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Deep hypothermia

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https://www.readbyqxmd.com/read/29707342/aortic-arch-repair-under-moderate-hypothermic-circulatory-arrest-with-or-without-antegrade-cerebral-perfusion-based-on-the-extent-of-repair
#1
Sung Jun Park, Bo Bae Jeon, Hee Jung Kim, Joon Bum Kim
Background: For aortic-arch repair, moderate hypothermic circulatory arrest (HCA) have shown favorable outcomes over conventional deep HCA when coupled with antegrade cerebral perfusion (ACP); however, recent studies have shown that ACP may not be essential when circulatory arrest time is less than 30 minutes. This study aims to evaluate the stratified arch repair strategy of moderate HCA with or without ACP based on the extent of procedure. Methods: Consecutive 138 patients (63 female; mean age, 60...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#2
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29667473/harnessing-neuroplasticity-modern-approaches-and-clinical-future
#3
Andrew Octavian Sasmita, Joshua Kuruvilla, Anna Pick Kiong Ling
Neurological diseases and injuries to the nervous system may cause inadvertent damage to neuronal and synaptic structures. Such phenomenon would catastrophically accumulate, leading to the development of neurological and neurodegenerative disorders which might affect memory, cognition, and motoric functions. The body has various negative feedback systems which are able to induce beneficial neuroplastic changes in mediating some neuronal damage, however, such efforts are often not enough to ameliorate the derogatory changes...
April 18, 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29660027/the-6-hydroxychromanol-derivative-sul-109-ameliorates-renal-injury-after-deep-hypothermia-and-rewarming-in-rats
#4
Pieter C Vogelaar, Maurits Roorda, Edwin L de Vrij, Martin C Houwertjes, Maaike Goris, Hjalmar Bouma, Adrianus C van der Graaf, Guido Krenning, Robert H Henning
Background: Mitochondrial dysfunction plays an important role in kidney damage in various pathologies, including acute and chronic kidney injury and diabetic nephropathy. In addition to the well-studied ischaemia/reperfusion (I/R) injury, hypothermia/rewarming (H/R) also inflicts acute kidney injury. Substituted 6-hydroxychromanols are a novel class of mitochondrial medicines that ameliorate mitochondrial oxidative stress and protect the mitochondrial network. To identify a novel 6-hydroxychromanol that protects mitochondrial structure and function in the kidney during H/R, we screened multiple compounds in vitro and subsequently assessed the efficacy of the 6-hydroxychromanol derivatives SUL-109 and SUL-121 in vivo to protect against kidney injury after H/R in rats...
April 11, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29657946/too-cold-to-clot-does-intraoperative-hypothermia-contribute-to-bleeding-after-aortic-surgery
#5
Louis H Stein, Gregory Rubinfeld, Leora B Balsam, Patricia Ursomanno, Abe DeAnda
Background: We determined the impact of intraoperative hypothermia on postoperative bleeding after thoracic aortic surgery. Methods: We retrospectively analyzed 98 consecutive patients who underwent aortic surgery with deep hypothermic circulatory arrest between 2010 and 2014. We evaluated lowest temperature, absolute decrease in temperature, and rewarming rate. Univariate and multivariate regression were used to determine relationships between temperature, clinical characteristics, and measures of postoperative bleeding...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29617791/beating-heart-aortic-arch-surgery-in-neonates-and-infants
#6
Juan-Miguel Gil-Jaurena, María-Teresa González-López, Ana Pita, Ramón Pérez-Caballero, Mónica Herviás, Dorotea Blanco
OBJECTIVES: Aortic arch repair has been shifted from deep hypothermia plus circulatory arrest to cerebral perfusion at tepid temperatures. A step forward is a simultaneous brain-coronary perfusion, allowing beating-heart arch surgery. METHODS: A 'Y' cannula from the arterial line delivers oxygenated blood to brain and heart. The arch is repaired on a beating heart at 25°C. Intracardiac repair is performed after running cardioplegia through the root line. Fifty patients are classified into 3 groups: A, Norwood (8 neonates); B, aortic arch (14 children) and C, aortic arch plus intracardiac repair (28 patients)...
April 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29580655/protection-of-the-rat-brain-from-hypothermic-circulatory-arrest-injury-by-a-chipmunk-protein
#7
Xuan Jiang, Tianxiang Gu, Yu Liu, Chun Wang, Enyi Shi, Guangwei Zhang, Zongyi Xiu
OBJECTIVES: The study objectives were to test the hypothesis that special protein exists in hibernating chipmunk albumin and whether this protein has a neuroprotective effect in Sprague-Dawley rats during deep hypothermia circulatory arrest. METHODS: Forty chipmunks were allocated into a hibernation group and an active group (20 chipmunks in each group). Special protein was detected and isolated from hibernating chipmunk albumin. Forty Sprague-Dawley rats were randomly divided into a sham group, deep hypothermia circulatory arrest group, special protein group, and naloxone group (10 rats in each group)...
