Advances in the effect of body temperature on perioperative neurocognitive disorders in elderly patients / 中华老年医学杂志

Perioperative neurocognitive disorders(PND)is a common complication after surgery or anesthesia, especially in elderly patients.The effects and mechanism of body temperature on PND are still controversial.In this paper, the relationship between body temperature and PND and its possible mechanism of action were discussed based on some research results of perioperative body temperature management in elderly patients, aiming at suggesting the significance of body temperature management in preventing PND.

Efeitos oxi-hemodinâmicos de diferentes banhos no leito: ensaio clínico randomizado cruzado / Efectos oxihemodinámicos de diferentes baños en cama: ensayo clínico aleatorizado cruzado / Oxy-hemodynamic effects of different bed baths: a randomized crossover clinical trial

Resumo Objetivo Comparar o tempo de execução do banho no leito pelo método tradicional e a seco e seus efeitos sobre as alterações oxi-hemodinâmicas em pacientes críticos. Métodos Ensaio clínico randomizado crossover, aberto, com 50 pacientes submetidos aos dois tipos de banho no leito: tradicional e a seco. Avaliou-se o tempo de execução dos banhos e as variáveis oxi-hemodinâmicas (temperatura timpânica e axilar, saturação de oxigênio arterial, frequência respiratória, frequência cardíaca e pressão arterial média), obtidas no início dos banhos, aos dez minutos, no início e no fim da lateralização dos pacientes, ao final do procedimento e 15 minutos depois. Para análise utilizou-se Teste T de Student pareado e modelo de equações de estimação generalizadas. Resultados O banho no leito a seco foi executado em menor tempo que o tradicional (18,59 versus 26,45 minutos; p<0,001). No banho tradicional, ao longo do tempo, houve redução da temperatura axilar e elevação da frequência respiratória (p<0,001). No banho a seco, apenas a temperatura axilar sofreu alteração, tornando-se menor que o valor inicial (p<0,001). Conclusão O banho a seco foi superior ao tradicional em decorrência do menor tempo de execução e menor instabilidade oxi-hemodinâmica dos pacientes entre os períodos observados. A monitorização dos pacientes é fundamental para identificar tais alterações.

Resumen Objetivo Comparar el tiempo de ejecución del baño en cama mediante el método tradicional y a seco y sus efectos sobre las alteraciones oxihemodinámicas en pacientes críticos. Métodos Ensayo clínico aleatorizado crossover, abierto, con 50 pacientes sometidos a dos tipos de baño en cama: tradicional y a seco. Se evaluó el tiempo de ejecución de los baños y las variables oxihemodinámicas (temperatura timpánica y axilar, saturación del oxígeno arterial, frecuencia respiratoria, frecuencia cardíaca y presión arterial promedio), obtenidas al comienzo de los baños, a los diez minutos, al comienzo y al final de la lateralización de los pacientes, al final del procedimiento y 15 minutos después. Para el análisis se utilizó el Test-T de Student pareado y el modelo de ecuaciones de estimación generalizadas. Resultados El baño en cama a seco fue ejecutado en menor tiempo que el tradicional (18,59 versus 26,45 minutos; p<0,001). En el baño tradicional, a lo largo del tiempo, hubo reducción de la temperatura axilar y elevación de la frecuencia respiratoria (p<0,001). En el baño a seco, solo la temperatura axilar estuvo alterada, fue menor que el valor inicial (p<0,001). Conclusión El baño a seco fue superior al tradicional como consecuencia del menor tiempo de ejecución y menor inestabilidad oxihemodinámica de los pacientes entre los períodos observados. El monitoreo de los pacientes es fundamental para identificar tales alteraciones.

