Circulatory Arrest, Deep Hypothermia Induced: A technique to arrest the flow of blood by lowering BODY TEMPERATURE to about 20 degrees Centigrade, usually achieved by infusing chilled perfusate. The technique provides a bloodless surgical field for complex surgeries.Hypothermia, Induced: Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries.Hypothermia: Lower than normal body temperature, especially in warm-blooded animals.Rewarming: Application of heat to correct hypothermia, accidental or induced.Heart Arrest, Induced: A procedure to stop the contraction of MYOCARDIUM during HEART SURGERY. It is usually achieved with the use of chemicals (CARDIOPLEGIC SOLUTIONS) or cold temperature (such as chilled perfusate).Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs.Extracorporeal Circulation: Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation.Perioperative Period: The time periods immediately before, during and following a surgical operation.Aorta, Thoracic: The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA.Aortic Aneurysm, Thoracic: An abnormal balloon- or sac-like dilatation in the wall of the THORACIC AORTA. This proximal descending portion of aorta gives rise to the visceral and the parietal branches above the aortic hiatus at the diaphragm.Blood Coagulation Disorders: Hemorrhagic and thrombotic disorders that occur as a consequence of abnormalities in blood coagulation due to a variety of factors such as COAGULATION PROTEIN DISORDERS; BLOOD PLATELET DISORDERS; BLOOD PROTEIN DISORDERS or nutritional conditions.Aortic Aneurysm: An abnormal balloon- or sac-like dilatation in the wall of AORTA.Aneurysm, Dissecting: Aneurysm caused by a tear in the TUNICA INTIMA of a blood vessel leading to interstitial HEMORRHAGE, and splitting (dissecting) of the vessel wall, often involving the AORTA. Dissection between the intima and media causes luminal occlusion. Dissection at the media, or between the media and the outer adventitia causes aneurismal dilation.Body Temperature: The measure of the level of heat of a human or animal.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Hypoxia-Ischemia, Brain: A disorder characterized by a reduction of oxygen in the blood combined with reduced blood flow (ISCHEMIA) to the brain from a localized obstruction of a cerebral artery or from systemic hypoperfusion. Prolonged hypoxia-ischemia is associated with ISCHEMIC ATTACK, TRANSIENT; BRAIN INFARCTION; BRAIN EDEMA; COMA; and other conditions.Heart Arrest: Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Body Temperature Regulation: The processes of heating and cooling that an organism uses to control its temperature.Asphyxia Neonatorum: Respiratory failure in the newborn. (Dorland, 27th ed)Shivering: Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals.Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE.Deep Brain Stimulation: Therapy for MOVEMENT DISORDERS, especially PARKINSON DISEASE, that applies electricity via stereotactic implantation of ELECTRODES in specific areas of the BRAIN such as the THALAMUS. The electrodes are attached to a neurostimulator placed subcutaneously.Coma: A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION.Cold Temperature: An absence of warmth or heat or a temperature notably below an accustomed norm.Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.Aortic Valve Stenosis: A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.Heart Valve Prosthesis Implantation: Surgical insertion of synthetic material to repair injured or diseased heart valves.Trauma, Nervous System: Traumatic injuries to the brain, cranial nerves, spinal cord, autonomic nervous system, or neuromuscular system, including iatrogenic injuries induced by surgical procedures.Hippocampus: A curved elevation of GRAY MATTER extending the entire length of the floor of the TEMPORAL HORN of the LATERAL VENTRICLE (see also TEMPORAL LOBE). The hippocampus proper, subiculum, and DENTATE GYRUS constitute the hippocampal formation. Sometimes authors include the ENTORHINAL CORTEX in the hippocampal formation.Brain Injuries: Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.Nervous System Diseases: Diseases of the central and peripheral nervous system. This includes disorders of the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscle.Aortic Aneurysm, Abdominal: An abnormal balloon- or sac-like dilatation in the wall of the ABDOMINAL AORTA which gives rise to the visceral, the parietal, and the terminal (iliac) branches below the aortic hiatus at the diaphragm.Aortic Rupture: The tearing or bursting of the wall along any portion of the AORTA, such as thoracic or abdominal. It may result from the rupture of an aneurysm or it may be due to TRAUMA.Aneurysm: Pathological outpouching or sac-like dilatation in the wall of any blood vessel (ARTERIES or VEINS) or the heart (HEART ANEURYSM). It indicates a thin and weakened area in the wall which may later rupture. Aneurysms are classified by location, etiology, or other characteristics.Blood Vessel Prosthesis Implantation: Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels.Pulmonary Veins: The veins that return the oxygenated blood from the lungs to the left atrium of the heart.Heart Defects, Congenital: Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.Scimitar Syndrome: An anomalous pulmonary venous return in which the right PULMONARY VEIN is not connected to the LEFT ATRIUM but to the INFERIOR VENA CAVA. Scimitar syndrome is named for the crescent- or Turkish sword-like shadow in the chest radiography and is often associated with hypoplasia of the right lung and right pulmonary artery, and dextroposition of the heart.Alkalosis, Respiratory: A state due to excess loss of carbon dioxide from the body. (Dorland, 27th ed)Ether: A mobile, very volatile, highly flammable liquid used as an inhalation anesthetic and as a solvent for waxes, fats, oils, perfumes, alkaloids, and gums. It is mildly irritating to skin and mucous membranes.National Socialism: The doctrines and policies of the Nazis or the National Social German Workers party, which ruled Germany under Adolf Hitler from 1933-1945. These doctrines and policies included racist nationalism, expansionism, and state control of the economy. (from Columbia Encyclopedia, 6th ed. and American Heritage College Dictionary, 3d ed.)Neuropsychological Tests: Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury.Periodicals as Topic: A publication issued at stated, more or less regular, intervals.Access to Information: Individual's rights to obtain and use information collected or generated by others.Journal Impact Factor: A quantitative measure of the frequency on average with which articles in a journal have been cited in a given period of time.Bibliometrics: The use of statistical methods in the analysis of a body of literature to reveal the historical development of subject fields and patterns of authorship, publication, and use. Formerly called statistical bibliography. (from The ALA Glossary of Library and Information Science, 1983)Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.Peer Review, Research: The evaluation by experts of the quality and pertinence of research or research proposals of other experts in the same field. Peer review is used by editors in deciding which submissions warrant publication, by granting agencies to determine which proposals should be funded, and by academic institutions in tenure decisions.Brain: The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.