February 24, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29570428/intravascular-cooling-catheter-related-venous-thromboembolism-after-hypothermia-a-case-report-and-review-of-the-literature
#8
Xuan Wang, Brian T Moy, Brett J Hiendlmayr, Felix Krainski, W Lane Duvall, Antonio B Fernandez
Fifty-four year-old man with recent history of myocardial infarction and a percutaneous coronary intervention who suffered a ventricular fibrillation arrest at home. He was resuscitated in the field. His heart rhythm was in atrial fibrillation. The cardiac catheterization showed a patent stent from his previous myocardial infarction and no new occlusions. He subsequently underwent hypothermia protocol using the Alsius CoolGard 3000 Temperature Control System and Icy Catheter. Heparin drip was started for atrial fibrillation 36 hours after catheter insertion and became therapeutic 2 hours before the end of cooling maintenance phase...
March 23, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29532651/an-innovative-arch-first-surgical-procedure-under-moderate-hypothermia-for-acute-type-a-aortic-dissection
#9
Kangjun Shen, Xinmin Zhou, Ling Tan, Feng Li, Jun Xiao, Hao Tang
BACKGROUND: We hypothesized that the arch-first procedure without extra devices under moderate-to-mild systemic hypothermia during acute type A aortic dissection is safe and efficient and will improve patient outcome compared with the standard total arch replacement technique. METHODS: From December 2014 to February 2017, 89 patients were enrolled in this study, 52 of whom underwent conventional deep hypothermic circulatory arrest (DHCA, 24.2 ± 0.71°C) using the antegrade cerebral perfusion surgical procedure (Group A) and 37 of whom underwent the "arch-first" technique with moderate (27...
March 12, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29530988/deletion-of-the-cold-thermoreceptor-trpm8-increases-heat-loss-and-food-intake-leading-to-reduced-body-temperature-and-obesity-in-mice
#10
Alfonso Reimúndez, Carlos Fernández-Peña, Guillermo García, Rubén Fernández, Purificación Ordás, Rosalía Gallego, Jose L Pardo-Vazquez, Victor Arce, Félix Viana, Rosa Señarís
The coupling of energy homeostasis to thermoregulation is essential to maintain homeothermy in changing external environments. We studied the role of the cold thermoreceptor TRPM8 in this interplay in mice of both sexes. We demonstrate that TRPM8 is required for a precise thermoregulation in response to cold, in fed and fasting. Trpm8 -/- mice exhibited a fall of 0.7°C in core body temperature when housed at cold temperatures, and a deep hypothermia (<30°C) during food deprivation. In both situations, TRPM8 deficiency induced an increase in tail heat loss...
April 11, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29510380/the-neuroprotective-effects-of-hypothermia-on-bilirubin-induced-neurotoxicity-in-vitro
#11
Nazli Kuter, Nese Aysit-Altuncu, Gurkan Ozturk, Eren Ozek
BACKGROUND: In high-risk newborns indirect hyperbilirubinemia can lead to acute bilirubin encephalopathy and kernicterus. Despite the current therapeutic modalities, preventing or reversing the neurotoxicity cannot be achieved in all infants. OBJECTIVE: To investigate the neuroprotective effects of hypothermia on bilirubin-induced toxicity in primary mouse neuronal cell cultures. METHODS: Hippocampal cell cultures, isolated from newborn mouse brains, were incubated with unconjugated bilirubin (UCB) at 3 days in vitro (DIV) and immediately exposed to varying degrees of hypothermia...
March 6, 2018: Neonatology
https://www.readbyqxmd.com/read/29508410/selective-cerebro-myocardial-perfusion-in-complex-neonatal-aortic-arch-pathology-midterm-results
#12
Stiljan Hoxha, Riccardo Giuseppe Abbasciano, Camilla Sandrini, Lucia Rossetti, Tiziano Menon, Luca Barozzi, Daniele Linardi, Alessio Rungatscher, Giuseppe Faggian, Giovanni Battista Luciani
Aortic arch repair in newborns and infants has traditionally been accomplished using a period of deep hypothermic circulatory arrest. To reduce neurologic and cardiac dysfunction related to circulatory arrest and myocardial ischemia during complex aortic arch surgery, an alternative and novel strategy for cerebro-myocardial protection was recently developed, where regional low-flow perfusion is combined with controlled and independent coronary perfusion. The aim of the present retrospective study was to assess short-term and mid-term results of selective and independent cerebro-myocardial perfusion in neonatal aortic arch surgery...
