• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.138-144
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• 2000

The studies were carried out to investigate the effects of esophageal thermal tube for rewarming in the hypothermia in rabbits. Thiry-one rabbits were continuously cooled with femoral arterio-venous bypass circulation to 25.0${\pm}$0.3$^{\circ}C$(profound hypothermia) of rectal temperature. The experiment was consisted with 3 esophageal thermal tube groups perfused with circulation water at 38${\pm}$1$^{\circ}C$(low, n=12), 42${\pm}$1$^{\circ}C$(medium, n=12), and 45${\pm}$1$^{\circ}C$(high, n=7). Esophageal thermla tube specially constructed double-lumen esophageal tube with circulating warm water at respective htermal grade. With this device, rewarming of the rabbits as follows; High-esophageal thermal tube group(45${\pm}$1$^{\circ}C$)had a more effect on mean arterial pressure(MAP), heart rate(HR), esophageal temperature, and rectal temperature than others groups, but the circulation water at 45$\pm$1$^{\circ}C$ may cause thermal injuries in the esophagus because esophageal temperature increased to 41.1$^{\circ}C$. Medium-esophageal thermal tube group(42${\pm}$1$^{\circ}C$) had a more effect on RR than others groups, but the circulation water at 42${\pm}$1$^{\circ}C$ may also cause thermal injuries in the esophagus if the temperature exceeds 42$^{\circ}C$ for an extended period of time because its esophageal temperature increased to 39.4$^{\circ}C$. Low-esophageal thermal tube group(38${\pm}$1$^{\circ}C$) had a more effect on MAP, RR, and esophageal temperature than others groups. In conclusion, rewarming of the central core in the treatment of profound hypothermia using the esophageal thermal tube perfused with circulation water at 38${\pm}$1$^{\circ}C$ appears to be a ideal alternative safety zone of the temperature of circulation water avoiding thermal injury in esophagus causing by out of order or lower precise thermostat of water bath to that of others groups.

• Korean Journal of Veterinary Research
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• v.39 no.1
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• pp.177-188
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• 1999

The studies were carried out to investigate the effect of recovery in rewarming using the esophageal thermal tube in the deep hypothermia($25{\pm}1^{\circ}C$ ; rectal temp) in rabbits. Fifteen rabbits were divided into control group(n=6), peritoneal dialysis group(n=5) irrigated with dialysate at $42{\pm}1^{\circ}C$, and esophageal rewarming group(n=4) perfused with circulating water at $38{\pm}1^{\circ}C$. Rewarming of the rabbits was performed for 5 hours. MAP, HR, RR, esophageal temp, rectal temp, pH, $pCO_2$, $pO_2$, $Na^+$, and $K^+$ were observed. The results obtained in these experiments were summarized as follows : Esophageal rewarming group($38{\pm}1^{\circ}C$) had more effect on esophageal temperature than other groups. Peritoneal dialysis group($42{\pm}1^{\circ}C$) had more effect on rectal temperature and $pO_2$ than other groups. The both groups also had more effects on MAP, HR, RR, and $pCO_2$ than control group. Three groups had no significant effect on pH, $Na^+$, and $K^+$. In conclusion, we found that the simple, safe, and non-invasive esophageal rewarming method had an effect on the treatment of profound hypothermia as well as the peritoneal dialysis method in spite of the temperature difference between the dialysate and the circulating water, and the circulating water at $38{\pm}1^{\circ}C$ for esophageal rewarming also had an effect on the recovery of deep hypothermia.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.49-54
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• 1994

Postoperative brain damage is one of most serious complications of cardiopulmonary bypass (CPB). To prevent brain damage during CPB, adequate cerebral perfusion for cerebral oxygen demand should be maintained. This study monitored jugular venous oxyhemoglobin saturation ($SjO_2$), which reflects the overall balance of cerebral oxygen supply and demand, intermittently in 10 patients undergoing cardiac surgery. At the initiation of CPB, in spite of a significant decrease in mean arterial pressure, $SjO_2$ did not change, and it was stable during the hypothermic period of CPB. But a significan reduction in $SjO_2$ was observed during the rewarming period, and $SjO_2$ had an inverse linear correlation with esophageal temperature. Furthermore, the percent decrease of $SjO_2$ was related to rewarming speed. Therefore, therapeutic approaches for $SjO_2$ desaturation include slower rewarming, increasing cerebral blood flow, decreasing the cerebral metabolic rate for oxygen, increasing oxygen content, and increasing perfusion flow rate.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.125-130
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• 1997

Separating the patient from hypothermic cardiopulmonary bypass(CPB) before achieving adequate rewarming often results in afterdrop, which can predispose to electrolyte disturbances, arrhythmia, hemodynamic alterations, and shivering-induced increase of oxygen consumption. In an attempt to find an adequate end point temperature of rewarming after hypothermic CPB, 50 pediatric cardiac surgical patients were r ndomly assigned for end point temperature of rewarming of 35.5$^{\circ}C$ (Group 1) or 37t (Group 2), rectal temperature. Thereafter the rectal temperature was measured half, one, four, eight, and 16 hour after arrival to the intensive care unit(ICU), with heart rate and blood pressure. Additionally the rectal temperature was compared with esophageal temperature during CPB, and axillary temperature luring stay in the ICU. Nonpulsatile perfusion with a roller pump was used in all patients and a membrane or bubble oxygenator was used for oxygenation. Both groups were comparable with respect to age, sex, body surface area, total bypass time, and rewarming time. There was no afterdrop in both groups, and there were no statistical differences in the rectal temperatures between two groups. There were also no statistical dilyerences with respect to the heart rate and blood pressure between two groups. At the end of rewarming the esophageal temperature was higher than the rectal temperature. The axil ary temperature measured in ICU was always lower than the rectal temperature. No shivering was noted in all patients. In conclusion, with restoration of rectal temperature above 35.5$^{\circ}C$ at the end of CPB in pediatric patients, we did not observe an afterdrop.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.2
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• pp.220-230
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• 2010

Purpose: This study was done to identify differences in three groups of operative patients (Forced Air Warming, Electrical Blanketrol, Control) for discomfort and pattern of body temperature during surgery and post operatively. Methods: The sample consisted of 3 randomized 3 groups of abdominal surgery patients admitted to an university hospital in D-city : The Bair Hugger and upper body blanket were used with the first group, electrical blanketrol with PVC Film with the second, and the third group was the control. ANOVA was used with the WIN SPSS 17.0 program to analyze the data. Results: Significant differences were found among the three groups for tympanic and esophageal body temperature at 1 hour after starting surgery. There was significant difference in tympanic body temperature during the 15 minute stay in the post anesthetic room. There were no significant differences in thermal discomfort while in the post anesthetic room. or There among the three groups for serum cortisol during surgery. Conclusion: According to the results of this study, application of a Bair Hugger or electrical blanketrol improves maintenance of body temperature of operative patients as well as body temperature of post operative patients, and is a clinically significant warming method providing a more consistent body temperature.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.752-759
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• 1997

Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.