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PubMed1988

Carbon dioxide elimination during total cardiopulmonary bypass in infants and children.

The authors measured the rate of carbon dioxide elimination (VCO2) in 25 pediatric patients (age 2 days to 9 yr) during total cardiopulmonary bypass at average venous blood temperatures ranging from 19.5 to 35.9 degrees C. A multiplexed mass spectrometer was connected to the gas inlet and exhaust ports of the bubble oxygenator, and the gas-phase Fick principle was used to determine VCO2. A curvilinear relationship was found between log VCO2 and venous blood temperature, and a quadratic regression equation (r2 = 0.74) was fit to the data. Q10 (the ratio of VCO2 before and after a 10 degree C temperature change) was estimated to be 2.7 or 3.0, depending on the analytic method used. Venous blood temperature as a predictor variable explained a greater proportion of the variability of log VCO2 than did nasopharyngeal or rectal temperatures. Analysis of covariance revealed that total circulatory arrest during bypass (utilized in 10 patients for 34 +/- 4 min, mean +/- SEM) affected the relationship of venous blood temperature with log VCO2, by increasing the y-intercept (P = .008) but not the slope. These data, with associated 95% prediction intervals, define the expected CO2 elimination rates at various temperatures during standard bypass conditions in our patients. Real-time measurement of VCO2 using mass spectrometry can be a useful routine monitor during CPB that may help to assess patient metabolic function, adequacy of perfusion, and oxygenator performance.

Blood Physiological Phenomena↗

PubMed1998

Influence of maternal dexamethasone administration on thermoregulation in lambs delivered by caesarean section.

We have previously shown that lambs delivered by caesarean section 1 week prematurely become hypothermic due to reduced brown adipose tissue function in conjunction with low plasma concentrations of cortisol and thyroid hormones. The present study therefore aimed to determine whether maternal dexamethasone (a synthetic corticosteroid) administration could improve thermoregulation in premature lambs to the extent that they become similar to term lambs. Lambs were either delivered by caesarean section into a warm (30 degrees C; WD) or cool (15 degrees C; CD) ambient temperature at 140 days of gestation, 2 days after maternal dexamethasone treatment, or at 146 days for controls. During the first 30 min of life the decline in colonic temperature was greater in dexamethasone treated lambs compared with controls delivered into the same ambient temperature. All lambs then restored colonic temperature although this adaptation took longest in dexamethasone treated lambs CD but these subsequently attained highest plateau colonic temperatures. Oxygen consumption, breathing frequency and plasma free fatty acid concentrations were highest in dexamethasone treated lambs CD. There were no differences in plasma thyroid hormones between groups, but cortisol concentrations were lower in dexamethasone treated lambs irrespective of delivery temperature. Analysis of brown adipose tissue samples at 6 h of life demonstrated that dexamethasone treated lambs WD had more uncoupling protein and, in both dexamethasone treated and control lambs, uncoupling protein content was higher in lambs CD compared with those WD. An effect of ambient temperature on thermogenic activity was only observed in the dexamethasone treated group. It is concluded that maternal dexamethasone treatment can significantly improve thermoregulation after birth following premature delivery by caesarean section. As a consequence, dexamethasone treated lambs delivered 1 week prematurely do not remain hypothermic and have higher or similar colonic temperatures compared with untreated lambs born 1-2 days before term.

Adipose Tissue, Brown↗

PubMed1991

Axillary, tympanic, and esophageal temperature measurement: descriptive comparisons in postanesthesia patients.

Body temperature in postanesthesia patients is considered to be an important vital sign; yet, measurement sites may vary from oral to axillary and rectal to tympanic membrane. The reviewed literature indicated that axillary and rectal temperatures are measures of shell temperature and esophageal and tympanic temperatures are measures of core temperature. This study compared temperatures measured with axillary mercury-in-glass and electronic thermometers with those measured by tympanic and esophageal thermometers in 96 postanesthesia patients. Analysis of the data using paired t test indicated there was no significant difference between the esophageal and tympanic temperatures; however, significant differences were found between mercury and electronic axillary temperatures. Analysis of variance indicated no significant difference between the axillary temperatures as measured by mercury and electronic methods in the arm extended on an arm board during surgery. Further studies are needed using a larger, randomly selected sample to validate this study's findings.

Adult↗

PubMed1982

Task categorization and the limits of human performance in extreme heat.

This paper examines human performance limitations in differing task categories in conditions of elevated ambient temperature. Analysis of extant data affirms that decrement in the three task categories, namely: 1.) mental and cognitive skills; 2.) tracking and 3.) dual task performance, may be expected as environmental exposure exceeds 85 degrees F, effective temperature (E.T.). Further, the systematic changes in impairment onset with tasks requiring differing levels of response complexity in varying time, E.T. conditions, are documented. These changes imply earlier heat stress related decrement in those task categories which require greater response complexity. The proposed thresholds of performance impairment are subsequently equated with absolute, physiologically noncompensable, rises in deep body temperature. Support for the notion that prescribed rises in deep body temperature may delimit efficient performance in each category is found in studies which have examined task performance in situations where deep body temperature has been independently manipulated. Performer skill level is posited as potentially most influential in the mitigation of such heat induced decrement.

Body Temperature↗

PubMedDate not supplied

[The relationship between oxygen consumption and the the rate of rewarming during extracorporeal circulation with induced hypothermia].

This study was performed to investigate the relation between total oxygen consumption (VO2) and the velocity of reheating in patients undergoing cardiopulmonary bypass with hypothermia. A total of 17 males undergoing this procedure were studied prospectively (mean age: 63 years, range: 52-72); during surgery they were cooled at 28 degrees C whole-body temperature. Before rewarming, patients were divided at random in two groups. Group A (n = 8) was reheated between 10 and 25 minutes, and group B (n = 9) between 26 and 50 minutes. In group A, VO2 expressed in ml.min-1 x m-2 increased from 76.6 +/- 6.99 at 28 degrees C until 100.0 +/- 6.72 at 34 degrees C; in group B increased from 68.4 +/- 4.55 until 129.1 +/- 4.73 at similar temperatures (analysis of variance: p < 0.01 at 28 degrees C). A greater VO2 in group B could indicate that slow rewarming would cause an even distribution of temperature with enough time for tissues to rid of their oxygen debt.

Aged↗