{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:21:15Z","timestamp":1784784075931,"version":"3.55.0"},"reference-count":9,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Wilderness Medicine Society and the Academy of Wilderness Medicine","award":["WMS Peter Hackett-Paul Auerbach Young Investigator"],"award-info":[{"award-number":["WMS Peter Hackett-Paul Auerbach Young Investigator"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cold exposure initially induces peripheral vasoconstriction. After 5\u201310\u2005min, distal blood vessels will transiently and cyclically vasodilate and vasoconstrict in a phenomenon known as cold-induced vasodilation (CIVD). Increased CIVD response is thought to improve dexterity and confer a reduced risk of frostbite injuries. Current guidelines recommend the use of an intravenous synthetic prostacyclin (PGI2) analog for the treatment of some cases of severe frostbite. This double-blind crossover study investigates the effects of the inhaled PGI2 analog epoprostenol on CIVD response through continuous finger temperature measurement during cold water immersion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen healthy volunteers completed both sessions of the study and were included in the analysis. Compared to placebo, inhaled epoprostenol sessions showed higher mean finger temperature (9.16 vs 8.34\u00b0 C;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.027), mean maxima temperature (10.86 vs 9.88\u00b0 C;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.045), and mean minima temperature (7.45 vs 6.80\u00b0 C;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.024). No significant difference was detected in the number of cycles (10.0 vs 7.93;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.104). No hypotension, hypothermia, or hypoxia was observed, and no subject requested discontinuation due to side effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this small study, inhaled epoprostenol induced a statistically significant increase in mean temperature, mean maxima temperature, and mean minima temperature in fingers immersed in a cold-water bath, consistent with an augmented CIVD response. The ability to deliver an inhaled PGI2 analog via nebulizer raises the possibility of early interventions to manage frostbite in austere environments, but further study is needed to draw any conclusions regarding the use of epoprostenol for frostbite care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10806032251387526","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T15:57:51Z","timestamp":1764345471000},"page":"239-243","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Inhaled Epoprostenol Augments Cold-Induced Vasodilation: A Double-Blind Crossover Trial"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1244-5827","authenticated-orcid":false,"given":"Theodore (TJ)","family":"Hartridge","sequence":"first","affiliation":[{"name":"University of Utah Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"McIntosh","sequence":"additional","affiliation":[{"name":"University of Utah Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Awad","sequence":"additional","affiliation":[{"name":"University of Utah Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Torre","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Milliner","sequence":"additional","affiliation":[{"name":"VA Health Clinics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Brickley","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-003-0818-2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1000538"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/10806032231222359"},{"key":"e_1_3_2_5_2","unstructured":"Flolan (epoprostenol sodium) for Injection: Prescribing Information. U.S. Food & Drug Administration. 2008. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2008\/020444s016lbl.pdf."},{"key":"e_1_3_2_6_2","unstructured":"Policy: Inhaled Epoprostenol (Flolan). University Health Care\u2019s Pharmacy & Therapeutics Committee. https:\/\/pulse.utah.edu\/policies\/Lists\/Policies\/DispForm.aspx?ID=3029. Accessed March 31 2020."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2020.03.002"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0122592"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00859.2004"},{"key":"e_1_3_2_10_2","first-page":"665","article-title":"Treatment of frostbite with intra-arterial prostaglandin E1","volume":"49","author":"Yeager RA","year":"1983","unstructured":"Yeager RA, Campion TW, Kerr JC, Hobson RW, Lynch TG. Treatment of frostbite with intra-arterial prostaglandin E1. Am Surg. 1983;49:665\u201367.","journal-title":"Am Surg"}],"container-title":["Wilderness &amp; Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032251387526","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10806032251387526","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032251387526","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T17:14:55Z","timestamp":1778951695000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10806032251387526"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/10806032251387526"],"URL":"https:\/\/doi.org\/10.1177\/10806032251387526","relation":{},"ISSN":["1080-6032","1545-1534"],"issn-type":[{"value":"1080-6032","type":"print"},{"value":"1545-1534","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]}}}