Circulatory arrest and low-flow cardiopulmonary bypass alter CREB phosphorylation in piglet brain. (1/89)

BACKGROUND: The purpose of this study was to determine the effects of low-flow cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest followed by postbypass recovery on the phosphorylation state of transcription factor, cyclic adenosine 3', 5'-monophosphate response element-binding protein (CREB), in the striatum of neonatal brain. METHODS: Neonatal piglets (1.4 to 2.5 kg) anesthetized with isoflurane and fentanyl were put on CPB. The animals were cooled to 18 degrees C during a 20-minute period. The CPB circuit flow was then either reduced to 20 mL.kg(-1).min(-1) for 90 minutes (low-flow CPB) or turned off for 90 minutes (deep hypothermic circulatory arrest), following with a gradual increase in the flow and rewarming during a 30-minute period and a 2-hour recovery. At the end of the recovery period, the animals were rapidly euthanized, and the striata were removed and frozen for immunochemical analysis by Western blot technique using antibodies against phosphorylated and total CREB. The results are presented as mean +/- standard deviation (p < 0.05 was significant). RESULTS: Deep hypothermic circulatory arrest did not result in alteration in either the level of CREB or its degree of phosphorylation in the piglet striatum whereas after low-flow CPB, CREB phosphorylation was significantly increased (p < 0.005) and there was also an increase in CREB expression (p < 0.01). CONCLUSIONS: This study indicates that at 2 hours of recovery, low-flow CPB but not deep hypothermic circulatory arrest causes an increase in CREB phosphorylation and expression. Future studies will determine the degree to which the increase in CREB phosphorylation correlates with cell survival and neuronal injury after CPB.  (+info)

