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Perfusion without systemic heparinization for rewarming in accidental hypothermia.
L K von Segesser1, E Garcia, M Turina
1Clinic for Cardiovascular Surgery, University Hospital, Zürich, Switzerland.
The Annals of Thoracic Surgery
|September 1, 1991
Summary
This study details successful rewarming of a patient with deep hypothermia and cardiorespiratory arrest using heparin-coated cardiopulmonary bypass. This technique avoided systemic anticoagulation, enabling patient recovery.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Hypothermia Research
Background:
- Severe craniocerebral injury can lead to accidental deep hypothermia and cardiorespiratory arrest.
- Systemic anticoagulation is often contraindicated in patients with severe brain injury due to bleeding risks.
Observation:
- A patient presented with accidental deep hypothermia (23.3°C) and cardiorespiratory arrest following severe craniocerebral injury.
- Standard anticoagulation therapy was deemed too risky for this patient.
Findings:
- Cardiopulmonary bypass was employed for rewarming without systemic heparinization.
- Heparin-coated perfusion equipment was utilized to mitigate thrombotic risks.
- The patient was successfully rewarmed and weaned from cardiopulmonary bypass.
Implications:
- Heparin-coated cardiopulmonary bypass offers a viable alternative for rewarming critically ill patients when systemic anticoagulation is contraindicated.
- This approach may improve outcomes in patients with combined hypothermia and severe head trauma.
- Further research into heparin-coated circuits in complex critical care scenarios is warranted.