Experiments with a bowl of saline: The hidden risk of hypothermic-osmotic damage during topical cardiac cooling

Robicsek, Francis; Duncan, Gordon D.; Rice, Harold E.; Robicsek, Steven A.

doi:10.1016/s0022-5223(19)34587-8

Cited by 7 publications

(1 citation statement)

References 11 publications

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“…Robicsek et al reported that cardiac myocyte dehydration due to relative hyperosmolarity secondary to hypothermal iced saline caused myocardial functional disorder, and with the progression of this process, cell death may occur in time. 18 In another study, Conno et al reported that topical cooling with iced saline may cause epicardial oedema via a hypothermic–hypo-osmolar effect and may create temporary ST-segment anomalies on ECG without myocardial functional disorders. 19 We did not see any significant abnormalities in ECG or echocardiography in our study.…”

Section: Other Parametersmentioning

confidence: 99%

Effects of topical hypothermia on postoperative inflammatory markers in patients undergoing coronary artery bypass surgery : cardiovascular topic

Kadan¹,

Erol²,

Oz³

et al. 2014

CVJA

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SummaryBackgroundWe aimed to examine the effects of topical hypothermia on inflammatory markers in patients undergoing coronary artery bypass surgery.MethodsFifty patients undergoing isolated coronary artery bypass surgery were included the study. They were randomised to two groups. Mild hypothermic cardiopulmonary bypass (28–32°C) was performed on both groups using standardised anaesthesiology and surgical techniques. Furthermore, topical cooling with 4°C saline was performed on patients in group I. We recorded peri-operative and intra-operative results of blood samples, pre-operative and postoperative outcomes of electrocardiography and echocardiography, diaphragm levels on X-ray, and the necessity of positive inotropic medication and intra-aortic balloon pump (IABP).ResultsTime-dependent changes in blood samples were compared between the two groups. The changes on complement 3 (C3) and TNF-α levels were more significant in group I than group II (p < 0.05 and p < 0.001, respectively). Spontaneous restoration rate of sinus rhythm was higher in group II than group I (80 vs 32%, p < 0.01). Atrial fibrillation was seen in six patients in group I and one patient in group II (p < 0.05). IABP was performed on four patients (16%) in group I (p < 0.05). Diaphragmatic paralysis was seen in seven patients in group I but not in group II (p < 0.01). Partial pericardiotomy rates were compared within the groups but there was no statistically significant difference (p > 0.05). One patient in group I died on the 18th postoperative day, but operative mortality rate was not statistically significant between the two groups (p > 0.05).ConclusionsTopical hypothermia had a negative impact on inflammatory markers and postoperative morbidities.

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Section: Other Parametersmentioning

confidence: 99%