Objective: To compare the physiologic status of infants before and after receiving kangaroo mother care (KMC) through assessment of their heart rate (HR), respiratory rate (RR), temperature, oxygen saturation, and pain scores. Methods: We conducted a retrospective study by chart review of all low-birth weight (LBW) infants enrolled in the KMC program of a tertiary medical center. Significance is defined by lower HR, RR, PIPP score and FLACC scale, and significant increase in temperature and oxygen saturation (within normal range) after 4 hours after each KMC session. Results: Out of the 46 LBW weight infants enrolled in the KMC program, only 23 infants had complete chart entries. A total of 99 KMC sessions were analyzed. There was no significant difference in the HR (p = 0.331), RR (p = 0.453), oxygen saturation (p = 0.839), and PIPP (p = 0.387)/FLACC (p = 0.13) scores among the LBW infants before and after the KMC session. However, there was a significantly higher axillary temperature (within normal range) four hours after KMC (p = 0.044). Conclusions KMC is associated with better thermoregulation even at four hours after the KMC session compared to four hours before. Other physiologic parameters such as heart rate, respiratory rate, oxygen saturation and pain scores were similar four hours before and after the KMC session.
Kangaroo-Mother Care Method ; Body Temperature Regulation

Recently, various combination therapies have been applied to the treatment of hepatocellular carcinoma (HCC). Among various treatment modalities, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) were combined to improve the therapeutic effect of RFA. The decrease of blood flow by TACE can increase the size of the ablation area by reducing heat loss during RFA. Based on these theoretical advantages, TACE and RFA combination therapy have been tried for the treatment of patients with HCC which is not feasible to be removed by surgery. However, TACE and RFA combination therapy has not been standardized by various protocols for each study. This review discusses the implications and role of this treatment, although there are several limitations to clearly demonstrate the indications and efficacy of TACE and RFA combination therapies.
Body Temperature Regulation ; Carcinoma, Hepatocellular* ; Catheter Ablation* ; Humans

Aging is a process of the progressive functional decline with time, leading to disability, dependence, morbidity, and mortality. While the organ function in the elderly is relatively uncompromised under basal conditions, their ability to tolerate increased physiologic stress is reduced. And the extent and onset of the deterioration in functional reserve is quite diverse from patient to patient. The aging population is rapidly growing and their medical management is becoming one of the greatest challenges to anesthesiologists. The understanding of the normal physiologic changes with aging is essential to frame any discussion of perioperative management in the elderly. In this review, we will focus on the physiologic changes in neurologic, cardiac, pulmonary, renal, and hepatic function, and thermoregulation.
Aged ; Aging* ; Body Temperature Regulation ; Humans ; Mortality ; Physiology

PURPOSE: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. METHODS: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. RESULTS: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG (χ²=6.15, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. CONCLUSION: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.
Aged* ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Blood Pressure* ; Blood Sedimentation ; Body Temperature Regulation ; Body Temperature* ; C-Reactive Protein ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypothermia ; Incheon ; Incidence ; Inflammation* ; Korea ; Shivering*

Hyperthermia can cause severe complications such as rhabdomyolysis, which can induce acute kidney injury. Normal thermoregulation can be disturbed by high fever, and maintenance of a normal body temperature by external cooling can reduce oxygen consumption, and increase vascular tone. Several studies have been conducted to determine the effectiveness of external cooling in treat rhabdomyolysis or renal failure. We report a case of rhabdomyolysis leading to multiple organ dysfunction, including renal failure. The use of an external cooling device achieved fever control and successfully treated rhabdomyolysis and renal failure.
Acute Kidney Injury* ; Body Temperature ; Body Temperature Regulation ; Fever ; Oxygen Consumption ; Renal Insufficiency ; Rhabdomyolysis*

