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Deep hypothermia

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https://www.readbyqxmd.com/read/29346537/cerebral-mitochondrial-dysfunction-associated-with-deep-hypothermic-circulatory-arrest-in-neonatal-swine
#1
Constantine D Mavroudis, Michael Karlsson, Tiffany Ko, Marco Hefti, Javier I Gentile, Ryan W Morgan, Ross Plyler, Kobina G Mensah-Brown, Timothy W Boorady, Richard W Melchior, Tami M Rosenthal, Brandon C Shade, Kellie L Schiavo, Susan C Nicolson, Thomas L Spray, Robert M Sutton, Robert A Berg, Daniel J Licht, J William Gaynor, Todd J Kilbaugh
OBJECTIVES: Controversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations in cerebral mitochondrial bioenergetics are thought to contribute to ischaemia-reperfusion injury in DHCA. The purpose of this study was to compare cerebral mitochondrial bioenergetics for DHCA with deep hypothermic continuous perfusion using a neonatal swine model. METHODS: Twenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling to 18°C, 10 underwent 40 min DHCA and 10 remained at deep hypothermia for 40 min; animals were subsequently rewarmed to normothermia...
January 15, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29303486/hearts-during-ischemia-with-or-without-htk-protection-analysed-by-dielectric-spectroscopy
#2
Michael Schaefer, Wolfgang Gross, Martha-Maria Gebhard
We investigated canine hearts during ischemia after aortic cross clamping (UI, n=20) and after HTK-cardioplegia (HTK, n=24) at 35°C, 25°C, 15°C, and 5°C with the aim to compare tissue changes caused by the activity of anaerobic metabolism(AAM), cell membrane destruction(CD), and gap junction uncoupling(GJU). We measured continuously the complex dielectric spectrum(DS), ATP- and lactate content, extracellular pH, and rigor contracture. To identify changes in DS caused by AAM, CD, and GJU we performed additional experiments on the gap junction-free skeletal muscle...
January 5, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#3
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29249769/open-conversion-for-type-a-ascending-aortic-dissection-after-thoracic-endovascular-aortic-repair-by-the-chimney-graft-technique
#4
Hirofumi Kasahara, Yoshito Inoue, Takashi Hachiya
An 83-year-old man with aortic arch aneurysm underwent zone 0 thoracic endovascular aortic repair (TEVAR) by the chimney graft technique with two supra-aortic arch debranching grafts and developed subacute type A ascending aortic dissection. We performed emergency open conversion with circulatory arrest under deep hypothermia. The tip of the chimney graft (around the sino-tubular junction in the ascending aorta) was stiff, making it difficult to inspect the lumen and perform anastomosis. Deep hypothermic circulatory arrest and cutting the endograft stents to mobilize the graft were necessary for secure anastomosis...
December 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29248962/effects-of-bilateral-pallidal-deep-brain-stimulation-on-chorea-after-pulmonary-thromboendarterectomy-with-deep-hypothermia-and-circulatory-arrest-a-case-report
#5
Kyoko Aoyagi, Yoshinori Higuchi, Yoji Okahara, Maidinamu Yakufujiang, Takuma Matsuda, Yoshitaka Yamanaka, Tatsuya Yamamoto, Shigeki Hirano, Yasuo Iwadate
A 41-year-old man was diagnosed with chronic pulmonary thromboembolism and underwent pulmonary thromboendarterectomy (PTE) with deep hypothermia and circulatory arrest. Five days after the operation, chorea emerged in the lower extremities. The patient was referred to our hospital for disabling chorea 16 years after PTE. Neurological examination revealed choreatic movements in the four extremities. Brain magnetic resonance images indicated atrophy in the bilateral head of the caudate nuclei. The patient underwent deep brain stimulation (DBS) of the bilateral globus pallidus interna (GPi)...
December 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29246356/a-novel-magnetic-resonance-imaging-score-predicts-neurodevelopmental-outcome-after-perinatal-asphyxia-and-therapeutic-hypothermia
#6
Lauren C Weeke, Floris Groenendaal, Kalyani Mudigonda, Mats Blennow, Maarten H Lequin, Linda C Meiners, Ingrid C van Haastert, Manon J Benders, Boubou Hallberg, Linda S de Vries
OBJECTIVE: To assess the predictive value of a novel magnetic resonance imaging (MRI) score, which includes diffusion-weighted imaging as well as assessment of the deep grey matter, white matter, and cerebellum, for neurodevelopmental outcome at 2 years and school age among term infants with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia. STUDY DESIGN: This retrospective cohort study (cohort 1, The Netherlands 2008-2014; cohort 2, Sweden 2007-2012) including infants born at >36 weeks of gestational age treated with therapeutic hypothermia who had an MRI in the first weeks of life...
