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A study of profound hypothermia by surface cooling
Canadian Anaesthetists' Society Journal
|July 1, 1980
Summary
This study demonstrates that profound hypothermia (below 20°C) with ether anesthesia safely enables over one hour of cardiac arrest for open-heart surgery, with low mortality and neurological complication rates.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Hypothermia Research
Background:
- Open-heart surgery requires controlled conditions for optimal outcomes.
- Achieving prolonged cardiac arrest safely is a significant surgical challenge.
Purpose of the Study:
- To evaluate the safety and efficacy of profound hypothermia and ether anesthesia for extended cardiac arrest during open-heart surgery.
- To assess physiological parameters and patient outcomes under these conditions.
Main Methods:
- Profound hypothermia (below 20°C) induced via ice water bath.
- Deep ether anesthesia supplemented with autonomic nerve blocking agents.
- Surgical procedures requiring cardiac arrest exceeding one hour.
Main Results:
- Stable vital signs and no arrhythmias observed during anesthesia.
- Ether blood levels ranged from 40.6 to 285.7 mg/dl.
- Post-arrest findings included hypocarbia, severe base deficit, and moderate catecholamine increase.
- Spontaneous recovery from metabolic acidosis with near-normal pH was noted.
- Elevated plasma renin activity, but non-significant angiotensin II levels.
- Excess lactate remained stable; hyperglycemia was observed.
Conclusions:
- Profound hypothermia and ether anesthesia provide a safe method for achieving prolonged cardiac arrest in open-heart surgery.
- The technique is associated with a low mortality rate (7.7%) and low incidence of neurological disorders (<5.8%).