Abstract Objective To compare the bed bath execution time using the traditional and dry method and its effects on the oxy-hemodynamic changes in critically ill patients. Methods This is a crossover, open, randomized clinical trial, with 50 patients submitted to two types of bed bath: traditional and dry. The duration of the baths and the oxy-hemodynamic variables (tympanic and axillary temperature, arterial oxygen saturation, respiratory rate, heart rate and mean arterial pressure), obtained at the beginning of the baths, at ten minutes, at the beginning and at the end of patient lateralization, at the end of the procedure and 15 minutes later. Paired Student's t-test and generalized estimating equations model were used for analysis. Results Dry bed bath was performed in less time than the traditional bath (18.59 versus 26.45 minutes; p<0.001). In traditional bath, over time, there was a reduction in axillary temperature and an increase in respiratory rate (p<0.001). In the dry bath, only the axillary temperature changed, becoming lower than the initial value (p<0.001). Conclusion Dry bath was superior to the traditional one, due to the shorter time of execution and lesser oxy-hemodynamic instability of patients between the periods observed. Monitoring patients is essential to identify such changes.

Thermoregulation in Hypertensive Rats during Exercise: Effects of Physical Training / Termorregulação durante o Exercício em Ratos Hipertensos: Efeitos do Treinamento Físico

Abstract Background: Spontaneously hypertensive rats (SHR) show deficit in thermal balance during physical exercise. Objective: To assess the effects of low-intensity physical exercise training on thermal balance of hypertensive rats undergoing an acute exercise protocol. Methods: Sixteen-week-old male Wistar rats and SHR were allocated into four groups: control Wistar rats (C-WIS), trained Wistar (T-WIS), control SHR (C-SHR) and trained SHR (T-SHR). Treadmill exercise training was performed for 12 weeks. Blood pressure, resting heart rate and total exercise time was measured before and after the physical exercise program. After the exercise program, a temperature sensor was implanted in the abdominal cavity, and the animals subjected to an acute exercise protocol, during which internal body temperature, tail skin temperature and oxygen consumption until fatigue were continuously recorded. Mechanical efficiency (ME), work, heat dissipation threshold and sensitivity were calculated. Statistical significance was set at 5%. Results: Physical training and hypertension had no effect on thermal balance during physical exercise. Compared with C-WIS, the T-WIS group showed higher heat production, which was counterbalanced by higher heat dissipation. Hypertensive rats showed lower ME than normotensive rats, which was not reversed by the physical training. Conclusion: Low-intensity physical training did not affect thermal balance in SHR subjected to acute exercise.

Resumo Fundamento: Ratos espontaneamente hipertensos (SHR) apresentam déficits no balanço térmico durante o exercício físico. Objetivo: Avaliar os efeitos do treinamento físico de baixa intensidade sobre o balanço térmico de ratos hipertensos submetidos a um protocolo de exercício físico agudo. Métodos: Ratos machos Wistar e SHR, com 16 semanas de idade, foram divididos em quatro grupos experimentais: Wistar controle (WIS-C), Wistar treinado (WIS-T), SHR controle (SHR-C) e SHR treinado (SHR-T). O treinamento físico em esteira rolante foi realizado durante 12 semanas. A pressão arterial, a frequência cardíaca de repouso e o tempo de exercício foram medidos previamente e após o programa de treinamento físico. Após o programa de treinamento físico, um sensor de temperatura foi implantado na região intraperitoneal e os ratos foram submetidos a um protocolo de exercício físico agudo com registros contínuos da temperatura corporal interna, temperatura da pele da cauda e do consumo de oxigênio até a fadiga. A eficiência mecânica (EM), o trabalho, o limiar e a sensibilidade para dissipação de calor foram calculados. Para as análises estatísticas o nível de significância adotado foi de 5%. Resultados: O treinamento físico e a hipertensão arterial não alteraram o balanço térmico durante o exercício físico. O grupo WIS-T quando comparado ao WIS-C, apresentou maior produção de calor, que foi contrabalanceado por uma maior dissipação de calor. Os animais hipertensos apresentaram menor EM em comparação aos animais normotensos, e o treinamento físico não foi capaz de reverter esta alteração. Conclusão: O treinamento físico de baixa intensidade não provocou alterações no balanço térmico de ratos hipertensos submetidos a um protocolo de exercício físico agudo.

