burn Patients. Mil Med. 2018 Mar 01;183(suppl_1):162-168 Authors: Naiman M, Markota A, Hegazy A, Dingley J, Kulstad E Abstract Core temperature management is an important aspect of critical care; preventing unintentional hypothermia, reducing fever, and inducing therapeutic hypothermia when appropriate are each tied to positive health outcomes. The purpose of this study is to evaluate the performance of a new temperature management device that uses the esophageal environment to conduct heat transfer. De-identified patient data were aggregated from three clinical sites where an esophageal heat transfer device (EHTD) was used to provide temperature management. The device was evaluated against temperature management guidelines and best practice recommendations, including performance during induction, maintenance, and cessation of therapy. Across all active cooling protocols, the average time-to-target was 2.37 h and the average maintenance phase was 22.4 h. Patients spent 94.9% of the maintenance phase within ±1.0°C and 67.2% within ±0.5°C (574 and 407 measurements, respectively, out of 605 total). For warming protocols, all of the patient temperature readings remained above 36°C throughout the surgical procedure (average 4.66 h). The esophageal heat transfer device met performance expectations across a ...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research

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In patients with severe burn, changes in hemostasis result from trauma itself (e.g. tissue hypoperfusion, hypothermia, altered platelet function, systemic inflammatory response) and from therapeutic interventions (e.g. hemodilution, blood loss due to wound excision) [1 –4]. Results of conventional coagulation assays measured in daily clinical practice [e.g. prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), low platelet count] are often interpreted as coagulopathy implying a bleeding tendency [5].
Source: Burns : Journal of the International Society for Burn Injuries - Category: Cosmetic Surgery Authors: Source Type: research
CONCLUSIONS: As per the results, the investigators believe these hyperthermic- and hypothermic-induced alterations in biomechanical skin properties are due to increased blood flow, in addition to a reversible increase in interstitial and intracellular fluid contents, thermal contraction, and expansion of collagen and elastic fibers, all of which are precursors to irreversible damage. PMID: 30256752 [PubMed - in process]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
This article contributes an example of the onset of severe hypothermia in burn victims due to negligence in thermal insulation.•Key implications for emergency nursing practice found in this article are the awareness of the impact of post-traumatic hypothermia on mortality and the need of careful insulation in burn victims. Maintaining normothermia can increase the chances of patient’s survival.
Source: Journal of Emergency Nursing - Category: Nursing Source Type: research
Publication date: August 2018Source: Burns, Volume 44, Issue 5Author(s): A.D. Rogers, M. Saggaf, N. ZiolkowskiAbstractBackgroundPatients with extensive burn injuries are susceptible to a host of accompanying adverse effects should they develop perioperative hypothermia, which occurs in up to ¼ of all major burn cases. This quality improvement project aimed to reduce the incidence of perioperative hypothermia to below 10% of cases in patients with major burn (Total Body Surface Area [TBSA] >15%), within a one year period.MethodsA baseline diagnostic phase was undertaken to provide a greater understanding of...
Source: Burns - Category: Dermatology Source Type: research
Burns are traumatic acute wounds which can be life-threatening. Despite improvement in burn wound care, severe burns are associated with high morbidity and disability [1,2]. For partial thickness and full thickness burns, acute burn management involves multiple activities including protecting the wound from further injury, initial cleansing and debridement, and determination of dressings with or without a topical antimicrobial agent [3,4]. Fluid resuscitation, prevention of hypothermia and pain management are also critical aspects of burn care and management [2,5].
Source: Burns : Journal of the International Society for Burn Injuries - Category: Cosmetic Surgery Authors: Source Type: research
Discussion The inevitable drop in temperature is ameliorated by sound perioperative practices, rather than just intraoperative ones. This initiative demonstrated the potential benefits of, and motivates for, the broad application of preoperative warming in the context of major acute burn surgery. Further investigations include PDSA cycles to determine whether the duration or degree of intraoperative hypothermia is more virulent. To consolidate the pre-warming initiative, we have introduced a standard order within our admission order sets to include preoperative warming for all eligible patients.
Source: Burns - Category: Dermatology Source Type: research
It is important for physicians treating children to be aware of unique presentation that require expertise and knowledge. Two areas of importance when caring for traumatized children are Thermal Burn Injuries, and Hypothermia. Burns commonly result in morb...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Infants and Children Source Type: news
Burn remains a prominent global health burden, with over 11 million burn injuries requiring medical attention annually, and is a leading cause of traumatic mortality and morbidity [1]. For full thickness and deep partial thickness burns, the widely-accepted practice, after initial critical care assessment and fluid resuscitation, is early excision and autografting [2 –11]. While outcomes are undoubtedly improved because of this approach, early aggressive debridement exposes susceptible patients to the sequelae of hypothermia in the perioperative period [12–14].
Source: Burns : Journal of the International Society for Burn Injuries - Category: Cosmetic Surgery Authors: Source Type: research
Follow me on Twitter @RobShmerling Venturing out in frigid conditions with our golden retriever, I was wishing I had worn another layer or two. And that got me thinking. Sparky’s got a thick coat of fur, but is that enough? Is there more I should be doing for him during cold snaps? On our last walk, I’m pretty sure he would have said yes. In fact, there are a number of things we can do to make sure our pets are safe during the worst of winter. Here are 10 things experts recommend: 1.  When returning from a walk, clean off your pet’s paws and check them for redness or cracks. 2.  Apply petroleum ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Pets Source Type: blogs
Conclusions Patients who undergo prolonged surgeries and become hypothermic are more likely to develop complications. We therefore advocate for diligent adherence to strategies to prevent hypothermia and recommend limiting operative time in clinical circumstances where intraoperative measures are unlikely to adequately prevent hypothermia.
Source: Burns - Category: Dermatology Source Type: research
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