Anesthesia for deep hypothermic circulatory arrest in adults: Experience with the first 50 patients

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• 作者：Jehangir J. Appoo ; Fiona Ralley ; Ghassan Baslaim ; Benoit de Varennes
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：1998
• 出版时间：June 1998
• 年：1998
• 卷：12
• 期：3
• 页码：261-265
• 全文大小：543 K

文摘

To evaluate the efficacy of a simple method of central nervous system (CNS) protection in patients undergoing deep hypothermic circulatory arrest (DHCA) lasting less than 30 minutes, for a variety of complex cardiovascular procedures.

A retrospective case review.

A university teaching hospital.

Fifty consecutive patients (25 women, 25 men) undergoing elective or emergency cardiovascular operations requiring DHCA between August 1991 and December 1996.

Patients underwent DHCA for a variety of surgical procedures. Neurologic protection was with thiopental, ice packs to the head, and systemic core hypothermia to a nasopharyngeal temperature (NPT) of 18° to 20°C.

The mean duration of circulatory arrest was 18 ± 10 minutes (range, 5 to 42 minutes). The mean NPT at time of arrest was 18.7° ± 1.7°C. Three patients (6 % ) had gross CNS morbidity, one of whom died. The circulatory arrest times for these three patients were 8, 39, and 40 minutes. Perioperative mortality was 8 % (n = 4). The circulatory arrest times for the patients who died were 12, 13, 23, and 39 minutes.

The anesthetic management of DHCA described is simple, effective, and safe, and can be performed in any institution that performs cardiac surgery.