Factors associated with intraoperative hypothermia in elderly patients and management strategies / 中华老年医学杂志

Objective To investigate the incidence of intraoperative hypothermia in elderly patients,and to analyze and discuss related influencing factors and targeted management strategies.Methods From February 2017 to February 2019,220 elderly patients admitted into our hospital for surgery were selected.According to whether or not they had intraoperative hypothermia,patients were divided into the hypothermia group and the non-hypothermia group.General information and surgical data were compared between the two groups.Measures for the prevention of intraoperative hypothermia were discussed.Results Of the 220 patients,103 had intraoperative hypothermia,and the incidence rate was 46.8％.The proportion of patients aged ≥70 years or with BMI ＜24 kg/m2 was higher in the hypothermia group than in the non-hypothermia group (all P ＜ 0.05).The proportion of patients with the anesthesia time ≥60 min or total intraoperative fluid intake ≥2000 ml was higher in the hypothermia group than in the non-hypothermia group(all P＜0.05).BMI ＜24 kg/m2 and total intraoperative fluid intake ≥ 2000 ml were the key risk factors for intraoperative hypothermia in elderly patients(all P＜0.05).Conclusions Intraoperative hypothermia is a common complication for elderly patients undergoing surgery.Intraoperative fluid intake and body mass are the key risk factors for intraoperative hypothermia.Targeted treatment measures based on the above related factors should be considered for elderly patients receiving surgery.

Uhthoff's phenomenon in a patient with multiple sclerosis during the perioperative period for hip surgery. Case report / Fenómeno de Uhthoff en paciente con esclerosis múltiple durante perioperatorio de cirugía de cadera. Reporte de un caso

Abstract Increase in body temperature is associated with neurological deficit exacerbations in patients with multiple sclerosis (MS). These are corrected with the resolution of hyperthermia, in what is known as Uhthoff's phenomenon. A 65-year-old patient with primary progressive MS, admitted because of hip fracture, developed acute respiratory failure in association with elevation in body temperature (38 °C) due to an increase in room temperature. Additional tests ruled out infection, pulmonary thromboembolism, or other concomitant processes. The patient's respiratory condition improved following a change in room temperature and the use of pharmacological treatment for hyperthermia. She was taken to surgery under general anesthesia 3 days after admission, with tight temperature monitoring, and surgery proceeded uneventfully. Anesthetic management in patients with MS is important, requiring close control of body temperature to avoid comorbidities and perioperative complications.

Resumen El aumento de la temperatura corporal se asocia a exacerbación de déficits neurológicos en pacientes con esclerosis múltiple (EM) que se corrigen con la resolución de la hipertermia, proceso denominado fenómeno de Uhthoff. Una paciente de 65 años con EM primaria progresiva, hospitalizada por fractura de cadera, presentó un cuadro de insuficiencia respiratoria aguda en relación al aumento de temperatura corporal (38 °C) debido a un incremento en la temperatura ambiental. Las pruebas complementarias descartaron patología infecciosa, tromboembolismo pulmonar y otros procesos intercurrentes. La paciente presentó mejoría respiratoria tras modificar la temperatura de la habitación y recibir tratamiento farmacológico para la hipertermia. Al tercer día de ingreso fue operada bajo anestesia general con control estricto de temperatura corporal, sin incidencias. Es importante el manejo anestésico en pacientes con EM, siendo el control estricto de la temperatura corporal necesario para evitar comorbilidad y complicaciones perioperatorias.

Study on establishing management programs for hypothermia in trauma patients in emergency department / 中华护理杂志

Objective To establish management programs for hypothermia in trauma patients in emergency department,so as to guide clinical nursing practice and provide references for scientific management of post-traumatic hypothermia.Methods The first draft of management prograns was established by retrieval of trauma-related guidelines and original studies at home and abroad.Two rounds of expert consultation were conducted via Delphi method to finalize the management programs.Results The management programs consisted of 4 first-level items (hypothermia related assessment,prevention and graded intervention,evaluation,coordination with the team),15 second-level items and 36 third-level items.The expert authority scores of two rounds were 0.85 and 0.86.The expert coordination coefficients at all levels ranged between 0.257 and 0.347.Conclusion There were high levels of enthusiasm,authority and team coordination in experts.The management programs can be used as a basis for comprehensive evaluation and scientific management for hypothermia in trauma patients.

