J Waves of Osborn Revisited
Author(s)Joynt, Karen; Edelman, Elazer R
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In 1953, Joseph Osborn examined the physiologic effects of hypothermia and defined typical associated changes in the electrocardiogram (ECG), now known as J waves of Osborn. There is a subtlety, however: Osborn's J waves were absent in hypothermic animals whose pH was maintained via mechanical ventilation. Osborn wrote: “We regard this as evidence that the ECG changes … may not be associated with the low temperature directly, but rather may be more closely associated with faulty elimination of CO2under hypothermic conditions” (1). This principle is illustrated in a 64-year-old man who presented hypothermic to 92°F and profoundly acidemic (pH 7.03) after cardiac arrest. Striking J waves are evident on initial ECG (A). Controlled cooling was initiated; hypothermia was maintained to preserve brain function. Intubation and resuscitation restored bicarbonate, carbon dioxide concentrations, and pH. At pH 7.33, although body temperature was identical at 92°F, the J waves had resolved (B).
DepartmentInstitute for Medical Engineering and Science; Harvard University--MIT Division of Health Sciences and Technology
Journal of the American College of Cardiology
Edelman, Elazer R., and Joynt, Karen. “J Waves of Osborn Revisited.” Journal of the American College of Cardiology 55, 20 (May 2010): 2287 © 2010 American College of Cardiology Foundation
Author's final manuscript