Bone As A Tissue

The hemodynamic and metabolic change observed in the hypothermic liver have been measured. Although much remains unexplored, the nonuniform depression of the many functions is made clear and the protection against anoxia that hypothermia offers the liver is described. Renal physiology lends itself well to accurate measurement and advantage is taken of this to investigate the degree of depression of renal blood flow, glomerular filtration rate, etc., at moderate levels of hypothermia. The urine volume is known to remain constant during hypothermia and the mechanism for this is described. This chapter will be especially rewarding since the terms and diagrams will be within the grasp of all on first reading. In four chapters the central nervous system is considered. This is an area in which extensive clinical experience with hypothermia has been gained. The several authors have described the response of the normal brain to hypothermia and the central nervous system control of body temperature. Also described is the value of hypothermia in preventing the progression of thermal and anoxic injuries in the brain even when there has been a delay of 3-4 hours. In profound hypothermia the temperature is reduced below 150C and the heart is in arrest. Under these conditions operative procedures can be undertaken that are not possible at normal temperatures or in moderate hypothermia. It requires little imagination to grasp the potential value of this modality. Because this review serves such a useful purpose, it is hoped that a comprehensive report at regular intervals will be continued.