Efficacy of forced-air and inhalation rewarming  by using a human model for severe hypothermia

Goheen, M. S. L.; Ducharme, Michel B.; Kenny, Glen P.; Johnston, Chad E.; Frim, J.; Bristow, Gerald K.; Giesbrecht, Gordon G.

doi:10.1152/jappl.1997.83.5.1635

Cited by 77 publications

(47 citation statements)

References 15 publications

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“…The seven subjects were 22±1.9 (±SD) years old, had a mass of 68.4±11.1 kg and were 1.70±0.07 m tall, with an average surface area of 1.79±0.15 m 2 . The surface area was calculated according to Goheen et al (1997). The subjects were physically active with a _ V O 2 max of 47.2±5.2 and 60.0±11.6 ml kg À1 min À1 for women and men, respectively (with an average _ V O 2 max of 54.5±11.1).…”

Section: Subjectsmentioning

confidence: 99%

Safe cooling limits from exercise-induced hyperthermia

2005

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We evaluated the cooling rate of hyperthermic subjects, as measured by three estimates of deep core temperatures (esophageal, rectal and aural canal temperatures), during immersion in a range of water temperatures. The objective of the study was to compare the three indices of core temperature and define safe cooling limits when using rectal temperature to avoid the development of hypothermia. On 4 separate days, seven subjects (four males, three females) exercised for 45.4+/-4.1 min at 65% V(O2)max at an ambient temperature of 39 degrees C, RH: 36.5%, until rectal temperature (T (re)) increased to 40.0 degrees C (39.5 degrees C for two subjects). Following exercise, the subjects were immersed in a circulated water bath controlled at 2, 8, 14 and 20 degrees C until T (re) returned to 37.5 degrees C. When T (re) reached normothermia during the cooling period (37.5+/-0.05 degrees C), both esophageal (T (es)) (35.6+/-1.3 degrees C) and aural canal (T (ac)) (35.9+/-0.9 degrees C) temperatures were approaching or reaching hypothermia, particularly during immersion in 2 degrees C water (T (es)=34.5+/-1.2 degrees C). On the basis of the heat loss data, the heat gained during the exercise was fully eliminated after 5.4+/-1.5, 7.9+/-2.9, 10.4+/-3.8 and 13.1+/-2.8 min of immersion in 2, 8, 14 and 20 degrees C water, respectively, with the coldest water showing a significantly faster cooling rate. During the immersion in 2 degrees C water, a decrease of only 1.5 degrees C in T (re) resulted in the elimination of 100% of the heat gained during exercise without causing hypothermia. This study would therefore support cooling the core temperature of hyperthermic subjects to a rectal temperature between 37.8 degrees C (during immersion in water >10 degrees C) and 38.6 degrees C (during immersion in water <10 degrees C) to eliminate the heat gained during exercise without causing hypothermia.

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Section: Subjectsmentioning

confidence: 99%

Safe cooling limits from exercise-induced hyperthermia

2005

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“…In case of severely hypothermic, non-shivering volunteers, it reduced the T c afterdrop and increased the rate of rewarming compared to the control condition. In another study using the human model for severe hypothermia (26), FAW reduced the afterdrop by 30-40% and increased the rewarming rate by 6-10 fold as compared to the control condition (31).…”

Section: Forced-air Warming (Faw)mentioning

confidence: 98%

Comparison of Heat Donation Through the Head or Torso on Mild Hypothermia Rewarming

Sran

McDonald

Steinman

et al. 2014

Wilderness & Environmental Medicine

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This study compared head vs. torso warming using a similar source of heat donation. Six subjects were cooled in 8˚C water to either a core temperature of 35˚C or for 60 min. They were then rewarmed by either shivering only, or charcoal heater applied to the head, or torso. There were no significant differences in rewarming rate between the three conditions. Head warming did not inhibit average shivering heat production resulting in greater net heat gain during 35-60 min of rewarming compared to shivering. Head warming is as effective as torso warming for hypothermic victims.Head warming could be a preferred method in some cases: extreme conditions in which removal of the insulation and exposure of the torso to the cold is contraindicated; excessive movement is contraindicated (e.g., severe hypothermia which has a risk of ventricular fibrillation, or potential spinal injury); or if emergency personnel are working on the torso.iii ACKNOWLEDGEMENTS

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“…D) Interno activo: en víctimas con hipotermia severa pero con ritmo cardiaco activo se puede realizar infundiendo líquidos endovenosos calientes, respirando aire u oxígeno caliente y humidificado 45,46 o lavando con suero caliente las cavidades orgánicas como la gástrica, pleural, peritoneal, colónica y/o vesical. Con este método puede elevarse a TCC entre 1-7…”

Section: Aislamiento Y Recalentamientounclassified

Manejo de la hipotermia accidental severa

Avellanas¹,

Ricart²,

Botella³

et al. 2012

Medicina Intensiva

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Resumen La hipotermia accidental es una patología ambiental con unos principios básicos de clasificación y reanimación que sirven tanto para el medio montañoso, marítimo o urbano. Esta patología ha formado parte, junto a la acidosis y la coagulopatía, de la famosa «tríada letal» de las víctimas traumáticas en situación crítica. En su manejo y asistencia está implicada toda una cadena asistencial que se extiende desde la medicina de urgencia prehospitalaria hasta la medicina intensiva, llegando incluso hasta la cirugía cardiaca y/o a los programas de circulación extracorpórea.Una buena clasificación prehospitalaria del grado de hipotermia facilitará su manejo inicial y evitará traslados interhospitalarios o secundarios innecesarios. Lo fundamental es trasladar, con la mayor urgencia posible, a las víctimas hipotérmicas en asistolia o fibrilación ventricular hasta aquellos hospitales que tengan la capacidad tecnológica adecuada para el tratamiento de estas especiales situaciones clínicas.Este artículo, trata de sentar las bases que faciliten un manejo adecuado de la hipotermia accidental desde la primera asistencia prehospitalaria hasta tratamiento final hospitalario, incluyendo la reanimación y el recalentamiento con circulación extracorpórea. © 2011 Elsevier España, S.L. y SEMICYUC. Todos los derechos reservados. KEYWORDSAccidental hypothermia; Classification of hypothermia; Cardiac arrest; Management of severe accidental hypothermiaAbstract Accidental hypothermia is an environmental condition with basic principles of classification and resuscitation that apply to mountain, sea or urban scenarios. Along with coagulopathy and acidosis, hypothermia belongs to the lethal triad of trauma victims requiring critical care. A customized healthcare chain is involved in its management, extending * Autor para correspondencia. Correo electrónico: mlavellanas@ono.com (M.L. Avellanas). 0210-5691/$ -see front matter

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Efficacy of forced-air and inhalation rewarming by using a human model for severe hypothermia

Cited by 77 publications

References 15 publications

Safe cooling limits from exercise-induced hyperthermia

Safe cooling limits from exercise-induced hyperthermia

Comparison of Heat Donation Through the Head or Torso on Mild Hypothermia Rewarming

Manejo de la hipotermia accidental severa

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