Effects of two different warming patterns on body temperature changes in patients undergoing orthopedic surgery / 中国实用护理杂志

Objective To observe the effects of two different warming patterns on body temperature changes in patients undergoing orthopedic surgery. Methods A total of 60 patients undergoing orthopedic surgery under general anesthesia were randomly divided into the observation group and the control group,with 30 cases in each group.In the observation group,the warming blanket was set at 38℃ in an intermittent warming pattern, i.e. every 1 hour heating period was followed by a 40 min interval.In the control group,the warming blanket was set at 38℃in a continuous warming pattern.Anal temperature was continuously monitored during operation to compare the preventive effects of the two warming patterns on hypothermia. Results Anal temperature changes were recorded at 8 time points including pre-anesthesia, the beginning of operation, 30 min, 60 min, 90 min and 120 min after the beginning of operation, completion of operation (after skin closure) and recovery of consciousness. The observation group were(36.68±0.34)℃,(36.69±0.41)℃,(36.60±0.37)℃,(36.54±0.40 )℃,(36.53± 0.49) ℃, (36.50 ± 0.58) ℃, (36.49 ± 0.61) ℃, (36.53 ± 0.52) ℃, the control group were (36.76 ± 0.43) ℃, (36.64±0.40)℃,(36.50±0.39)℃,(36.45±0.41)℃,(36.51±0.52)℃,(36.65±0.42)℃,(36.65±0.44)℃, (36.69±0.44)℃.There were no statistical differences in anal temperature at all time points between the two groups (t=-1.332~1.083, P>0.05). In addition, the comparison of post-operation shivering, skin injury,recovery time of consciousness post-anesthesia,the observation group were,16.67%(5/30),0(0/30), (10.13±6.51)min,the control group were,10.00%(3/30),10.00%(3/30),(10.07±7.49)min,there were not significantly difference between two groups(P>0.05).However,the incidence of sweating during operation in the control group was higher than that of the observation group (χ2=4.286, P<0.05), the observation group was 0(0/30),the control group was 13.33%(4/30). Conclusions Application of warming blanket in an intermittent warming pattern showed a similar preventive effect on hypothermia as the continuous warming pattern in patients undergoing orthopedic surgery. Moreover, intermittent warming reduced the incidences of sweating and skin injury during operation,reduce health care costs.

Effects of rewarming interventions in hypothermia trauma patients:a network meta-analysis / 中华护理杂志

Objective To evaluate the clinical effects of multiple rewarming interventions in adult hypothermia trauma patients.Methods A systematic search of Cochrane Library,PubMed,EMBASE,Scopus,CINAHL,Chinese Biomedical Literature Database (CBM),Chinese Knowledge Infrastructure (CNKI),VIP and Wan Fang Database was carried out to identify all randomized controlled trials(RCTs) and controlled clinical trials(CCTs) that explored the effects of rewarming interventions in adult hypothermia trauma patients.The quality of the literature was evaluated using JBI 2008 RCT and quasi-experimental study evaluation criteria.Data and network plot were analyzed and drawn by ADDIS 1.16.7 software.Results Totally 6 RCTs and 1 quasi-experimental design were included,involving 10 interventions and 619 patients.There was statistically significant difference in body temperature after rewarming between the warm blankets and the forced-air blankets in all rewarming measures.The results of the top three interventions were carbon-fiber heating blanket(set to 42℃),forced-air blankets,warmed intravenous fluids plus blanket which resulted from the primary outcome indicators.The incidence of chills and cold discomfort decreased with the use of forced-air blankets and chemical heat pad as compared with traditional warm blankets,while the heart rate of the patients who used chemical heating pads and continuous heating of carbon fiber blanket were declined more than those used normal blankets.Conclusion The effects of carbon-fiber heating blanket which set to 42°C was the best method in all rewarming interventions.But this conclusion still requires randomized controlled trials with larger sample size to further verify.