Effects of cold cardioplegia on pH, Na, and Ca in newborn rabbit hearts. (2/89)

Many studies suggest myocardial ischemia-reperfusion (I/R) injury results largely from cytosolic proton (H(i))-stimulated increases in cytosolic Na (Na(i)), which cause Na/Ca exchange-mediated increases in cytosolic Ca concentration ([Ca]i). Because cold, crystalloid cardioplegia (CCC) limits [H]i, we tested the hypothesis that in newborn hearts, CCC diminishes H(i), Na(i), and Ca(i) accumulation during I/R to limit injury. NMR measured intracellular pH (pH(i)), Na(i), [Ca]i, and ATP in isolated Langendorff-perfused newborn rabbit hearts. The control ischemia protocol was 30 min for baseline perfusion, 40 min for global ischemia, and 40 min for reperfusion, all at 37 degrees C. CCC protocols were the same, except that ice-cold CCC was infused for 5 min before ischemia and heart temperature was lowered to 12 degrees C during ischemia. Normal potassium CCC solution (NKCCC) was identical to the control perfusate, except for temperature; the high potassium (HKCCC) was identical to NKCCC, except that an additional 11 mmol/l KCl was substituted isosmotically for NaCl. NKCCC and HKCCC were not significantly different for any measurement. The following were different (P < 0.05). End-ischemia pH(i) was higher in the CCC than in the control group. Similarly, CCC limited increases in Na(i) during I/R. End-ischemia Na(i) values (in meq/kg dry wt) were 115 +/- 16 in the control group, 49 +/- 13 in the NKCCC group, and 37 +/- 12 in the HKCCC group. CCC also improved [Ca]i recovery during reperfusion. After 40 min of reperfusion, [Ca](i) values (in nmol/l) were 302 +/- 50 in the control group, 145 +/- 13 in the NKCCC group, and 182 +/- 19 in the HKCCC group. CCC limited ATP depletion during ischemia and improved recovery of ATP and left ventricular developed pressure and decreased creatine kinase release during reperfusion. Surprisingly, CCC did not significantly limit [Ca]i during ischemia. The latter is explained as the result of Ca release from intracellular buffers on cooling.  (+info)

Increasing duration of deep hypothermic circulatory arrest is associated with an increased incidence of postoperative electroencephalographic seizures. (3/89)

OBJECTIVE: Electroencephalographic seizures have been shown to occur in 5% to 20% of neonates and infants after biventricular repair of a variety of cardiac defects. Occurrence of a seizure is a predictor of adverse long-term neurodevelopmental sequelae. The contemporary incidence of postoperative seizures after repair of cardiac defects such as hypoplastic left heart syndrome and other forms of single ventricle is not known. METHODS: A prospective study of 178 patients less than 6 months of age undergoing cardiopulmonary bypass with or without deep hypothermic circulatory arrest (DHCA) was conducted at a single institution from September 2001 through March 2003 to identify postoperative seizures assessed by 48-hour continuous video electroencephalographic monitoring. RESULTS: Cardiac defects included transposition of the great arteries with or without a ventricular septal defect (n = 12), ventricular septal defect with or without coarctation (n = 28), tetralogy of Fallot (n = 24), hypoplastic left heart syndrome or variant (n = 60), other functional single ventricle (n = 14), and other defects suitable for biventricular repair (n = 40). Median age at the time of the operation was 7 days (range, 1-188 days) and was 30 days or less in 110 (62%) patients. DHCA was used in 117 (66%) patients, with multiple episodes in 9 patients. Median total duration of DHCA was 40 minutes (range, 1-90 minutes). Electroencephalographic seizures were identified in 20 (11.2%) patients. Seizures occurred in 15 (14%) of 110 neonates and 5 (7%) of 68 older infants. Seizures occurred in 1 (4%) of 24 patients with tetralogy of Fallot, 1 (8%) of 12 with transposition of the great arteries, and 11 (18%) of 60 with hypoplastic left heart syndrome or variant. By stepwise logistic regression analysis, once increasing duration of total DHCA (P = .001) was considered, no other variable improved prediction of occurrence of a seizure. Patients with DHCA duration of more than 40 minutes had an increased incidence of seizures (14/58 [24.1%]) compared with those with a DHCA duration of 40 minutes or less (4/59 [6.8%], P = .04). The incidence of seizures for patients with a DHCA duration of 40 minutes or less was not significantly different from those in whom DHCA was not used (2/61 [3.3%], P = .38). CONCLUSIONS: In the current era, continuous electroencephalographic monitoring demonstrates early postoperative seizures in 11.2% of a heterogeneous cohort of neonates and infants with complex congenital heart defects. Increasing duration of DHCA was identified as a predictor of seizures. However, the incidence of seizures in children with limited duration of DHCA was similar to that in infants undergoing continuous cardiopulmonary bypass alone.  (+info)

