Browsing by Author "Radke, O."

In emergency medicine accidental hypothermia in non-traumatized patients is a rare situation. To emphasize the need for a precise preclinical temperature measurement, two cases of accidental hypothermia (28.2 degrees C and 29.3 degrees C core temperature) are presented which occurred under conditions that did not give a direct suspicion of hypothermia. In one case the immediate diagnosis lead to complete convalescence, the other patient died of multiple organ failure. The primary diagnosis, diagnostic methods and therapy as well as the primary treatment are discussed.

Background and objective: The transcerebral double-indicator dilution technique is a recently developed method to measure global cerebral blood flow at bedside. It is based on bolus injection of ice-cold indocyanine green dye and simultaneous recording of resulting thermo- and dye-dilution curves in the aorta and the jugular bulb. However, with this method 40 mL of ice-cold solution is administered as a bolus. Therefore, this prospective clinical study was performed to elucidate the effects of repeated administration of indicator on absolute blood temperature and on cerebral blood flow and metabolism. Methods: The investigation was performed in nine male patients scheduled for elective coronary artery bypass grafting. Absolute blood temperature was measured in the jugular bulb and in the aorta before and after repeated measurements using the transcerebral double-indicator dilution technique. Results: During the investigated time course, the blood temperature in the jugular bulb, compared to the aorta, was significantly higher with a mean difference of 0.21degreesC. The administration of an ice-cold bolus reduced the mean blood temperature by 0.06degreesC in the jugular bulb as well as in the aorta. After the transcerebral double-indicator dilution measurements a temperature recovery to baseline conditions was not observed during the investigated time period. Cerebral blood flow and cerebral metabolism did not change during the investigated time period. Conclusions: Repeated measurements with the transcerebral double-indicator dilution technique do not affect absolute jugular bulb blood temperatures negatively. Global cerebral blood flow and metabolism measurements remain unaltered. However, accuracy and resolution of this technique is not high enough to detect the effect of minor changes of physiological variables.

We present a case of severe accidental hypothermia (core temperature 22degreesC) after a suicide attempt. The initial symptoms and the pre-hospital and hospital treatment are discussed. Additionally, different rewarming strategies for patients with severe accidental hypothermia are compared.

By saving time and improving acceptance, the using of total intravenous anesthesia TIVA offers potential for improved operating room efficiency and cost reduction. A common problem in daily routine is the continuous infusion of several drugs using a single IV line. The TIVA set presented in this paper is a preconfigured solution that allows further standardization while increasing patient safety.