Effects of 37℃ Carbon Dioxide Pneumoperitoneum on Core Body Temperature, Systolic Blood Pressure, Heart Rate and Acid-Base Balance: A Randomized Double-blind Controlled Trial

PURPOSE: The purpose of this study was to compare the effects of 21℃ CO₂ and 37℃ CO₂ pneumoperitoneum on body temperature, blood pressure, heart rate, and acid-base balance. METHODS: Data were collected at a 1300-bed university hospital in Incheon, from February through September 2012. A total of 74 patients who underwent laparoscopic colectomy under general anesthesia with desflurane were randomly allocated to either a control group or an experimental group. The control group received 21℃ CO₂ pneumoperitoneum; the experimental group received 37℃ CO₂ pneumoperitoneum. The pneumoperitoneum of the two groups was under abdominal pressure 15 mmHg. Body temperature, systolic blood pressure, heart rate and acid-base balance were assessed at 30 minutes and 90 minutes after pneumoperitoneum, and again at 30 minutes after arriving at the Post Anesthesia Care Unit. RESULTS: Body temperature in the 37℃ CO2 pneumoperitoneum group was significantly higher (F=9.43, p<.001) compared to the 21℃ CO₂ group. However, there were no statistically significant differences in systolic blood pressure (p=.895), heart rate (p=.340), pH (p=.231), PaCO₂ (p=.490) and HCO3- (p=.768) between the two groups. CONCLUSION: Pneumoperitoneum of 37℃ CO₂ is effective for the increase of body temperature compared to pneumoperitonium of 21℃ CO₂, and it does not result in a decrease of blood pressure, heart rate or acid-base imbalance.

Capillary refill time in febrile neutropenia / Tempo de enchimento capilar e neutropenia febril

Summary Introduction: Febrile neutropenia is a major cause of morbidity and mortality in patients presenting this condition following chemotherapy against several malignancies. Objective: To evaluate if capillary refill time (CRT) allows the prediction of poor clinical outcome with or without antibiotic dose escalation. Method: Capillary refill time was assessed in 50 patients with febrile neutropenia at its nadir after chemotherapy admitted to the emergency department at Hospital Universitário de Brasília. All patients included had a minimum average arterial blood pressure of 75 mmHg, O2/FiO2 saturation rate > 300, and 15 points in the Glasgow coma scale. Inclusion depended on at least three of the systemic inflammatory response syndrome (SIRS) criteria, suspected infection, and neutropenia after chemotherapy. Capillary refill time was calculated by pressing the index finger for 15 seconds, and then timing the return to the initial color. We studied whether there is a relationship between CRT and antibiotic escalation. The gold standard used to gravity was the level of lactate. Results: 31 patients had CRT ≥ 3 seconds, which it is associated with increased serum concentration of lactate (> 2 mmol/L; p<0.05). 32 patients underwent antibiotic escalation, which it is associated with CRT ≥ 3 seconds (p<0.01). Conclusion: CRT higher than three seconds was effective to predict antibiotic escalation.

Resumo Introdução: a neutropenia febril é uma das principais causas de morbimortalidade nos pacientes neutropênicos febris pós-quimioterapia para neoplasias diversas. Objetivo: avaliar se o tempo de enchimento capilar (TEC) é capaz de predizer pior desfecho clínico, pelo escalonamento ou não da antibioticoterapia. Método: foi pesquisado o TEC em 50 pacientes neutropênicos febris no nadir de pós-quimioterapia, que deram entrada no departamento de emergência do Hospital Universitário de Brasília. Todos os incluídos estavam com uma pressão arterial média mínima de 75 mmHg, relação saturação de O2/FiO2 > 300 e escala de coma de Glasgow de 15. Os critérios de inclusão foram pelo menos três da síndrome da resposta inflamatória sistêmica (SRIS), suspeita de infecção e neutropenia pós-quimioterapia. O TEC foi calculado através da pressão sobre o indicador por 15 segundos e cronometrado o tempo de retorno à cor inicial. Foi estudado se há relação entre valor encontrado no TEC e escalonamento de antibiótico. O padrão-ouro utilizado para gravidade foi o nível de lactato. Resultados: trinta e um pacientes tiveram o TEC ≥ 3 segundos, que se associou com o aumento da concentração de lactato (> 2 mmol/L; p<0,05). Trinta e dois pacientes tiveram escalonados seus antibióticos, que se associou com o TEC ≥ 3 segundos (p<0,01). Conclusão: o TEC maior que três segundos mostrou-se eficaz para predizer escalonamento de antibiótico.

