Abstract
Background & aim
The aim of this study was to compare hypothermia patients with and without an Osborn
wave (OW) in terms of physical examination findings, laboratory results, and clinical
survival.
Methods
The study was carried out retrospectively on hypothermic patients. The hypothermic
patients were divided into two groups. Group 1 comprised patients with OW on electrocardiogram
(ECG), and Group 2 comprised patients without OW on ECG. The Mann–Whitney U test was used to compare the two groups, and the relationships between the variables
and the presence of OW and mortality were analyzed with ANOVA. A value of p < 0.05 was considered statistically significant.
Results
OW was detected on ECG of 41.9% of the patients (Group 1). The mean body temperature
was 30.8 ± 4.1 °C in Group 1 and 33.3 ± 1.6 °C in Group 2 (p = 0.106). The mean creatinine level was 1.01 ± 0.6 mg/dl in Group 1 and 0.73 ± 0.5 mg/dl
in Group 2 (p = 0.046). The mean bicarbonate level was 15.9 ± 3.8 mmol/l in Group 1 and 18.6 ± 3.5 mmol/l
in Group 2 (p = 0.038). A relationship was determined between the presence of OW and pH, bicarbonate,
and creatinine levels (p = 0.026; 0.013; 0.042, respectively). The mortality rate was 69.2% in Group 1 and
77.8% in Group 2 (p = 0.689).
Conclusion
Although there is a relationship between the decrease in bicarbonate levels, changes
in kidney functions that cause acidosis, and the presence of OW, it has no effect
on mortality. The presence of OW in hypothermic patients is insufficient to make a
decision regarding mortality.
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References
- Experimental hypothermia; respiratory and blood pH changes in relation to cardiac function.Am J Phys. 1953; 175: 389-398
- ECG phenomenon called the J wave. History, pathophysiology, and clinical significance.J Electrocardiol. 1995; 28: 49-58
- The Osborn wave of hypothermia in normothermic patients.Clin Cardiol. 1994; 17: 273-276
- The Osborn wave in a hypothermic patient with head trauma.Archives of the Turkish Society of Cardiology. 2007; 35: 37-39
- Report of a case with huge Osborn waves.Anadolu Kardiyol Derg. 2006; 6: 411-412
- A prospective evaluation of the electrocardiographic manifestations of hypothermia.Acad Emerg Med. 1999; 6: 1121-1126
- Electrocardiographic changes in hypothermia.Heart Lung. 2001; 30: 161-163
- The EKG of hypothermia1.J Emerg Med. 2002; 22: 87-91
- Osborn waves of hypothermia.Circulation. 2000; 101: e233-e244
- J waves in accidental hypothermia.Circ J. 2014; 78: 128-134
- The significance of changes in the electrocardiogram in hypothermia.Br Heart J. 1959; 21: 343
- Diagnostic value of electrocardiographic abnormalities observed in subjects accidentally exposed to cold.Am J Cardiol. 1972; 29: 729-734
- The arrythmogenic potential of the Osborn wave.Am J Emerg Med. 2013; 31: 424-426
- Accidental hypothermia.Can Med Assoc J. 1970; 103: 1357-1361
- Accidental hypothermia.Lancet. 1961; 278: 1213-1219
- 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science.Circulation. 2010; 122: S639-S946
- The correlation between the amplitude of Osborn wave and core body temperature.Eur Heart J Acute Cardiovasc Care. 2015; 4: 373-377
- J waves of Osborn revisited.J Am Coll Cardiol. 2010; 55: 2287
- A cool ECG.S Afr Med J. 2018; 108: 22
- ECG changes due to hypothermia developed after drowning: case report.Turk J Emerg Med. 2014; 14: 37-40
- Prevalence and prognostic significance of ‘J waves’ in patients experiencing ventricular fibrillation during acute coronary syndrome.Arch Cardiovasc Dis. 2012; 105: 578-586
Article Info
Publication History
Published online: August 19, 2018
Accepted:
August 18,
2018
Received in revised form:
August 17,
2018
Received:
March 2,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