January 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29167026/safety-of-moderate-hypothermia-with-antegrade-cerebral-perfusion-in-total-aortic-arch-replacement
#7
W Brent Keeling, David H Tian, Brad G Leshnower, Satoshi Numata, G Chad Hughes, George Matalanis, Yutaka Okita, Tristan D Yan, Nicholas Kouchoukos, Edward P Chen
BACKGROUND: Total aortic arch replacement (TOTAL) is a complicated operation and has traditionally required deep hypothermic circulatory arrest. In this study, the impact of moderate hypothermic circulatory arrest (MHCA) and antegrade cerebral perfusion (ACP) for TOTAL were examined. METHODS: The ARCH International aortic database was queried and 3,265 patients undergoing TOTAL using ACP were identified. Patients were divided into groups based on lowest cooling temperature: MHCA (20° to 28°C) or deep hypothermia (DHCA) (12° to 20°C)...
November 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29155935/early-and-late-outcomes-of-open-repair-for-dissecting-aneurysms-of-the-descending-or-thoraco-abdominal-aorta
#8
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29109881/hypothermia-with-extreme-bradycardia-following-spinal-cord-infarction-of-septic-origin
#9
Philippe Hantson, Thierry Duprez
Among other autonomic dysfunctions complicating acute spinal cord injury, deep hypothermia is rare but may induce serious cardiovascular complications. There are few pharmacological options to influence hypothermia. A 66-year-old woman was transferred to the intensive care unit (ICU) for serious cardiac arrhythmias (atrial fibrillation and asystole) in the context of a deep hypothermia (axillary temperature below 32°C). She had been admitted to the hospital two months before for an acute L4-L5 infectious spondylodiscitis without any initial neurological deficit...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29076774/2016-survey-about-temperature-management-during-extracorporeal-circulation-in-china
#10
Zhen Guo, Xin Li
OBJECTIVE: In order to assess the current status of temperature management during cardiopulmonary bypass (CPB) in China and, thereby, implement standardized management protocols, the authors carried out a national survey about institutions performing CPB. METHOD: The survey was carried out from September 2015 to February 2016 and was supported by the Chinese Society of ExtraCorporeal Circulation. A total of 114 institutions participated, accounting for 15.64% (114/729) of the total of germane Chinese institutions, whereby, 80...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29049808/cold-inducible-ribonucleic-acid-binding-protein-attenuates-acute-kidney-injuries-after-deep-hypothermic-circulatory-arrest-in-rats
#11
Lei Yu, Tianxiang Gu, Yu Liu, Xuan Jiang, Enyi Shi
OBJECTIVES: Cold-inducible ribonucleic acid-binding protein (CIRP) has been identified to play a role in the antiapoptotic effect of hypothermia. We sought to investigate the renoprotection of CIRP in a rat model of deep hypothermic circulatory arrest. METHODS: Overexpression and knockdown of CIRP were achieved in vivo by directly injecting lentivirus vectors containing packaging lentivirus (pL)/internal ribosome entry site (IRES)/green fluorescent protein (GFP)-CIRP or pL/short hairpin RNA (shRNA)/F-cold inducible RNA binding protein (F-CIRP)-A into the renal parenchyma of rats 7 days before deep hypothermic circulatory arrest under the ultrasound guidance...
August 14, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28930905/effectiveness-of-early-warming-with-self-warming-blankets-on-postoperative-hypothermia-in-total-hip-and-knee-arthroplasty
#12
Baris B Koc, Martijn G M Schotanus, Jean-Paul A P A C Kollenburg, Maurice J A Janssen, Fabian Tijssen, Edwin J P Jansen
BACKGROUND: Hypothermia is an important complication in joint arthroplasty. Commonly, forced air warming (FAW) devices are used intraoperatively to maintain body temperature in patients undergoing surgery. However, it is believed that these convective warming systems could increase the risk of deep surgical site infections due to disruption of unidirectional downward laminar airflow. Conductive warming devices have no noticeable effect on ventilation airflow. Nevertheless, the effectiveness of the self-warming (SW) blanket, a novel conductive warming device, on postoperative hypothermia in elective joint arthroplasty is unknown...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28844545/the-risk-of-neurological-dysfunctions-after-deep-hypothermic-circulatory-arrest-with-retrograde-cerebral-perfusion
#13
Giuseppe Gatti, Bernardo Benussi, Placido Currò, Gabriella Forti, Elisabetta Rauber, Alessandro Minati, Marco Gabrielli, Umberto Tognolli, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue. METHODS: For 344 (59.5%) of 578 consecutive patients (mean age, 66.9 ± 10.9 years) who underwent cardiovascular surgery under DHCA at the present authors' institution (1999-2015), RCP was the sole technique of cerebral protection that was adopted in addition to deep hypothermia...
