The Role of Deep Hypothermia in Cardiac Surgery

Radosław Gocoł, Damian Hudziak, Jarosław Bis, Konrad Mendrala, Łukasz Morkisz, Paweł Podsiadło, Sylweriusz Kosiński, Jacek Piątek and Tomasz Darocha
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Radosław Gocoł: Upper-Silesian Heart Center, Department of Cardiac Surgery, 40-635 Katowice, Poland
Damian Hudziak: Upper-Silesian Heart Center, Department of Cardiac Surgery, 40-635 Katowice, Poland
Jarosław Bis: Upper-Silesian Heart Center, Department of Cardiac Surgery, 40-635 Katowice, Poland
Konrad Mendrala: Department of Anaesthesiology and Intensive Care, Medical University of Silesia, 40-752 Katowice, Poland
Łukasz Morkisz: Upper-Silesian Heart Center, Department of Cardiac Surgery, 40-635 Katowice, Poland
Paweł Podsiadło: Institute of Medical Sciences, Jan Kochanowski University, 25-317 Kielce, Poland
Sylweriusz Kosiński: Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland
Jacek Piątek: Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, 31-202 Kraków, Poland
Tomasz Darocha: Department of Anaesthesiology and Intensive Care, Medical University of Silesia, 40-752 Katowice, Poland

IJERPH, 2021, vol. 18, issue 13, 1-14

Abstract: Hypothermia is defined as a decrease in body core temperature to below 35 °C. In cardiac surgery, four stages of hypothermia are distinguished: mild, moderate, deep, and profound. The organ protection offered by deep hypothermia (DH) enables safe circulatory arrest as a prerequisite to carrying out cardiac surgical intervention. In adult cardiac surgery, DH is mainly used in aortic arch surgery, surgical treatment of pulmonary embolism, and acute type-A aortic dissection interventions. In surgery treating congenital defects, DH is used to assist aortic arch reconstructions, hypoplastic left heart syndrome interventions, and for multi-stage treatment of infants with a single heart ventricle during the neonatal period. However, it should be noted that a safe duration of circulatory arrest in DH for the central nervous system is 30 to 40 min at most and should not be exceeded to prevent severe neurological adverse events. Personalized therapy for the patient and adequate blood temperature monitoring, glycemia, hematocrit, pH, and cerebral oxygenation is a prerequisite and indispensable part of DH.

Keywords: cardiac surgery; deep hypothermia; cardiac arrest; DHCA (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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