BACKGROUND: Hypothermia is common during arthroscopic shoulder surgery under general anesthesia, and anesthetic-impaired thermoregulation is thought to be the major cause of hypothermia. This prospective, randomized, double-blind study was designed to compare perioperative temperature during arthroscopic shoulder surgery with interscalene brachial plexus block (IBPB) followed by general anesthesia vs. general anesthesia alone. METHODS: Patients scheduled for arthroscopic shoulder surgery were randomly allocated to receive IBPB followed by general anesthesia (group GB, n = 20) or general anesthesia alone (group GO, n = 20), and intraoperative and postoperative body temperatures were measured. RESULTS: The initial body temperatures were 36.5 ± 0.3℃ vs. 36.4 ± 0.4℃ in group GB vs. GO, respectively (P = 0.215). The body temperature at 120 minutes after induction of anesthesia was significantly higher in group GB than in group GO (35.8 ± 0.3℃ vs. 34.9 ± 0.3℃; P < 0.001). The body temperatures at 60 minutes after admission to the post-anesthesia care unit were 35.8 ± 0.3℃ vs. 35.2 ± 0.2℃ in group GB vs. GO, respectively (P < 0.001). The concentrations of desflurane at 0, 15, and 120 minutes after induction of anesthesia were 6.0 vs. 6.0% (P = 0.330), 5.0 ± 0.8% vs. 5.8 ± 0.4% (P = 0.001), and 3.4 ± 0.4% vs. 7.1 ± 0.9% (P < 0.001) in group GB vs. GO, respectively. CONCLUSIONS: The present study demonstrated that preoperative IBPB could reduce both the intraoperative concentration of desflurane and the reduction in body temperature during and after arthroscopic shoulder surgery.
Anesthesia ; Anesthesia, General ; Arthroscopy ; Body Temperature ; Body Temperature Regulation ; Brachial Plexus Block* ; Brachial Plexus* ; Double-Blind Method ; Humans ; Hypothermia ; Prospective Studies ; Shoulder*

BACKGROUND: Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. METHODS: Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. RESULTS: Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. CONCLUSIONS: Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.
Anesthesia, Local ; Body Temperature Regulation ; Congenital Abnormalities ; Diagnosis ; Diagnostic Imaging ; Female ; Fingers ; Follow-Up Studies ; Glomus Tumor* ; Hand* ; Humans ; Ice ; Magnetic Resonance Imaging ; Microvessels ; Physical Examination ; Postoperative Period ; Recurrence ; Retrospective Studies ; Tourniquets ; Ultrasonography ; Wood

BACKGROUND: Heart attack is the most common cause of line-of-duty death in the fire service. Daily aspirin therapy is a preventative measure used to reduce the morbidity of heart attacks but may decrease the ability to dissipate heat by reducing skin blood flow. METHODS: In this double-blind, placebo-controlled, crossover study, firefighters were randomized to receive 14 days of therapy (81-mg aspirin or placebo) before performing treadmill exercise in thermal-protective clothing in a hot room [38.8 +/- 2.1degrees C, 24.9 +/- 9.1% relative humidity (RH)]. Three weeks without therapy was provided before crossing to the other arm. Firefighters completed a baseline skin blood-flow assessment via laser Doppler flowmetry; skin was heated to 44degrees C to achieve maximal cutaneous vasodilation. Skin blood flow was measured before and after exercise in a hot room, and at 0 minutes, 10 minutes, 20 minutes, and 30 minutes of recovery under temperature conditions (25.3 +/- 1.2degrees C, 40.3 +/- 13.7% RH). Platelet clotting time was assessed before drug administration, and before and after exercise. RESULTS: Fifteen firefighters completed the study. Aspirin increased clotting time before and after exercise compared with placebo (p = 0.003). There were no differences in absolute skin blood flow between groups (p = 0.35). Following exercise, cutaneous vascular conductance (CVC) was 85 +/- 42% of maximum in the aspirin and 76 +/- 37% in the placebo groups. The percentage of maximal CVC did not differ by treatment before or after recovery. Neither maximal core body temperature nor heart rate responses to exercise differed between trials. CONCLUSION: There were no differences in skin blood flow during uncompensable heat stress following exercise after aspirin or placebo therapy.
Arm ; Aspirin* ; Blood Platelets ; Body Temperature ; Body Temperature Regulation* ; Clothing ; Cross-Over Studies ; Firefighters* ; Fires ; Heart ; Heart Rate ; Hot Temperature ; Humans ; Humidity ; Laser-Doppler Flowmetry ; Skin ; Vasodilation

