Deep hypothermia without extracorporeal circulation in surgery of congenital cardiac defects. 1994

E E Litasova, and V N Lomivirotov, and J N Gorbatich, and A V Shunkin, and J A Vlassov
Institute of Circulation Pathology, Novosibirsk, Russia.

Operations on the open heart under perfusionless deep hypothermia were performed in 3,141 patients with congenital cardiac defects. The patients ages ranged from 3 months to 44 years. The body was cooled to 26-24 degrees C by covering with crushed ice. Cooling was performed under conditions of not deep ether anesthesia with the use of minimum doses of narcotic analgetics (morphine 0.5 mg/kg). Lactacidemia was registered during hypothermia. In contrast to lactate, the content of fatty acids and 11-hydroxycorticosteroids during all the stages of hypothermia did not change significantly. The time of circulatory arrest ranged from 10-89 min. It took 2-7 min to restore cardiac activity. Of 3,141 patients operated on, 265 died (8.44%). The mortality pattern demonstrated that the major cause of death was cardiac insufficiency (5.9%). Neurological sequelae were observed in 110 patients (3.5%). Based on the results of tests with Luria's neuropsychological method, neurological disturbances were registered in 15.4% of patients. The frequencies of neuropsychological complications were not related to the time of circulatory arrest. Unstable hemodynamics after operation was the most contributory factor to the development of neurological complications. Perfusionless deep hypothermia is an efficient method providing conditions for performance of open heart operations, and it can be used in surgical repair of congenital cardiac defects.

UI MeSH Term Description Entries
D007036 Hypothermia, Induced Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries. Induced Hypothermia,Mild Hypothermia, Induced,Moderate Hypothermia, Induced,Targeted Temperature Management,Therapeutic Hypothermia,Hypothermia, Therapeutic,Induced Mild Hypothermia,Induced Mild Hypothermias,Induced Moderate Hypothermia,Induced Moderate Hypothermias,Mild Hypothermias, Induced,Moderate Hypothermias, Induced,Targeted Temperature Managements
D007223 Infant A child between 1 and 23 months of age. Infants
D009206 Myocardium The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow. Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D001927 Brain Diseases Pathologic conditions affecting the BRAIN, which is composed of the intracranial components of the CENTRAL NERVOUS SYSTEM. This includes (but is not limited to) the CEREBRAL CORTEX; intracranial white matter; BASAL GANGLIA; THALAMUS; HYPOTHALAMUS; BRAIN STEM; and CEREBELLUM. Intracranial Central Nervous System Disorders,Brain Disorders,CNS Disorders, Intracranial,Central Nervous System Disorders, Intracranial,Central Nervous System Intracranial Disorders,Encephalon Diseases,Encephalopathy,Intracranial CNS Disorders,Brain Disease,Brain Disorder,CNS Disorder, Intracranial,Encephalon Disease,Encephalopathies,Intracranial CNS Disorder
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D005112 Extracorporeal Circulation Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation. Circulation, Extracorporeal,Circulations, Extracorporeal,Extracorporeal Circulations
D006324 Heart Arrest, Induced A procedure to stop the contraction of MYOCARDIUM during HEART SURGERY. It is usually achieved with the use of chemicals (CARDIOPLEGIC SOLUTIONS) or cold temperature (such as chilled perfusate). Cardiac Arrest, Induced,Cardioplegia,Induced Cardiac Arrest,Induced Heart Arrest,Cardioplegias

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