Deep hypothermic circulatory arrest

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Deep hypothermic circulatory arrest.

Effective cerebral protection remains the principle concern during aortic arch surgery. Hypothermic circulatory arrest (HCA) is entrenched as the primary neuroprotection mechanism since the 70s, as it slows injury-inducing pathways by limiting cerebral metabolism. However, increases in HCA duration has been associated with poorer neurological outcomes, necessitating the adjunctive use of antegr...

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Perioperative management of deep hypothermic circulatory arrest.

m d t r e t n a a h c n i l r t 1 t d u t 2 g g l t HE GOAL OF this article is to provide a review of deep hypothermic circulatory arrest (DHCA), covering major isues including pathophysiology of ischemic injury, organ protecion (both pharmacologic and nonpharmacologic), temperature ontrol, and perfusion methods. The purpose of this review is to erve as a resource for board review or as introdu...

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Apoptotic neuronal death following deep hypothermic circulatory arrest in piglets.

BACKGROUND Deep hypothermic circulatory arrest (DHCA), as used in infant heart surgery, carries a risk of brain injury. In a piglet DHCA model, neocortical neurons appear to undergo apoptotic death. Caspases, cytochrome c, tumor necrosis factor (TNF), and Fas play a role in apoptosis in many ischemic models. This study examined the expression of these factors in a DHCA piglet model. METHODS T...

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Accuracy of core temperature measurement in deep hypothermic circulatory arrest.

Deep hypothermia is an effective technique for neuroprotection in cardiac surgery. However, standard body temperature measurement may deviate from actual brain temperature. Therefore, we simultaneously measured brain and core temperatures during neurosurgical interventions in hypothermic circulatory arrest to determine its accuracy. Between 1994 and May 2007, 26 patients (12 female, mean age 46...

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Protecting The Brain During Deep Hypothermic Circulatory Arrest

Neurological complications after cardiac surgery are a recognized source of prolonged hospitalization, high hospital cost, altered quality of life, and mortality. Surgery involving the aortic arch is a particularly high risk procedure associated with stroke rates over four times higher than after CABG surgery (~9% vs ~2%). Although the use of selective antegrade cerebral perfusion via the brach...

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ژورنال

عنوان ژورنال: Continuing Education in Anaesthesia Critical Care & Pain

سال: 2010

ISSN: 1743-1816

DOI: 10.1093/bjaceaccp/mkq024