The Circulation in Hypothermia

Ke, Cooper

doi:10.1093/oxfordjournals.bmb.a069863

Cited by 22 publications

(4 citation statements)

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“…However, Tofler (1962) observed that further reduction of the temperature caused bradycardia, atrial fibrillation, ventricular fibrillation, and finally asystole at 13GC. Cooper (1961) stated that in the limitation of arrhythmias, important parameters were the arterial Pco2, pH, and serum potassium and calcium levels. Unfortunately we have insufficient biochemical data on our patients who developed arrhythmias to comment on this postulate, as most were operated on under hypothermia with minimal biochemical control.…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrhythmias following successful surgical closure of atrial septal defect.

Reid¹,

Stevenson²

1967

Heart

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Section: Discussionmentioning

confidence: 99%

Cardiac arrhythmias following successful surgical closure of atrial septal defect.

Reid¹,

Stevenson²

1967

Heart

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“…At a body temperature of 33°C oxygen consumption is 70% lower compared to baseline levels [31,32]. At the same time the number of oxygen carriers increases [33] most likely due to the effect of reduced plasmatic volume and simultaneous stimulation of erythrocytes released by the spleen [34] leading to an increase of the haematocrit. This should result in an increase of PmyO 2 even if blood flow is unchanged.…”

Section: Discussionmentioning

confidence: 92%

Influence of systemic hypothermia on the myocardial oxygen tension during extracorporeal circulation: Comparative study in German Landrace pigs

Matschke

Knaut

Kanig

et al. 2012

Clinical Hemorheology and Microcirculation

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During extracorporeal circulation (ECC) controlled hypothermia is a common method of myocardial protection due to a reduction of the myocardial oxygen consumption. Although the beneficial aspects of hypothermia on the myocardial metabolism have been widely demonstrated the effect of hypothermia on the myocardial oxygen tension (PmyO 2) is unclear. For this reason the PmyO 2 of German Landrace pigs (male, three months of age) during ECC was analysed under mild hypothermia (32 °C, n=6 pigs) and under normothermia (n=10 pigs, control group) within a time period of 23 min (1400 sec). Flexible invasive Clark type microcatheters were used to measure the PmyO 2 in the beating heart. During normothermal ECC a continuous PmyO 2 increase from 36.5±15.8 mmHg to 52.6±27.2 mmHg (+44.1%) after 1400 sec was measured (p=0.02). In contrast, mild hypothermia caused a continuous PmyO 2 decrease from initially 46.9±17.5 mmHg to 36.7±20.8 mmHg (-21.8%, p<0.013) in the test period. Electrocardiography revealed no signs of ischemia or arrhythmia during normo-and hypothermic ECC. It seems obvious that mild hypothermia results in a reduction of the oxygen transfer to the myocardial cells and that this effect outweighs the beneficial effects of hypothermia in the myocardium which are related to reduced oxygen consumption. However, in mild hypothermia oxygen supply to the myocardium remained sufficient for normal myocardial function.

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“…In addition to the possible beneficial metabolic effects, there was also evidence that moderate hypothermia may have a direct beneficial effect on myocardial function, particularly if there was pre‐existing ventricular dysfunction [4, 16–19]. There may also be some added direct beneficial effect on the failing myocardium secondary to the decrease in heart rate caused by the direct effect of cold on the sino‐atrial node [20].…”

Section: Discussionmentioning

confidence: 99%

Induced hypothermia in the postoperative management of refractory cardiac failure following paediatric cardiac surgery

Deakin¹,

Knight²,

Edwards³

et al. 1998

Anaesthesia

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Postoperative low cardiac output states are a major cause of postoperative mortality in infants and children following corrective cardiac surgery for congenital heart defects. In this unit, whole body hypothermia has been used since 1979 in the management of these low output states when they are refractory to conventional modes of therapy. Twenty cases treated in this way between July 1986 and June 1990 were reviewed in 1992. The current report reviews the 50 further cases treated with moderate hypothermia between July 1990 and December 1995. The median (range) age of patients was 8 months (0 days-16 years) with a median weight of 4.1 kg (2.5-33 kg). Following cooling, there was a decrease in heart rate (p < 0.001), an increase in mean arterial pressure (p < 0.001) and a decrease in mean atrial pressure (p < 0.001). Significant increases in pH and urine output were also noticed, the increase in urine output being greater in the surviving group (p = 0.02). A decrease in platelet count occurred (p < 0.001) but white blood cell count remained unchanged (p = 0.18). Twenty-five of the 50 patients survived to leave hospital. Induced hypothermia does not appear to be associated with any complications and after the failure of all conventional treatment, it seems likely that the technique may have been beneficial to outcome in some patients.

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The Circulation in Hypothermia

Cited by 22 publications

References 0 publications

Cardiac arrhythmias following successful surgical closure of atrial septal defect.

Cardiac arrhythmias following successful surgical closure of atrial septal defect.

Influence of systemic hypothermia on the myocardial oxygen tension during extracorporeal circulation: Comparative study in German Landrace pigs

Induced hypothermia in the postoperative management of refractory cardiac failure following paediatric cardiac surgery

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