[Bilateral diaphragm paralysis after cardiac surgery].

Area of Science:

• Cardiology
• Neurology
• Pulmonology

Background:

• Myocardial protection during cardiac surgery often involves hypothermia.
• Local hypothermia with slushed ice is a technique used for this purpose.

Observation:

• Two patients developed bilateral diaphragm paralysis and subsequent respiratory failure after cardiac surgery utilizing local hypothermia with slushed ice.
• The paralysis was diagnosed using neurophysiologic studies.

Findings:

• Local hypothermia with slushed ice was associated with diaphragm paralysis in these cardiac surgery patients.
• Recovery required prolonged ventilatory support over several weeks, with full recovery taking months.

Implications:

• This case series highlights a potential neurological complication of local hypothermia with slushed ice in cardiac surgery.
• Neurophysiologic monitoring may be crucial for diagnosing diaphragm dysfunction in such cases.
• Further research is warranted to understand the mechanism and incidence of this complication.