Brain oxygen and metabolism during circulatory arrest with intermittent brief periods of low-flow cardiopulmonary bypass in newborn piglets. (4/89)

OBJECTIVE: We performed this study to determine whether brief intermittent periods of low-flow cardiopulmonary bypass during deep hypothermic circulatory arrest would improve cortical metabolic status and prolong the "safe" time of deep hypothermic circulatory arrest. METHODS: After a 2-hour baseline, newborn piglets were placed on cardiopulmonary bypass and cooled to 18 degrees C. The animals were then subjected to 80 minutes of deep hypothermic circulatory arrest interrupted by 5-minute periods of low-flow cardiopulmonary bypass at either 20 mL x kg(-1) x min(-1) (LF-20) or 80 mL x kg(-1) x min(-1) (LF-80) during 20, 40, 60, and 80 minutes of deep hypothermic circulatory arrest. All animals were rewarmed, separated from cardiopulmonary bypass, and maintained for 2 hours (recovery). The oxygen pressure in the cerebral cortex was measured by the quenching of phosphorescence. The extracellular dopamine level in the striatum was determined by microdialysis. Results are means +/- SD. RESULTS: Prebypass oxygen pressure in the cerebral cortex was 65 +/- 7 mm Hg. During the first 20 minutes of deep hypothermic circulatory arrest, cortical oxygen pressure decreased to 1.3 +/- 0.4 mm Hg. Four successive intermittent periods of LF-20 increased cortical oxygen pressure to 6.9 +/- 1.2 mm Hg, 6.6 +/- 1.9 mm Hg, 5.3 +/- 1.6 mm Hg, and 3.1 +/- 1.2 mm Hg. During the intermittent periods of LF-80, cortical oxygen pressure increased to 21.1 +/- 5.3 mm Hg, 20.6 +/- 3.7 mm Hg, 19.5 +/- 3.95 mm Hg, and 20.8 +/- 5.5 mm Hg. A significant increase in extracellular dopamine occurred after 45 minutes of deep hypothermic circulatory arrest alone, whereas in the groups of LF-20 and LF-80, the increase in dopamine did not occur until 52.5 and 60 minutes of deep hypothermic circulatory arrest, respectively. CONCLUSIONS: The protective effect of intermittent periods of low-flow cardiopulmonary bypass during deep hypothermic circulatory arrest is dependent on the flow rate. We observed that a flow rate of 80 mL x kg(-1) x min(-1) improved brain oxygenation and prevented an increase in extracellular dopamine release.  (+info)

Management of air embolism during HeartMate XVE exchange. (5/89)

