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DOI: 10.1055/s-2008-1037991
Is deep hypothermia with cardiocirculatory arrest=deep hypothermia with cardiocirculatory arrest?
Objective: Deep hypothermia (DH) with cardiocirculatory arrest is – according to current literature data – associated with severe multiorgan damage in up to 30% of the patients including cerebral, renal, liver and gut function. The present study analyses deep hypothermia in exactly defined patients with no disturbances of the system-arterial tree.
Methods: The perioperative course 70 patients (60±16 years; W/M:33/37) with pulmonary thromendarterictomie (PTE) and DH (18°C) with circulatory arrest were evaluated. Postoperative recovery including neurological performance, renal-, liver- and gut-function, were analyzed as a function of intraoperative data. Data are given as MEAN+SEM.
Results: Mean circulatory arrest was: 31.6min, total bypass-time 240±64 minutes. 41% of the patients were extubated at the day after surgery, 75% within 3 days. Two patients were postoperatively not well orientated, confused and agitated. These symptoms were not accompanied by motoric or sensible disorders and disappeared completely within a week without any specific therapy. One patient had a reversible tremor of both legs and a motoric aphasia for three days without any residual symptoms afterwards. Neurological examination did not show any paresis. Postoperatively acute irreversible renal-, gut- or liver -damage was not observed. 9/70 patients died intra- or postoperatively (right-heart-failure: 2; endo-bronchial bleeding:4, late multi-organ-failure on the basis of heart failure: 3).
Conclusion: The current suggest, that deep hypothermia per se is not related to an irreversible pathology as long as the systemic arterial tree is intact. Therefore, hypothermia per se can not explain the unsatisfactory surgical results described after some operations performed in hypothermia.