PubMed · 15393027
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C V SHEVADE. 1949. Temperature chart; its diagnostic value.. https://pubmed.ncbi.nlm.nih.gov/15393027/
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The heated necrotic element created by a single high intensity focused ultrasound exposure can be considered as the foundation of high intensity focused ultrasound ablation of tumour lesions. In this paper, we studied the effects of exposure dose and focal depth in tissue on heated necrotic elements, using numerical simulation and experiment. The acoustic field of one of the transducers for the Model-JC HAIFU focused ultrasound tumour therapeutic system was modeled using O Neill's equation, and then using this information together with Pennes' bio-heat-transfer-equation and finite difference techniques, the heated necrotic element was simulated numerically. The results showed that the theoretical predictions were basically in agreement with the experimental data for low exposures, but that the experimental values suddenly increased with the increasing exposure and exceeded the theoretical predictions. The element volume from the theoretical prediction and experiment for the heated necrotic element decreased with increasing focal depth in tissue for a given exposure, and the theoretical predictions were a little lower than the experimental ones. Therefore, heated necrotic elements created by high intensity focused ultrasound can be well predicted from a knowledge of ultrasonic biophysics theories.
OBJECTIVE: To explore the changes in the QTc interval during mild hypothermia in neonates receiving extracorporeal membrane oxygenation (ECMO). DESIGN: Twenty seven neonates (median gestation 40 weeks; range 33-41 weeks) enrolled in a pilot study of mild hypothermia were studied during the first five days of ECMO. The first group (N=7) were maintained at 37 degrees C throughout the study period. Subsequent groups (N=5) were cooled to 36 degrees C, 35 degrees C and 34 degrees C respectively for twenty four hours and the final group to 34 degrees C for forty eight hours before being rewarmed to 37 degrees C. Using a 24 h digital monitor, the QT and QTc intervals were recorded continuously during the cooling and rewarming period and validated using standard 12 lead electrocardiograms. Patients were carefully assessed clinically and routine biochemistry (including magnesium and calcium) laboratory tests measured pre ECMO and at timed intervals during cooling and rewarming. RESULTS: The mean difference between the continuous digital and 12 lead ECG values for QTc was -13.3 ms. During the first 24 h of cooling, the mean (95th centile) values for the digitally measured QTc interval at 37 degrees C=431(506) milliseconds (ms); 36 degrees C=459(521) ms; 35 degrees C=445(516) ms; 34 degrees C=465(531) ms; 34 degrees C for 48 h=466(521) ms. During this period overall QTc increased by 3.12 ms (95% confidence intervals 6.17 to 0.84; p=0.04) for each degree fall in body temperature. During rewarming, there was no significant relationship between QTc and temperature change. No serious arrhythmias were during cooling. Using univariate analysis, no relationship was found between QTc and electrolytes, heart rate and blood pressure. CONCLUSIONS: QTc shows significant variability in individuals, and only a small proportion of this can be explained by rectal temperature. Mild hypothermia was not associated with serious cardiac arrhythmias.
OBJECTIVE: To establish whether there is consensus in the management of body temperature in patients with severe traumatic brain injury (TBI) admitted to hospitals in the United Kingdom and Ireland for neurosurgical intensive care. METHODS: Permission was granted from the Society of British Neurosurgeons (SBNS) and the Local Research Ethics Committee to undertake the survey. A senior member of nursing staff from all adult neurosurgical units, excluding our own, was contacted by telephone. RESULTS: All 33 adult neurosurgical centres participated. Six units had a formal written protocol for the management of body temperature. For the remainder (27 units), interest was expressed in a protocol for temperature management particularly for those patients with intractable hyperthermia/fever. Administration of the antipyretic paracetamol was the most common 'first-line' treatment (13 units). Other 'first-line' methods were: circulating air-cooling blankets (9 units), water-filled cooling blankets (6 units), tepid sponging or wet soaks (2 units), convection fans (2 units) and administration of cold fluids via the gut or circulation (1 unit). When 'first-line' methods failed to bring about a fall in temperature, different combinations of these methods were used. CONCLUSIONS: From this survey, it is evident that there is no consensus in the approach to temperature management in neurosurgical intensive care patients with severe TBI. Review and rationalisation of systems of care may be required in an effort to develop evidence-based nationwide guidelines.