Air embolism is a rare and usually fatal complication of major cardiac surgery. We present a case in which a 45-year-old man supported by a HeartMate(R) XVE left ventricular assist device required a pump exchange due to failure of the device motor. During pump dissection, a massive amount of air entered the systemic circulation. Urgent cannulation for cardiopulmonary bypass was performed, and cardiopulmonary bypass was initiated, followed by profound hypothermia, circulatory arrest, retrograde cerebral perfusion, retrograde coronary sinus perfusion, and then barbiturate coma and steroid therapy. The HeartMate XVE left ventricular assist device was removed, and a HeartMate II was implanted. After 5 days, the patient awoke with left hemiparesis, which nearly resolved with aggressive physical therapy. Forty-four days after the pump exchange operation, the patient was discharged from the hospital with only mild left hemiparesis. Exposure of the left ventricular assist device or its external components requires careful monitoring, because air can enter the pump-particularly in a hypovolemic patient. Rapid response after massive air entry into the left ventricular assist device system, as in our patient, can result in a successful outcome.  (+info)

Response of brain oxygenation and metabolism to deep hypothermic circulatory arrest in newborn piglets: comparison of pH-stat and alpha-stat strategies. (6/89)

BACKGROUND: To determine the effect of pH-stat as compared with alpha-stat management on brain oxygenation, level of striatal extracellular dopamine, phosphorylation, and levels of protein kinase B (Akt) and cyclic adenosine 3', 5'-monophosphate response element-binding protein (CREB), and levels of extracellular signal-regulated kinase (ERK)1/2, Bcl-2, and Bax in a piglet model of deep hypothermic circulatory arrest (DHCA). METHODS: The piglets were placed on cardiopulmonary bypass (CPB), cooled with pH-stat or alpha-stat to 18 degrees C, subjected to 90 minutes of DHCA, rewarmed, weaned from CPB, and maintained for two hours recovery. The cortical oxygen was measured by: quenching of phosphorescence; dopamine by microdialysis; phosphorylation of CREB (p-CREB), ERK (p-ERK) 1/2, Akt (p-Akt), and level of Bcl-2, Bax by Western blots. RESULTS: Oxygen pressure histograms for the microvasculature of the cortex show substantially higher oxygen levels during cooling and during the oxygen depletion period after cardiac arrest (up to 15 minutes) when using pH-stat compared with alpha-stat management. Significant increases in dopamine occurred at 45 minutes and 60 minutes of DHCA in the alpha-stat and pH-stat groups, respectively. The p-CREB and p-Akt in the pH-stat group were significantly higher than in the alpha-stat group (140 +/- 9%, p < 0.05 and 125 +/- 6%, p < 0.05, respectively). There was no significant difference in p-ERK1/2 and Bax. The Bcl-2 increased in the pH-stat group to 121 +/- 4% (p < 0.05) compared with the alpha-stat group. The ratio Bcl-2:Bax increased in the pH-stat group compared with the alpha-stat group. CONCLUSIONS: The increase in p-CREB, p-Akt, Bcl-2, Bcl-2/Bax, and delay in increase of dopamine indicated that pH-stat, in the piglet model, prolongs "safe" time of DHCA and provides some brain protection against ischemic injury.  (+info)

Giant size abdominal aortic aneurysm repair using open proximal anastomosis under hypothermic circulatory arrest: a report of two cases. (7/89)

Hypothermic total circulatory arrest and open proximal anastomosis techniques are not commonly used in abdominal or juxtarenal abdominal aortic aneurysm repair. Proximal aortic clamping is usually adequate for surgical repair of abdominal aortic pathologies. We present two cases of giant-sized abdominal aortic aneurysms, one was juxtarenal and one was a Crawford type IV thoracoabdominal aneurysm, that were repaired by using open proximal anastomosis under hypothermic total circulatory arrest and a transabdominal approach. This technique may be useful for both thoracoabdominal and large abdominal aortic aneurysms because it offers the opportunity to not clamp the aorta and operate in bloodless surgical field.  (+info)

Hybrid antegrade repair of the arch and descending thoracic aorta with a new integrated stent-Dacron graft in acute type A aortic dissection: a look into the future with new devices. (8/89)

