title: Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis.
abstract: OBJECTIVE
  This study was performed to investigate the effect of the rewarming rate on survival and acute lung injury in sepsis.
  
  
  METHODS
  Male Sprague-Dawley rats underwent cecal ligation and incision. After 1 hour of sepsis induction, normothermia (37°C±0.5°C, NT group) or hypothermia (32°C±0.5°C) was induced. Hypothermia was maintained for 4 hours and rats were divided into two groups according to the rewarming rate: RW1 group, 1 hour of rewarming; and RW2 group, 2 hours of rewarming. In the survival study, rats were observed for 12 hours after sepsis induction (n=6 per group). In the second experiment, rats were sacrificed 7 hours after sepsis induction, and lung tissues and plasma were harvested (n=10 per group).
  
  
  RESULTS
  In the survival study, the RW2 group survived longer than the RW1 group (P<0.05), but the RW1 and NT groups showed no significant difference in survival duration (P>0.05). The histological lung injury score and malondialdehyde concentrations in the lung tissues were significantly higher in the RW1 group than in the RW2 group (P<0.05). Plasma interleukin (IL)-6 concentration and the ratio of IL-6 to IL-10 were higher in the RW1 group than in the RW2 group (P<0.05).
  
  
  CONCLUSIONS
  Rapid rewarming after therapeutic hypothermia results in a shorter survival period and acute lung injury in sepsis, which could be associated with the inflammatory responses.
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: You Hwan
authors.initials: YH
authors.lastname: Jo
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyuseok
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, St. Carollo General Hospital, Suncheon, Korea.
authors.forename: Kwang Pil
authors.initials: KP
authors.lastname: Rim
authors.affiliation: Department of Emergency Medicine, Kepco Medical Center, Seoul, Korea.
authors.forename: In Soo
authors.initials: IS
authors.lastname: Cho
keywords: Hypothermia; Lung injury; Rewarming; Sepsis; Survival