Risk factors for early postoperative elevation in body temperature in patients undergoing coronary artery bypass grafting / 中华麻醉学杂志

Objective To identify the risk factors for early postoperative elevation in body temperature in patients undergoing coronary artery bypass grafting (CABG).Methods Nine hundred and forty-one patients of both sexes,aged 14-70 yr,were assigned into hyperthermia (≥ 38 ℃) group or non-hyperthermia (＜ 38 ℃) group according to the bladder temperature at 8h after operation.Factors including age,sex,height,weight,complications (hypertension,hyperlipemia,diabetes),history of smoking and drinking,preoperative blood pressure,heart rate,ejection fraction,routine blood examination,routine urine examination,and respiratory function examination,intraoperative cardiopulmonary bypass (CPB) and hormone,operation time,extubation time,duration of stay in the intensive care unit,and blood pressure,heart rate,ejection fraction,routine blood examination,and routine urine examination at the end of operation,and postoperative analgesia were recorded.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for early postoperative elevation in body temperature after CABG.Results Six hundred and ninety patients developed early postoperative elevation in body temperature (73.3％).Logistic regression analysis showed that preoperative respiratory dysfunction,preoperative ejection fraction ≤ 50％ and CPB were independent risk factors for early postoperative hyperthermia after CABG (P ＜ 0.05).Conclusion Preoperative respiratory dysfunction,preoperative ejection fraction≤ 50％ and CPB are independent risk factors for early postoperative elevation in body temperature in patients undergoing CABG.

A finite element thermal analysis of various dowel and core materials.

Aim: Thermal analysis of the temperature and stress distribution of parallel sided, threaded and non-threaded dowels and core materials under thermal loading within a maxillary central incisor using a three dimensional finite element study. Materials and Methods: 3D models of endodontically treated maxillary central incisor with parallel sided, threaded and non- threaded post and core materials were simulated using the ANSYS software. Materials simulated were parallel sided cast gold post and core, parallel sided fibre reinforced composite (FRC) post and core, and parallel sided, threaded, prefabricated stainless steel post and amalgam core. Thermal loads simulating hot (60 degree C/ 333K) and cold (15 degree C/288K) liquid were applied for 15 seconds at the incisal edge. The temperature changes at the selected nodes were obtained on the various post and core materials, interface between post and dentin, interface between core and dentin, within the dentin and within the cement layer. Results: Temperature and stress distribution pattern were represented in numerical and color coding and results interpreted. Thermal stresses arises as a result of temperature changes. A decreased temperature gradient of the metallic dowels and core (T1 hot - 0.002K, T3 hot - 1.071K, T1 cold -0.99K, T3 cold - 0K) were obtained than that of the FRC dowel and core of 1.982K(hot) and1.55K(cold) respectively due to the higher thermal conductivity of the metals. Higher thermal stress values of 3.567 Mpa(hot) and 3.092 Mpa(cold) respectively were obtained for the FRC dowels and higher stress values of 39.679 Mpa(hot) and 57.855 Mpa(cold) respectively were also obtained for the FRC cores. These values indicated that thermal stresses of the FRC dowel and core were greater than that of cast gold dowel and core and prefabricated stainless steel dowel and amalgam core due to its high coefficient of thermal expansion. Maximum stress values of the FRC dowel and core of 1.87 Mpa(hot) and 2.57 Mpa(cold) respectively were also generated in the cement layer, core and metal ceramic crown. The junction of the metal ceramic crown and dentin demonstrated the maximum stress. Higher thermal stress values of 59.162 ± 10 Mpa were obtained in the restoration and the coronal portion of the dentin than the stress levels of .0039 ± 10Mpa in the supporting bone due to an increased thermal expansion. Conclusion: Non-metallic dowel and core materials such as fibre reinforced composite dowels (FRC) generate greater stress than metallic dowel and core materials. This emphasized the preferable use of the metallic dowel and core materials in the oral environment.