A young male patient underwent supracoronary replacement of the ascending aorta for acute type A dissection under hypothermic circulatory arrest. After discharge, he was readmitted two weeks later due to severe aortic regurgitation and acute arch redissection. Under a second period of hypothermic circulatory arrest three weeks after the initial operation, radical treatment with aortic valve replacement, replacement of the ascending aorta and arch, together with antegrade deployment of a stent-graft in the true lumen for frozen elephant-trunk technique, were successfully performed. Computed tomography at four weeks showed complete proximal repair and thrombosis of the false lumen. Transesophageal echocardiography at eight weeks confirmed repair. The patient is currently leading an active life. A hybrid approach for complex cases of acute type A dissection with arch involvement can be considered for the future.  (+info)

OBJECTIVE Selective antegrade cerebral perfusion (SACP) seems to be associated with a better outcome compared to hypothermic circulatory arrest (HCA) alone. This study was undertaken to evaluate the influence of different SACP temperatures on the neurological integrity. METHODS Twenty-six pigs were included in the study and assigned to 100 min HCA at 20 degrees C body temperature without (n = 6) or with either 10 degrees C (n = 6), 20 degrees C (n = 7) or 30 degrees C (n = 7) of SACP. Haemodynamics, metabolics and neurophysiology (EEG, SSEP, ICP, sagittal sinus saturation) were monitored. Animals were sacrified 4h after reperfusion and brains perfused for histological and molecular genetic assessment. RESULTS There were no clinically relevant differences in haemodynamics between groups. The rise in ICP during SACP was significantly more marked in the 30 degrees C group (p | 0.05) and remained high during the entire experiment. In the 10 degrees C group the rise in ICP was postponed, but increased
Neonates with a congenital heart defect are often in need of early cardiac surgery. In complex congenital heart defects, cardiopulmonary bypass is usually employed, with or without deep hypothermic circulatory arrest (DHCA). The brain is especially vulnerable to ischemic injury, which puts neonates undergoing complex operations at high risk of neurodevelopmental disorders. Selective antegrade cerebral perfusion (ACP) instead of DHCA during these complex operations may contribute to less cerebral damage, but literature is not conclusive on this issue.. Therefore, the investigators will perform a randomised controlled trial comparing DHCA and ACP in neonatal aortic arch reconstructions, focusing on cerebral damage and neurological outcome. ...
TY - JOUR. T1 - Neuropsychologic outcome after deep hypothermic circulatory arrest in adults. AU - Reich, D. L.. AU - Uysal, S.. AU - Sliwinski, Martin John. AU - Ergin, M. A.. AU - Kahn, R. A.. AU - Konstadt, S. N.. AU - McCullough, J.. AU - Hibbard, M. R.. AU - Gordon, W. A.. AU - Griepp, R. B.. AU - Jonas, R. A.. PY - 1999/1/1. Y1 - 1999/1/1. N2 - Introduction: Pediatric patients undergoing prolonged periods of deep hypothermic circulatory arrest have been found to experience long-term deficits in cognitive function. However, there is limited information of this type in adult patients who are undergoing deep hypothermic circulatory arrest for thoracic aortic repairs. Methods: One hundred forty-nine patients undergoing elective cardiac or thoracic aortic operations were evaluated preoperatively; 106 patients were evaluated early in the postoperative period (EARLY), and 77 patients were evaluated late in the postoperative period (LATE) with a battery of neuropsychologic tests. Seventy-three ...
In this report, we have presented the results of TAR using a 4-branched graft, DHCA, and SABP in 12 patients. Of the 12 patients, 2 deaths occurred and 1 patient experienced lower extremity paraplegia resulting in an in-hospital mortality rate of 16.6% and a permanent neurological deficit rate of 8%.. Retrograde cerebral perfusion (RCP) with DHCA has been widely used since 1993 [13, 14], but sustained neurologic deficits are observed in some patients who receive prolonged DHCA, even with RCP. SABP can be used to deliver oxygenated blood to the brain during DHCA. Sasaki et al. [13] reported a series of 305 patients who received TAR between 2000 and 2005 with SABP via the right axillary artery; 1.6% experienced permanent neurological dysfunction, 6.6% temporary neurological dysfunction, and the mid-term survival rate was 94.6%. The advantages of axillary cannulation include avoiding manipulation of an atherosclerotic femoral artery or calcified ascending aorta and physiological antegrade cerebral ...
