{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:08:22Z","timestamp":1747188502775,"version":"3.40.5"},"reference-count":62,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,4,4]],"date-time":"2021-04-04T00:00:00Z","timestamp":1617494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003556","name":"Ministry of Foreign Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003556","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>New Findings<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item>\n<jats:p><jats:bold>What is the central question of this study?<\/jats:bold><\/jats:p>\n<jats:p>Detailed guidelines for volume replacement to counteract hypothermia\u2010induced intravascular fluid loss are lacking. Evidence suggests colloids might have beneficial effects compared to crystalloids. Are central haemodynamic function and level of hypothermia\u2010induced calcium overload, as a marker of cardiac injury, restored by fluid substitution during rewarming, and are colloids favourable to crystalloids?<\/jats:p>\n<\/jats:list-item>\n<jats:list-item>\n<jats:p><jats:bold>What is the main finding and its importance?<\/jats:bold><\/jats:p>\n<jats:p>Infusion with crystalloid or dextran during rewarming abolished post\u2010hypothermic cardiac dysfunction, and partially mitigated myocardial calcium overload. The effects of volume replacement to support haemodynamic function are comparable to those using potent cardio\u2010active drugs. These findings underline the importance of applying intravascular volume replacement to maintain euvolaemia during rewarming.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Previous research exploring pathophysiological mechanisms underlying circulatory collapse after rewarming victims of severe accidental hypothermia has documented post\u2010hypothermic cardiac dysfunction and hypothermia\u2010induced elevation of intracellular Ca<jats:sup>2+<\/jats:sup> concentration ([Ca<jats:sup>2+<\/jats:sup>]<jats:sub>i<\/jats:sub>) in myocardial cells. The aim of the present study was to examine if maintaining euvolaemia during rewarming mitigates cardiac dysfunction and\/or normalizes elevated myocardial [Ca<jats:sup>2+<\/jats:sup>]<jats:sub>i<\/jats:sub>. A total of 21 male Wistar rats (300\u00a0g) were surface cooled to 15\u00b0C, then maintained at 15\u00b0C for 4\u00a0h, and subsequently rewarmed to 37\u00b0C. The rats were randomly assigned to one of three groups: (1) non\u2010intervention control (<jats:italic>n<\/jats:italic>\u00a0=\u00a07), (2) dextran treated (i.v. 12\u00a0ml\/kg dextran 70; <jats:italic>n<\/jats:italic>\u00a0=\u00a07), or (3) crystalloid treated (24\u00a0ml\/kg 0.9% i.v. saline; <jats:italic>n<\/jats:italic>\u00a0=\u00a07). Infusions occurred during the first 30\u00a0min of rewarming. Arterial blood pressure, stroke volume (SV), cardiac output (CO), contractility (d<jats:italic>P<\/jats:italic>\/d<jats:italic>t<\/jats:italic><jats:sub>max<\/jats:sub>) and blood gas changes were measured. Post\u2010hypothermic changes in [Ca<jats:sup>2+<\/jats:sup>]<jats:sub>i<\/jats:sub> were measured using the method of radiolabelled Ca<jats:sup>2+<\/jats:sup> (<jats:sup>45<\/jats:sup>Ca<jats:sup>2+<\/jats:sup>). Untreated controls displayed post\u2010hypothermic cardiac dysfunction with significantly reduced CO, SV and d<jats:italic>P<\/jats:italic>\/d<jats:italic>t<\/jats:italic><jats:sub>max<\/jats:sub>. In contrast, rats receiving crystalloid or dextran treatment showed a return to pre\u2010hypothermic control levels of CO and SV after rewarming, with the dextran group displaying significantly better amelioration of post\u2010hypothermic cardiac dysfunction than the crystalloid group. Compared to the post\u2010hypothermic increase in myocardial [Ca<jats:sup>2+<\/jats:sup>]<jats:sub>i<\/jats:sub> in non\u2010treated controls, [Ca<jats:sup>2+<\/jats:sup>]<jats:sub>i<\/jats:sub> values with crystalloid and dextran did not increase to the same extent after rewarming. Volume replacement with crystalloid or dextran during rewarming abolishes post\u2010hypothermic cardiac dysfunction, and partially mitigates the hypothermia\u2010induced elevation of [Ca<jats:sup>2+<\/jats:sup>]<jats:sub>i<\/jats:sub>.<\/jats:p><\/jats:sec>","DOI":"10.1113\/ep089397","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T08:59:47Z","timestamp":1615971587000},"page":"1196-1207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Maintaining intravenous volume mitigates hypothermia\u2010induced myocardial dysfunction and accumulation of intracellular Ca<sup>2+<\/sup>"],"prefix":"10.1113","volume":"106","author":[{"given":"Jan Harald","family":"Nilsen","sequence":"first","affiliation":[{"name":"Anesthesia and Critical Care research group Department of Clinical Medicine, UiT Arctic University of Norway  Troms\u00f8 Norway"},{"name":"Department of Research and Education Norwegian Air Ambulance Foundation  Dr\u00f8bak Norway"},{"name":"Division of Surgical Medicine and Intensive Care University Hospital of North Norway  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torstein","family":"Schanche","sequence":"additional","affiliation":[{"name":"Anesthesia and Critical Care research group Department of Clinical Medicine, UiT Arctic University of Norway  Troms\u00f8 Norway"},{"name":"Department of Physiology &amp; Biomedical Engineering Mayo Clinic  Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timofei V.","family":"Kondratiev","sequence":"additional","affiliation":[{"name":"Anesthesia and Critical Care research group Department of Clinical Medicine, UiT Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olav","family":"Hevr\u00f8y","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Haukeland University Hospital  Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3040-9424","authenticated-orcid":false,"given":"Gary C.","family":"Sieck","sequence":"additional","affiliation":[{"name":"Department of Physiology &amp; Biomedical Engineering Mayo Clinic  Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6137-7790","authenticated-orcid":false,"given":"Torkjel","family":"Tveita","sequence":"additional","affiliation":[{"name":"Anesthesia and Critical Care research group Department of Clinical Medicine, UiT Arctic University of Norway  Troms\u00f8 Norway"},{"name":"Division of Surgical Medicine and Intensive Care University Hospital of North Norway  Troms\u00f8 Norway"},{"name":"Department of Physiology &amp; Biomedical Engineering Mayo Clinic  Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,4,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(96)00203-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1006\/jmcc.1996.0296"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.280502"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1989.sp017817"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1114208"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181863117"},{"key":"e_1_2_9_8_1","first-page":"H136","article-title":"Hemodynamic functions and blood viscosity in surface hypothermia","volume":"235","author":"Chen R. 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