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Establishment of Deep Hypothermic Circulatory Arrest in Rats

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[Anesthetic management using auto-transfusion and hypothermia for massive bleeding].

Michi Ishizawa¹, Sonoko Matsumoto, Keiko Tajima

¹Department of Anesthesiology, Juntendo Tokyo Koto Geriatric Medical Center Tokyo 136-0075.

Masui. the Japanese Journal of Anesthesiology

|September 21, 2012

Summary

Intraoperative blood salvage and mild hypothermia were used in a patient with severe bleeding during surgery for cervical cancer complications. These techniques helped manage massive blood loss and protect the brain, proving life-saving.

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Area of Science:

Anesthesiology
Surgical Oncology
Critical Care Medicine

Background:

A 51-year-old female patient presented with hypovolemic shock due to internal iliac artery bleeding, a complication of prior cervical cancer radiotherapy.
The patient required emergency enterectomy and vascular repair under general anesthesia.

Observation:

Massive intraoperative hemorrhage occurred, with blood loss exceeding 6,000 ml in the first two hours.
Hemoglobin levels dropped to 3.8 g/dL despite transfusion of 38 units of packed red blood cells.
Intraoperative blood salvage (Cell Saver) and mild hypothermia were implemented.

Findings:

Total blood loss reached approximately 10,000 ml, with a total transfused volume of 8,740 ml.
The patient experienced no postoperative neurological deficits or systemic infections.
Cell Saver likely minimized further hemoglobin loss, and mild hypothermia may have protected against cerebral ischemia.

Implications:

Intraoperative blood salvage can be a life-saving intervention in managing massive hemorrhage, even in complex surgical cases.
Mild hypothermia may offer neuroprotection during major surgery with significant blood loss.
Further research is warranted on the safety and efficacy of cell salvage in oncology patients, despite current controversies.