April 2018: Artificial Organs
https://www.readbyqxmd.com/read/29476389/age-and-mortality-in-pediatric-severe-traumatic-brain-injury-results-from-an-international-study
#13
Ajit Sarnaik, Nikki Miller Ferguson, A M Iqbal O'Meara, Shruti Agrawal, Akash Deep, Sandra Buttram, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Monica S Vavilala
BACKGROUND: Although small series have suggested that younger age is associated with less favorable outcome after severe traumatic brain injury (TBI), confounders and biases have limited our understanding of this relationship. We hypothesized that there would be an association between age and mortality in children within an ongoing observational, cohort study. METHODS: The first 200 subjects from the Approaches and Decisions for Acute Pediatric TBI trial were eligible for this analysis (inclusion criteria: severe TBI (Glasgow Coma Scale [GCS] score ≤ 8], age 18 years, and intracranial pressure (ICP) monitor placed; exclusion: pregnancy)...
February 23, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29425522/direct-splanchnic-perfusion-safely-avoids-deep-hypothermia
#14
REVIEW
Muhammad Aanish Raees, David P Bichell
Deep hypothermia for the operative correction of congenital cardiac lesions protects hypoperfused organs, mostly because of its effect on lowering metabolic demand and oxygen requirement. Deleterious cerebral and extracranial side effects of deep hypothermia itself calls for a reexamination of the therapeutic value of hypothermia, and has led to the development of alternative perfusion strategies. Here we describe the potential advantages of milder hypothermia over deep hypothermia and our method of a practical and reproducible implementation of multisite perfusion under mild hypothermia (32°C)...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/29420129/combined-application-of-glutamate-transporter-inhibitors-and-hypothermia-discriminates-principal-constituent-processes-involved-in-glutamate-homo-and-heteroexchange-in-brain-nerve-terminals
#15
Artem Pastukhov, Tatiana Borisova
Deep and profound hypothermia is successfully practiced in the prevention of ischemic stroke consequences and aortic arch cardiac surgery accompanied by reduction of cerebral circulation. Hypothermia is a current neuroprotection standard in hypoxic/ischemic encephalopathy. Drug-hypothermia administration is proposed as a new approach in pharmacotherapy for neonatal seizures. Also, hypothermia is useful as neuroprotective approach in long-term interplanetary space missions. We recently revealed gradual dynamics of hypothermia-induced decrease in transporter-mediated release and uptake of L-[14 C]glutamate in presynaptic rat brain nerve terminals (synaptosomes), thereby confirming potent unspecific neuroprotective effect of hypothermia...
February 8, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29408298/from-hypothermia-to-cephalosomatic-anastomoses-the-legacy-of-robert-white-1926-2010-at-case-western-reserve-university-of-cleveland
#16
REVIEW
Sunil Manjila, Vilakshan Alambyan, Gagandeep Singh, Priyanka Satish, Robert T Geertman
Dr. Robert J. White (1926-2010) was an eminent neurosurgeon and bioethicist, renowned for his classic work in hypothermia and pioneering mammalian head transplant experiments. He founded the Division of Neurosurgery at the Cleveland Metropolitan General Hospital (currently MetroHealth Medical Center, a level 1 trauma county hospital) and became the youngest full professor at the Case Western Reserve University in Cleveland, Ohio. With over 500 research articles to his credit, he founded the Brain Research Laboratory at what was then the Cleveland Metropolitan General Hospital, which was also home to future leaders in neurosurgery, neurosciences, and allied specialties...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29379254/inadvertent-hypothermia-in-hip-and-knee-total-joint-arthroplasty
#17
M Williams, Y El-Houdiri
Background: This clinical study aims to establish rates of inadvertent hypothermia (IH) in both primary and revision total hip/knee arthroplasty (THA/TKA and rTHA/rTHA). We postulate differences exist between demographic, surgical and anesthetic variables and outcomes for IH and normothermic patients. Methods: We conducted a single centre, retrospective study of 2431 total joint arthroplasty (TJA) patients having undergone THA (n = 1096), TKA (n = 1083), rTHA (n = 165) and rTKA (n = 87) from March 2013 to December 2016...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29346537/cerebral-mitochondrial-dysfunction-associated-with-deep-hypothermic-circulatory-arrest-in-neonatal-swine
#18
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
#19
Michael Schaefer, Wolfgang Gross, Martha-Maria Gebhard
OBJECTIVE: 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). APPROACH: We measured continuously the complex dielectric spectrum(DS), ATP- and lactate content, extracellular pH, and rigor contracture...
February 26, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#20
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
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