1/12. resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest.In a victim of very deep accidental hypothermia, 9 h of resuscitation and stabilisation led to good physical and mental recovery. This potential outcome should be borne in mind for all such victims.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/12. hypothermia from prolonged immersion: biophysical parameters of a survivor.We report a case of survival following prolonged immersion and hypothermia. The patient survived for over 9 h in open water, after his vessel capsized and sank in the pacific ocean off the coast of Northern california. water temperature on the day of the sinking was 14.4 degrees C (58.0 degrees F). Although he did have adequate flotation, the patient did not wear a survival suit. On initial physical examination in the Emergency Department (ED), the patient's rectal temperature was 30.0 degrees C (86.0 degrees F). With active rewarming, his temperature returned to normal (37.0 degrees C (98.6 degrees F)) within 5 h. Body fat of the patient was 19.6%, near the 50th percentile for his age (19.0%). Surface/volume ratio of the patient (.0228 m(2)/L) was 19% smaller than a predicted average (.0282 m(2)/L). We believe that the patient's large body habitus contributed to survival and that surface/volume ratio was likely the biophysical variable most closely associated with decreased cooling.- - - - - - - - - - ranking = 6keywords = physical (Clic here for more details about this article) |
3/12. Somatosensory and skin temperature disturbances caused by infarction of the postcentral gyrus: a case report.Somatosensory functions are subdivided into 2 large groups: the elementary somatosensory functions, which consist of light touch, pain, thermal sensation, joint position sense, and vibration sense, and the intermediate somatosensory functions, which include 2-point discrimination, tactile localization, weight, texture, and shape perception. In this report, we describe a patient with somatosensory dysfunction after infarction of the postcentral gyrus. On physical examination a month after the onset of the infarction, voluntary movements were skillful, and both the elementary and intermediate somatosensory functions were disturbed in the right hand. The patient also displayed a decrease in the skin temperature of the right hand. The sensory-evoked potential in response to electrical stimulation of the right median nerve was normal, and brain MRI showed that the infarction was located in the posterior half of the left postcentral gyrus. These findings suggested that the lesion was situated at areas 1 and 2, and that area 3b was preserved. thermography revealed that the skin temperature of the right hand was decreased predominantly on the ulnar side, and that recovery from cooling with ice water was delayed. By comparing the results of our patient with a case report that showed no disturbance of the elementary somatosensory functions with a localized lesion in the postcentral gyrus, we suggest that area 1 participates in the elementary somatosensory functions and that skin temperature may be controlled somatotopically in the somatosensory cortex.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/12. Extensive subcutaneous soft tissue calcification in a neonate following hypothermia: case report.A ten-hour old newborn found in the street where a dog was savaging him, was brought to Black Lion Hospital in 1998. The history, physical findings and radiological features suggested widespread subcutaneous fat necrosis, which later became calcified. Although this is a rare condition, medical workers need to be aware of the possibility of this self-limiting disease, which may occur in abandoned and hypothermic neonates.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/12. Use of an automatic mechanical chest compression device (LUCAS) as a bridge to establishing cardiopulmonary bypass for a patient with hypothermic cardiac arrest.We report the case of a victim of deep accidental hypothermia who was extracted from the ice and received 1.5 h of mechanical chest compression. This was followed with rapid rewarming on cardiopulmonary bypass and resulted in good physical and mental recovery. This management option should be considered for similar victims.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/12. Urban hypothermia.A case is reported of a 23-year-old man who became hypothermic within 4 hours of exposure. Full physical recovery occurred within 5 hours of an asystolic cardiac arrest using simple rewarming techniques.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/12. Recovery after prolonged asystolic cardiac arrest in profound hypothermia. A case report and literature review.Asystole can be the presenting ECG finding of accidental hypothermia when the core temperature is less than 28 degrees C. Even two hours of persistent asystole does not represent irreversible cardiac compromise. With cardiopulmonary support and active rewarming, resuscitation and survival without serious sequelae can be achieved. case reports and electrophysiology studies suggest that asystole is a primary manifestation of hypothermia potentiated by carbon dioxide retention. However, ventricular fibrillation in this setting is probably a secondary complication of resuscitation efforts, being precipitated by hypocapnic alkalosis, physical manipulation of the heart, and rewarming.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/12. Management of profound accidental hypothermia with cardiorespiratory arrest.Complete recovery following rapid rewarming is described in three tourists who were admitted in a state of profound hypothermia with total cardiorespiratory arrest (rectal temperature ranging from 19 to 24 C). In all three patients, respiration and circulation had ceased during the rescue operation. Rapid core rewarming was achieved by thoracotomy and continuous irrigation of the pericardial cavity with warm fluids in one patient, whereas in the other two patients rewarming was accomplished with extracorporeal circulation using femoro-femoral bypass. In the first patient, the heart could not be defibrillated earlier than 90 minutes following thoracotomy; in the other patients rewarming was attained very rapidly, and within half an hour after institution of bypass, resuscitation of the heart was successful. The patients fully recovered their intellectual and physical abilities, despite the prolonged periods of circulatory arrest lasting from 2 1/2 to 4 hours. We conclude that rapid core rewarming is the adequate therapy for profound accidental hypothermia with circulatory arrest or low cardiac output. If feasible extracorporeal circulation represents the method of choice because it combines the advantage of immediate central rewarming with the benefit of efficient circulatory support, the heart is rewarmed before the shell, thus preventing the "rewarming shock" due to peripheral vasodilatation. Resuscitative efforts should be promptly initiated and vigorously pursued, even in the state of clinical death; in profound hypothermia neurologic examination is inconclusive regarding prognosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/12. Treatment of hypothermic circulatory arrest with thoracotomy and pleural lavage.We describe a successful case of severe hypothermia due to coldwater immersion. An eight-year-old boy was saved from cold water (4 degrees C) after forty minutes. Open rewarming and resuscitation was performed by thoracotomy and pleural lavage for cardiac arrest due to the low core temperature (25 degrees C). The patient recovered primarily well without any postoperative complications. The follow-up of two years shows good state of physical health but some neuropsychological defects disturbing normal progress in school work.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/12. A schizophrenic patient who developed extreme hypothermia after an increase in the dose of haloperidol: a case report.A patient with chronic schizophrenia, who had been treated for a long time with chlorpromazine, haloperidol, levodopa, benserazide hydrochloride, diazepam and biperiden, developed extreme hypothermia (about 32 degrees C) when the dose of haloperidol was increased because of a deterioration of the patient's mental symptoms. No other physical manifestations were observed, except bradycardia. The turnover of noradrenaline in the cerebrospinal fluid and blood was increased in association with the hypothermia in this patient. A hypothesis about the involvement of monoamine imbalance in changes in body temperature is discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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