The “Ice Age” in Cardiac Surgery: Evolution of the “Siberian” Method of Brain Protection During Deep Hypothermic Perfusionless Circulatory Arrest

Guvakov, Dmitri; Bezinover, Dmitri; Ломиворотов, В. В.; Постнов, В. Г.; Weiss, Stuart J.; Cheung, Albert T.; Swain, Julie A.; Ломиворотов, В. Н.

doi:10.1053/j.jvca.2019.04.001

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…19 Indeed, hypothermia reduces tissue oxygen and metabolic demand to the extent that systemic perfusion may be interrupted for limited periods. 20 To differentiate the confounding effects of general anesthesia from the consequence of circulatory arrest, patients who had thoracic aortic surgery both with and without HCA were included in our study. In the scientific literature, few cases of NDE during general anesthesia are reported and they may be distinguished from "intraoperative awareness."…”

Section: Discussionmentioning

confidence: 99%

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Does Hypothermic Circulatory Arrest for Aortic Surgery Trigger Near-Death Experience? Incidence of Near-Death Experiences after Aortic Surgeries Performed under Hypothermic Circulatory Arrest

et al. 2021

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Background Understanding near-death experiences (NDE) could provide a new insight into the analysis of human consciousness and the neurocognitive processes happening upon the approach of death. With a temporary interruption of systemic perfusion, aortic surgery under hypothermic circulatory arrest (HCA) may be the only available model of reversible clinical death. We present, herein, the results of an observational study designed to assess the incidence of NDE after aortic surgery. Methods We performed a prospective study including consecutive patients who underwent thoracic aortic surgery between July 2018 and September 2019 at our institution. Procedures without HCA were included to constitute a control group. The primary outcome was the incidence of NDE assessed with the Greyson NDE scale during the immediate postoperative course, via a standardized interview of the patients in the surgical ward. Results One hundred and one patients were included. Twenty-one patients (20.8%) underwent nonelective interventions for aortic dissection. Ninety-one patients had hemiarch replacement (90.1%). Sixty-seven (66.3%) interventions were performed with HCA, with an average circulatory arrest duration of 26.9 ± 25.5 minutes, and a mean body temperature of 23.7 ± 3.8°C. None of the patients reported any recollection from their period of unconsciousness. There was no NDE experiencer in the study cohort. Conclusion Several confounding factors regarding anesthesia, or NDE evaluation, might have impaired the chance of NDE recollections, and might have contributed to this negative result. Whether HCA may trigger NDE remains unknown.

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Section: Discussionmentioning

confidence: 99%

“… 19 Indeed, hypothermia reduces tissue oxygen and metabolic demand to the extent that systemic perfusion may be interrupted for limited periods. 20 …”

Section: Discussionmentioning

confidence: 99%

Does Hypothermic Circulatory Arrest for Aortic Surgery Trigger Near-Death Experience? Incidence of Near-Death Experiences after Aortic Surgeries Performed under Hypothermic Circulatory Arrest

et al. 2021

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“…Also, cold has protective effects on cells by down regulating their metabolism [ 10 ]. For example, the first cardiac operations were performed in ice water baths [ 11 ]. Then, topical cooling for myocardial protection has been replaced by cold blood or cold crystalloid cardioplegia: moderate hypothermia (below 28 °C) induces cardiac arrest [ 12 ], while profound hypothermia (temperature around 17.5 °C) is sometimes used for total circulatory arrest and brain protection [ 13 ].…”

Section: How Cold Promotes Entry Of the Virus In The Respiratory Tract?mentioning

confidence: 99%

On the footsteps of Hippocrates, Sanctorius and Harvey to better understand the influence of cold on the occurrence of COVID-19 in European countries in 2020

et al. 2021

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COVID-19 pandemic has been characterized by a pattern of consecutive declines and regrowth in European countries in 2020. After being partially regressed during the summer, the reappearance of the infection during fall 2020 in many temperate countries strongly suggests that temperature and cold may play a role in influencing the infectivity and virulence of SARS-CoV-2. While promoting medicine as an art, Hippocrates interpreted with logical reasoning the occurrence of diseases such as epidemics, as a consequence of environmental factors, in particular climatic variations. During the Renaissance, Sanctorius was one of the first to perform quantitative measurements, and Harvey discovered the circulation of blood by performing experimental procedures in animals. We think that a reasoning mixing various observations, measurements and experiments is fundamental to understand how cold increases infectivity and virulence of SARS-CoV-2. By this review, we provide evidence linking cold, angiotensin-II, vasoconstriction, hypoxia and aerobic glycolysis (the Warburg effect) to explain how cold affects the epidemiology of COVID-19. Also, a low humidity increases virus transmissibility, while a warm atmosphere, a moderate airway humidity, and the production of vasodilator angiotensin 1-7 by ACE2 are less favorable to the virus entry and/or its development. The meteorological and environmental parameters impacting COVID-19 pandemic should be reintegrated into a whole perspective by taking into account the different factors influencing transmissibility, infectivity and virulence of SARS-CoV-2. To understand the modern enigma represented by COVID-19, an interdisciplinary approach is surely essential.

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Monitoring cardiac and ascending aortic procedures

Stecker

Keselman

2022

Intraoperative Neuromonitoring

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The “Ice Age” in Cardiac Surgery: Evolution of the “Siberian” Method of Brain Protection During Deep Hypothermic Perfusionless Circulatory Arrest

Cited by 5 publications

References 21 publications

Does Hypothermic Circulatory Arrest for Aortic Surgery Trigger Near-Death Experience? Incidence of Near-Death Experiences after Aortic Surgeries Performed under Hypothermic Circulatory Arrest

Does Hypothermic Circulatory Arrest for Aortic Surgery Trigger Near-Death Experience? Incidence of Near-Death Experiences after Aortic Surgeries Performed under Hypothermic Circulatory Arrest

On the footsteps of Hippocrates, Sanctorius and Harvey to better understand the influence of cold on the occurrence of COVID-19 in European countries in 2020

Monitoring cardiac and ascending aortic procedures

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