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Related Experiment Videos

Intramyocardial temperature following various cooling procedures.

H Vejlsted, K Andersen, B Husum

    Scandinavian Journal of Thoracic and Cardiovascular Surgery
    |January 1, 1983
    PubMed
    Summary

    Effective cardiac cooling during surgery requires general moderate hypothermia combined with local cooling methods. Local cooling alone, even with ice, failed to adequately reduce intramyocardial temperatures in all heart regions.

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    Area of Science:

    • Cardiovascular Surgery
    • Hypothermia Research
    • Myocardial Protection

    Background:

    • Maintaining optimal intramyocardial temperature is crucial during cardiac arrest.
    • Previous cooling methods have shown variable efficacy in reaching target temperatures throughout the myocardium.

    Purpose of the Study:

    • To evaluate the effectiveness of different local myocardial cooling techniques during cardiopulmonary bypass.
    • To determine the optimal strategy for achieving uniform low intramyocardial temperatures during anoxic cardiac arrest.

    Main Methods:

    • Intramyocardial temperatures were measured in 12 dogs using microthermoelectrodes in the left ventricle and septum.
    • Different cooling protocols were tested, including external pericardial cooling and direct coronary infusion followed by ice packing.

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  • The impact of local cooling was assessed with and without general moderate hypothermia.

    • Main Results:

    • External cooling with iced glucose solution did not significantly lower temperatures in the septum or posterior wall.
    • Local cardiac cooling with ice and glucose infusion reduced septal and posterior wall temperatures to approximately 30°C.
    • Combining local cooling with general moderate hypothermia successfully lowered intramyocardial temperatures to around 20°C in all measured regions.

    Conclusions:

    • Local myocardial cooling strategies alone are insufficient for achieving therapeutic hypothermia in all cardiac regions.
    • General moderate hypothermia is essential and must be combined with local cooling for effective intramyocardial temperature reduction.
    • Combined cooling approaches are necessary for comprehensive myocardial protection during cardiac arrest.