Myocardial Temperature Gradients and Ventricular Fibrillation During Hypothermia

Mouritzen, C; Andersen, Murray N.

doi:10.1016/s0022-5223(19)33398-7

Cited by 39 publications

(4 citation statements)

References 23 publications

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“…between epicardium and endocardium, Figure 6) and the onset of fibrillation. These results are in agreement with those of Mouritzen & Andersen (1965) who showed that, at temperatures above 25°C, fibrillation did not occur with temperature gradients less than 2°C and that below 20°C fibrillation could occur with no measurable gradient.…”

Section: Electrophysiologysupporting

confidence: 93%

The Effect of the Aminosteroid, Org 6001, on Hypothermia‐induced Ventricular Fibrillation in the Cat

Kane

McDonald

Parratt

1979

British J Pharmacology

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The effect of the antidysrhythmic aminosteroid, ORG 6001, on hypothermia‐induced ventricular fibrillation was investigated in cats anaesthetized with pentobarbitone. ORG 6001 (total dose, 10 mg/kg, by intravenous injection) reduced both the incidence of fibrillation and the temperature at which it occurred. The number of animals that survived to 16°C was increased. This protective effect of ORG 6001 could not be explained by changes in respiratory acidosis, plasma concentrations of sodium and potassium, or by changes in the action potential of excised hypothermic ventricular muscle. The hypothermia‐induced elevation of blood lactate was less in cats treated with the aminosteroid. Over a limited temperature range, ORG 6001 prolonged the P wave and QRS duration and shortened the QTC interval. ST segment elevation was slightly reduced in the drug‐treated group. J deflections were observed but were not correlated with the development of fibrillation. The onset of fibrillation was not considered to be due to temperature differences between the myocardium and arterial blood or between localized areas of the left ventricular wall.

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Section: Electrophysiologysupporting

confidence: 93%

The Effect of the Aminosteroid, Org 6001, on Hypothermia‐induced Ventricular Fibrillation in the Cat

Kane

McDonald

Parratt

1979

British J Pharmacology

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“…Due to viability, we had to use Sprague‐Dawley rats for this study and, although these animals have some limitations, they are probably sensitive to hypothermia. Previous reports (32,42), and the findings of our pilot study, showed that prolongation of the hypothermia state to 40 min resulted in 50% mortality with abrupt hypotension and lethal dysrhythmia. Because of these findings, we decided to limit the hypothermia period to 20 min only.…”

Section: Discussionsupporting

confidence: 66%

“…The modest changes of mean arterial pressure, heart rate, cardiac output and the SVR during the fast cooling period, can be explained by the swiftness of the procedure which did not allow the time‐consuming pathophysiological changes to fully occur. Subsequently, at peak hypothermia of 28 °C, a cardiodepressor effect was noticed in response to the hypothermia itself (32), and/or accumulation of lactic acid (33,34) and low pH (35,36).…”

Section: Discussionmentioning

confidence: 99%

Comparison of fast versus slow rewarming following acute moderate hypothermia in rats

Eshel

Reisler

Berkovitch

et al. 2002

Pediatric Anesthesia

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“…In transit to hospital or in hospital, precordial stimulation (chest compressions! ), central vein catheterization have been linked anecdotally to initiation of ventricular fibrillation, often in the presence of acid-base disturbances and coronary vasoconstriction that is found with severe hypothermia (Swan et al 1953;Vandam and Burnap 1959;Westin et al1961;Mouritzen and Anderson 1965;Lloyd and Mitchell 1974;Swain et al 1984). However, when assessing the ability to survive a cardiac arrest in hypothermia one should consider that the time for irreversible cerebral damage after cardiac arrest will be considerably prolonged due to the decreased cerebral metabolism, compared to normal core temperature; at 30ºC 6 min, at 25ºC 10 min, at 20ºC 18 min, at 15ºC 30 min and at 10ºC 60 minutes (Steinman 1986).…”

Section: Circulatory Systemmentioning

confidence: 99%

Accidental hypothermia and local cold injury: physiological and epidemiological studies on risk

Brändström

2013

Acta Anaesthesiol Scand

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PhD dissertation abstractBackground and objective: The objectives were to first determine incidence and contributing factors to cold-related injuries in Northern Sweden, both of those that led to hospitalisation and those that led to fatality. A further aim was to assess post-cooling hand-rewarming responses and the effects of training in a cold environment, both on fingertip rewarming and on function of the autonomic nervous system, to evaluate if there was adaptation related to prolonged occupational cold exposure. Methods: In a retrospective analysis, cases of accidental coldrelated injury with hospital admission in Northern Sweden in 2000-2007 were analysed. Cases of fatal hypothermia in the same region in 1992-2008 were analysed. A cohort of volunteers was studied before and after many months of occupational cold exposure. Subject hand-rewarming response was measured after a cold hand immersion provocation, and was categorised as slow, moderate, or normal in rewarming speed. This cold provocation and rewarming assessment was performed before and after their winter training. Heart rate variability (HRV) was analysed from the same cold provocation/recovery sequences. Results: For the 379 cases of hospitalisation for cold-related injury, annual incidences for hypothermia, frostbite, and drowning were 3.4/100,000, 1.5/100,000, and 1.0/100,000 inhabitants, respectively. Male gender was more frequent for all categories. Annual frequencies for hypothermia hospitalisations increased during the study period. Hypothermia degree and distribution of cases were 20% mild (between 32°C and 35°C), 40% moderate (31.9-28°C), and 24% severe (< 28°C), while 12% had temperatures over 35.0°C. The 207 cases of fatal hypothermia showed an annual incidence of 1.35 per 100,000 inhabitants: 72% in rural areas, 93% outdoors, and 40% found within 100 m of a building. Paradoxical undressing was documented in 30%. Ethanol was detected in femoral vein blood in 43%. Contributing comorbidity was common, including heart disease, previous stroke, dementia, psychiatric disease, alcoholism, and recent trauma. Post-training, baseline fingertip temperatures, and cold recovery

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Myocardial Temperature Gradients and Ventricular Fibrillation During Hypothermia

Cited by 39 publications

References 23 publications

The Effect of the Aminosteroid, Org 6001, on Hypothermia‐induced Ventricular Fibrillation in the Cat

The Effect of the Aminosteroid, Org 6001, on Hypothermia‐induced Ventricular Fibrillation in the Cat

Comparison of fast versus slow rewarming following acute moderate hypothermia in rats

Accidental hypothermia and local cold injury: physiological and epidemiological studies on risk

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