August 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28836154/randomized-controlled-trial-of-moderate-hypothermia-versus-deep-hypothermia-anesthesia-on-brain-injury-during-stanford-a-aortic-dissection-surgery
#14
Xufang Sun, Hua Yang, Xinyu Li, Yue Wang, Chuncheng Zhang, Zhimin Song, Zhenxiang Pan
This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n = 40, nasopharyngeal temperature 25 °C, and rectal temperature 28 °C) and deep hypothermia group (DH, n = 42, nasopharyngeal temperature 20 °C, and rectal temperature 25 °C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used...
August 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28795615/international-survey-on-the-perioperative-management-of-pulmonary-endarterectomy-the-perfusion-perspective
#15
Roger D P Stanzel, Johannes Gehron, Matthias Wolff, Natalie Striegl, Peter Roth, Rolf-Hasso Boedeker, Christine Scheibelhut, Johannes Herrmann, Ingeborg Welters, Eckhard Mayer, Matthias Scheffler
INTRODUCTION: Pulmonary endarterectomy (PEA) is the most effective treatment available for chronic thromboembolic pulmonary hypertension (CTEPH). Patient selection, surgical technique and perioperative management have improved patient outcomes, which are traditionally linked to surgical and center experience. However, optimal perfusion care has not been well defined. The goal of the international survey was to better characterize the contemporary perfusion management of PEA and highlight similarities and controversies...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28776203/adaptive-temperature-regulation-in-the-little-bird-in-winter-predictions-from-a-stochastic-dynamic-programming-model
#16
Anders Brodin, Jan-Åke Nilsson, Andreas Nord
Several species of small birds are resident in boreal forests where environmental temperatures can be -20 to -30 °C, or even lower, in winter. As winter days are short, and food is scarce, winter survival is a challenge for small endothermic animals. A bird of this size will have to gain almost 10% of its lean body mass in fat every day to sustain overnight metabolism. Birds such as parids (titmice and chickadees) can use facultative hypothermia, a process in which body temperature is actively down-regulated to a specific level, to reduce heat loss and thus save energy...
September 2017: Oecologia
https://www.readbyqxmd.com/read/28719038/static-cerebrovascular-pressure-autoregulation-remains-intact-during-deep-hypothermia
#17
Dheeraj Goswami, Katherine McLeod, Samantha Leonard, Kathleen Kibler, Ronald Blaine Easley, Charles D Fraser, Dean Andropoulos, Ken Brady
BACKGROUND: Clinical studies measuring cerebral blood flow in infants during deep hypothermia have demonstrated diminished cerebrovascular pressure autoregulation. The coexistence of hypotension in these cohorts confounds the conclusion that deep hypothermia impairs cerebrovascular pressure autoregulation. AIM: We sought to compare the lower limit of autoregulation and the static rate of autoregulation between normothermic and hypothermic piglets. METHODS: Twenty anesthetized neonatal piglets (5-7 days old; 10 normothermic and 10 hypothermic to 20°C) had continuous measurements of cortical red cell flux using laser Doppler flowmetry, while hemorrhagic hypotension was induced without cardiopulmonary bypass...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28709662/neonatal-aortic-arch-reconstruction-with-direct-splanchnic-perfusion-avoids-deep-hypothermia
#18
Muhammad Aanish Raees, Clinton D Morgan, Venessa L Pinto, Ashly C Westrick, Chevis N Shannon, Karla G Christian, Bret A Mettler, David P Bichell
BACKGROUND: Neonatal aortic arch reconstruction, typically performed with deep hypothermia and selective cerebral perfusion, leaves splanchnic organ protection dependent on hypothermia alone. A simplified method of direct in-field descending aortic perfusion during neonatal arch reconstruction permits the avoidance of deep hypothermia. We hypothesize that direct splanchnic perfusion at mild hypothermia provides improved or equivalent safety compared with deep hypothermia and may contribute to postoperative extracardiac organ recovery...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28689048/the-impact-of-hypothermia-on-serum-potassium-concentration-a-systematic-review
#19
REVIEW
Sarah Buse, Marc Blancher, Damien Viglino, Mathieu Pasquier, Maxime Maignan, Pierre Bouzat, Thorsten Annecke, Guillaume Debaty
BACKGROUND: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. METHODS: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28687308/deep-hypothermia-therapy-attenuates-lps-induced-microglia-neuroinflammation-via-the-stat3-pathway
#20
G Tong, A Krauss, J Mochner, S Wollersheim, P Soltani, F Berger, K R L Schmitt
Deep hypothermia therapy (HT) is a standard method for neuroprotection during complex pediatric cardiac surgery involving extracorporeal circulation and deep hypothermic cardiac arrest. The procedure, however, can provoke systemic inflammatory response syndrome (SIRS), one of the most severe side effects associated with pediatric cardiac surgery. To date, the cellular inflammatory mechanisms induced by deep HT remain to be elucidated. Therefore, we investigated the effects of deep HT (17°C) and rewarming on the inflammatory response in lipopolysaccharide (LPS) stimulated BV-2 murine microglia...
September 1, 2017: Neuroscience
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