BACKGROUND: During head and neck surgery including orthognathic surgery, mild intraoperative hypothermia occurs frequently. Hypothermia is associated with postanesthetic shivering, which may increase the risk of other postoperative complications. To improve intraoperative thermoregulation, devices such as forced-air warming blankets can be applied. This study aimed to evaluate the effect of supplemental forced-air warming blankets in preventing postanesthetic shivering. METHODS: This retrospective study included 113 patients who underwent orthognathic surgery between March and September 2015. According to the active warming method utilized during surgery, patients were divided into two groups: Group W (n = 55), circulating-water mattress; and Group F (n = 58), circulating-water mattress and forced-air warming blanket. Surgical notes and anesthesia and recovery room records were evaluated. RESULTS: Initial axillary temperatures did not significantly differ between groups (Group W = 35.9 ± 0.7℃, Group F = 35.8 ± 0.6℃). However, at the end of surgery, the temperatures in Group W were significantly lower than those in Group F (35.2 ± 0.5℃ and 36.2 ± 0.5℃, respectively, P = 0.04). The average body temperatures in Groups W and F were, respectively, 35.9 ± 0.5℃ and 36.2 ± 0.5℃ (P = 0.0001). In Group W, 24 patients (43.6%) experienced postanesthetic shivering, while in Group F, only 12 (20.7%) patients required treatment for postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147-0.772). CONCLUSIONS: Additional use of forced-air warming blankets in orthognathic surgery was superior in maintaining normothermia and reduced the incidence of postanesthetic shivering.
Anesthesia ; Body Temperature ; Body Temperature Regulation ; Head ; Humans ; Hypothermia ; Incidence ; Methods ; Neck ; Odds Ratio ; Orthognathic Surgery* ; Postoperative Complications ; Recovery Room ; Retrospective Studies ; Shivering*

OBJECTIVE: To investigate changes in the core temperature and body surface temperature in patients with incomplete spinal cord injuries (SCI). In incomplete SCI, the temperature change is difficult to see compared with complete spinal cord injuries. The goal of this study was to better understand thermal regulation in patients with incomplete SCI. METHODS: Fifty-six SCI patients were enrolled, and the control group consisted of 20 healthy persons. The spinal cord injuries were classified according to International Standards for Neurological Classification of Spinal Cord Injury. The patients were classified into two groups: upper (neurological injury level T6 or above) and lower (neurological injury level T7 or below) SCIs. Body core temperature was measured using an oral thermometer, and body surface temperature was measured using digital infrared thermographic imaging. RESULTS: Twenty-nine patients had upper spinal cord injuries, 27 patients had lower SCIs, and 20 persons served as the normal healthy persons. Comparing the skin temperatures of the three groups, the temperatures at the lower abdomen, anterior thigh and anterior tibia in the patients with upper SCIs were lower than those of the normal healthy persons and the patients with lower SCIs. No significant temperature differences were observed between the normal healthy persons and the patients with lower SCIs. CONCLUSION: In our study, we found thermal dysregulation in patients with incomplete SCI. In particular, body surface temperature regulation was worse in upper SCIs than in lower injuries. Moreover, cord injury severity affected body surface temperature regulation in SCI patients.
Abdomen ; Body Temperature Regulation ; Body Temperature* ; Classification ; Humans ; Skin Temperature ; Spinal Cord Injuries* ; Spinal Cord* ; Thermography ; Thermometers ; Thigh ; Tibia