Risk of hypothermia in a new olympic event: the 10-km marathon swim

INTRODUCTION: There are no available data addressing the potential clinical risks of open-water swimming competitions. OBJECTIVE: Address the risks of hypothermia and hypoglycemia during a 10-km open-water swimming competition in order to alert physicians to the potential dangers of this recently-introduced Olympic event. METHODS: This was an observational cross-sectional study, conducted during a 10-km open-water event (water temperature 21ºC). The highest ranked elite open-water swimmers in Brazil (7 men, 5 women; ages 21±7 years old) were submitted to anthropometrical measurements on the day before competition. All but one athlete took maltodextrine ad libitum during the competition. Core temperature and capillary glycemia data were obtained before and immediately after the race. RESULTS: Most athletes (83 percent) finished the race with mild to moderate hypothermia (core temperature <35ºC). The body temperature drop was more pronounced in female athletes (4.2±0.7ºC vs. male: 2.7±0.8ºC; p=0.040). When data from the athlete who did not take maltodextrine was excluded, capillary glycemia increased among athletes (pre 86.6±8.9 mg/dL; post 105.5±26.9 mg/dL; p=0.014). Time to complete the race was inversely related to pre- competition body temperature in men (r=-0.802; p=0.030), while it was inversely correlated with the change in capillary glycemia in women (r=-0.898; p=0.038). CONCLUSION: Hypothermia may occur during open-water swimming events even in elite athletes competing in relatively warm water. Thus, core temperature must be a chief concern of any physician during an open-water swim event. Capillary glycemia may have positive effects on performance. Further studies that include more athletes in a controlled setting are warranted.

The Effect of Pre and Intra-Operative Warming Therapy on Tympanic Temperature Changes during Perioperative Phase in Receiving Patients with Total Hip Replacement / 기본간호학회지

The purpose of the study was to investigate the effects of Warming Therapy used with patients consistantly before and during surgery to on changes in their body temperatures. The data were collected from patients in a university hospital in Taegu between December 1, 1998 and May 31, 1999. The subjects were selected from patients who were hospitalized for total hip replacement surgery. Thirty participants were assigned to two groups : experimental(Warming Therapy) group and control group. Each group consisted of 15 patients. The research design was a repeated measurement design, using a nonequivalent control group. The Warming Therapy, using a forced-air warming blanket, that is a, 'Bair Hugger' was applied to subjects in the experimental group. The subjects in the group were treated with the 'Bair Hugger' to warm up the whole body for 40 minutes before surgery and upper body and face during the operation. The core temperature was measured using a tympanic thermometer. The body temperature of the patients was measured 13 times every 15 minutes during the surgery. After the operation the body temperature of the patients was measured 4 times every 15 minutes, from the time of arrivial in the recovery room to the time of leaving the recovery room. The SPSS Win 9.0 program was used for data analysis. Specific methods tested were done using x2-test, t-test, repeated measures ANOVA. The findings of the study are as follows. 1. The first hypothesis, "The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group during the operation", was supported (F=32.16, p=0.000). 2. The second hypothesis, "The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group after the operation", was supported.(F=33.36, p=0.000) 3. During recovery, shivering was observed one patient in the experimental group and seven patients in the control group. In summary, the findings of the study suggest that the "Warming Therapy" applied before and during the surgery was a very effective treatment for surgical patients in maintaining the core temperature during surgery