Use of an Esophageal Heat Exchanger to Maintain Core Temperature during Burn Excisions and to Attenuate Pyrexia on the Burns Intensive Care Unit.

Introduction. Burns patients are vulnerable to hyperthermia due to sepsis and SIRS and to hypothermia due to heat loss during excision surgery. Both states are associated with increased morbidity and mortality. We describe the first use of a novel esophageal heat exchange device in combination with a heater/cooler unit to manage perioperative hypothermia and postoperative pyrexia. Material and Methods. The device was used in three patients with full thickness burns of 51%, 49%, and 45% body surface area to reduce perioperative hypothermia during surgeries of >6 h duration and subsequently to control hyperthermia in one of the patients who developed pyrexia of 40°C on the 22nd postoperative day due to E. coli/Candida septicaemia which was unresponsive to conventional cooling strategies. Results. Perioperative core temperature was maintained at 37°C for all three patients, and it was possible to reduce ambient temperature to 26°C to increase comfort levels for the operating team. The core temperature of the pyrexial patient was reduced to 38.5°C within 2.5 h of instituting the device and maintained around this value thereafter. Conclusion. The device was easy to use with no adverse incidents and helped maintain normothermia in all cases.

The effect of a traditional dance training program on the physical fitness of adults with hearing loss.

The purpose of this study was to evaluate the effect of a traditional dance training program on aerobic capacity and muscle strength of adults with hearing loss. Twenty-three adults with hearing loss were separated into 2 groups. Thirteen subjects (6 men, 7 women, mean age, 25.7 +/- 3.9 years) constituted the intervention group, whereas 10 subjects (5 men, 5 women, mean age, 26.4 +/- 5.9 years) formed the control group. Pretraining and posttraining treadmill tests were performed to determine heart rate (HR peak), peak minute ventilation (VE peak), peak oxygen consumption (VO2 peak, absolute and relative), and time to exhaustion (min). Peak torque of hamstring and quadriceps muscles at angular velocities of 60 degrees /s, 180 degrees /s, and 300 degrees /s was also measured. The intervention group followed a 12-week traditional dance training program, whereas the control group received no training during this period. Repeated measures of multiple analyses of variance were used to test mean differences between the values of both groups. A paired t-test was used to compare the values within each group prior and after program participation. A significance level of 0.05 was used for all tests. Following the 12-week training program, significant improvements in peak physiological parameters were seen for the intervention group for peak minute ventilation, peak oxygen consumption (both absolute and relative), time to exhaustion, and peak torque values between the 2 measurements (initial and final). No significant improvements in peak physiological parameters and peak torque were noticed in the control group. In conclusion, adults with hearing loss can improve their physical fitness levels with the application of a systematic and well-designed traditional dance training program.