Case of Severe Accidental Hypothermia Cardiac Arrest in a Subtropical Climate and Review of Management.

A patient was brought to the hospital with severe accidental hypothermia due to cold exposure associated with acute alcohol intoxication. Initial bladder core temperature was 21°C (70°F). The patient was agitated and combative with altered mental status and suffered rescue collapse during transport. Initial rhythm was ventricular fibrillation and we initiated a standard advanced cardiac life support (ACLS) protocol with rewarming measures. The patient received 28 mg of epinephrine and 13 shocks. Active and passive rewarming were initiated without extracorporeal rewarming. The patient achieved return of spontaneous circulation (ROSC) at a core temperature of 23.8°C (74.8°F). Patient was discharged 15 days later neurologically intact with no organ damage. The clinical management and implications for further research in severe accidental hypothermia management are discussed. In patients with severe accidental hypothermia (defined as <30°C or <86°F) in cardiac arrest, the optimal rewarming technique, use of epinephrine, and time when defibrillation should be attempted remain controversial. In our patient, the patient achieved ROSC in less than 2 hours with standard ACLS procedures despite a minimal increase in core temperature (21°C to 23.8°C or 70°F to 73.9°F).

Biogeochemical validation of an interannual simulation of the ROMS-PISCES coupled model in the Southeast Pacific / Validación biogeoquímica de una simulación interanual del modelo acoplado ROMS-PISCES en el Pacífico Sudeste

Currently biogeochemical models are used to understand and quantify key biogeochemical processes in the ocean. The objective of the present study was to validate predictive ability of a regional configuration of the PISCES biogeochemical model on main biogeochemical variables in Humboldt Current Large Marine Ecosystem (HCLME). The statistical indicators used to evaluate the model were the bias, root-mean-square error, correlation coefficient and, graphically, the Taylor’s diagram. The results showed that the model reproduces the dynamics of the main biogeochemical variables (chlorophyll, dissolved oxygen and nutrients); in particular, the impact of El Niño 1997-1998 in the chlorophyll (decrease) and oxygen minimum zone depth (increase). However, it is necessary to carry out sensitivity studies of the PISCES model with different key parameters values to obtain a more accurate representation of the properties of the Ocean.

Los modelos biogeoquímicos en la actualidad son utilizados para entender y cuantificar los principales procesos biogeoquímicos que suceden en el océano. El objetivo del presente estudio es validar estadísticamente la habilidad predictiva de una simulación del modelo biogeoquímico PISCES en reproducir la dinámica de las principales variables biogeoquímicas del Ecosistema de la Corriente de Humboldt (ECH). Para evaluar el modelo se utilizaron indicadores estadísticos: sesgo, error de la raíz del cuadrado medio, coeficiente de correlación y gráficamente el diagrama de Taylor. Los resultados muestran que el modelo es capaz de reproducir la dinámica de las principales variables biogeoquímicas (clorofila, oxígeno disuelto y nutriente), captando bien el impacto que tiene El Niño 1997-1998 en la clorofila (disminución) y profundidad de la zona mínima de oxígeno (incremento). Es necesario llevar a cabo estudios de sensibilidad del modelo PISCES usando diferentes valores de los principales parámetros para obtener una mejor representación de las propiedades biogeoquímicas del océano.

Seasonality in marine ecosystems: Peruvian seabirds, anchovy, and oceanographic conditions.

In fluctuating environments, matching breeding timing to periods of high resource availability is crucial for the fitness of many vertebrate species, and may have major consequences on population health. Yet, our understanding of the proximate environmental cues driving seasonal breeding is limited. This is particularly the case in marine ecosystems, where key environmental factors and prey abundance and availability are seldom quantified. The Northern Humboldt Current System (NHCS) is a highly productive, low-latitude ecosystem of moderate seasonality. In this ecosystem, three tropical seabird species (the Guanay Cormorant Phalacrocorax bougainvillii, the Peruvian Booby Sula variegata, and the Peruvian Pelican Pelecanus thagus) live in sympatry and prey almost exclusively on anchovy, Engraulis ringens. From January 2003 to December 2012, we monitored 31 breeding sites along the Peruvian coast to investigate the breeding cycle of these species. We tested for relationships between breeding timing, oceanographic conditions, and prey availability using occupancy models. We found that all three seabird species exhibited seasonal breeding patterns, with marked interspecific differences. Whereas breeding mainly started during the austral winter/early spring and ended in summer/early fall, this pattern was stronger in boobies and pelicans than in cormorants. Breeding onset mainly occurred when upwelling was intense but ecosystem productivity was below its annual maxima, and when anchovy were less available and in poor physiological condition. Conversely, the abundance and availability of anchovy improved during chick rearing and peaked around the time of fledging. These results suggest that breeding timing is adjusted so that fledging may occur under optimal environmental conditions, rather than being constrained by nutritional requirements during egg laying. Adjusting breeding time so that fledglings meet optimal conditions at independence is unique compared with other upwelling ecosystems and could be explained by the relatively high abundances of anchovy occurring throughout the year in the NHCS.

Oxygen: a fundamental property regulating pelagic ecosystem structure in the coastal southeastern tropical Pacific.

BACKGROUND: In the southeastern tropical Pacific anchovy (Engraulis ringens) and sardine (Sardinops sagax) abundance have recently fluctuated on multidecadal scales and food and temperature have been proposed as the key parameters explaining these changes. However, ecological and paleoecological studies, and the fact that anchovies and sardines are favored differently in other regions, raise questions about the role of temperature. Here we investigate the role of oxygen in structuring fish populations in the Peruvian upwelling ecosystem that has evolved over anoxic conditions and is one of the world's most productive ecosystems in terms of forage fish. This study is particularly relevant given that the distribution of oxygen in the ocean is changing with uncertain consequences. METHODOLOGY/PRINCIPAL FINDINGS: A comprehensive data set is used to show how oxygen concentration and oxycline depth affect the abundance and distribution of pelagic fish. We show that the effects of oxygen on anchovy and sardine are opposite. Anchovy flourishes under relatively low oxygen conditions while sardine avoid periods/areas with low oxygen concentration and restricted habitat. Oxygen consumption, trophic structure and habitat compression play a fundamental role in fish dynamics in this important ecosystem. CONCLUSIONS/SIGNIFICANCE: For the ocean off Peru we suggest that a key process, the need to breathe, has been neglected previously. Inclusion of this missing piece allows the development of a comprehensive conceptual model of pelagic fish populations and change in an ocean ecosystem impacted by low oxygen. Should current trends in oxygen in the ocean continue similar effects may be evident in other coastal upwelling ecosystems.