TY - JOUR. T1 - Retrograde cerebral perfusion provides limited distribution of blood to the brain. T2 - A study in pigs. AU - Ye, J.. AU - Yang, L.. AU - Del Bigio, M. R.. AU - Summers, R.. AU - Jackson, D.. AU - Somorjai, R. L.. AU - Salerno, Tomas. AU - Deslauriers, R.. PY - 1997/10/25. Y1 - 1997/10/25. N2 - Objective: The objective of this study was to investigate flow distribution during retrograde and antegrade cerebral perfusion with India ink as a marker. Methods: Ten pigs received cerebral perfusion with a solution containing 50% filtered India ink for 5 minutes either antegradely through both internal carotid arteries at a flow of 180 to 200 ml/min (n = 5) or retrogradely via the superior vena cava at a flow of 300 to 500 ml/min (n = 5). The brains were then fixed for quantitative measurement of the density of ink-filled capillaries (reported as a percentage of the total selected area). The assessment was done with the use of an in-house software program. Results: In the antegrade ...
Introduction: Despite recent improvements in surgical technique and cerebral protection methods, surgical thoracic aortic repair is still an invasive procedure with a substantial rate of mortality and neurologic injury. The aim of this study is to investigate the impact of surgical stroke on early and late outcomes including ADL and QOL as well as mortality after thoracic aortic surgery.. Methods: We retrospectively analyzed consecutive 500 cases (male: 350, mean age: 62.9±13.2 years) of open aortic repair from 1986 to 2008 performed in our institute. Urgent status was 20.6%. Type of aneurysm was atherosclerotic in 68%, dissected in 32%. Replacement segment was root and ascending (31%), arch (39%), extended arch (10%), descending and its distal (19%). Brain protection method was retrograde cerebral perfusion (RCP) (58%), antegrade cerebral perfusion (ACP) (26%), deep hypothermic circulatory arrest (DHCA) (16%). Surgical stroke was defined as neurological deficit persist over 72 hours after ...
OBJECTIVES: Renal neoplasms frequently expand into renal veins and inferior vena cava from the early stages of the disease. In this study, we set out to define the long-term outcomes of patients with Stage IV tumorous cavoatrial extension, undergoing radical nephrectomy with excision of cavoatrial extension in deep hypothermic circulatory arrest (DHCA). METHODS: Thirty-five patients with Stage IV cavoatrial extension of renal cell carcinoma underwent radical nephrectomy combined with en bloc excision of cavoatrial tumour-thrombus extension, performed in DHCA. The preoperative staging of the tumour and assessment of the intravascular position of the tumour were performed using standard imaging techniques, including computed tomography angiography, magnetic resonance imaging and echocardiography. Patient data were collected in the patient data bank and analysed retrospectively. RESULTS: In this study cohort, we demonstrate acceptable long-term results (the mean overall survival of 4.9 +/- 1.0 ...
All information about the latest scientific publications of the Clínica Universidad de Navarra. Cardiopulmonary by-pass with cardiac arrest and deep hypothermia for the surgical treatment of tumor thrombi in the vena cava caused by kidney carcinoma
Kaneko T, Neely RC, Shekar P, Javed Q, Asghar A, McGurk S, Gosev I, Byrne JG, Cohn LH, Aranki SF. The safety of deep hypothermic circulatory arrest in aortic valve replacement with unclampable aorta in non-octogenarians. Interact Cardiovasc Thorac Surg. 2015 Jan; 20(1):79-84 ...
International Scholarly Research Notices is a peer-reviewed, Open Access journal covering a wide range of subjects in science, technology, and medicine. The journals Editorial Board as well as its Table of Contents are divided into 108 subject areas that are covered within the journals scope.
Purpose of Review The purpose of this manuscript is to review the surgical techniques of aortic arch repair, imaging techniques for evaluating the pre- and post-operative aortic arch, and both normal...
Data & statistics on Carbon dioxide transfer rate in relation to cardiopulmonary bypass times: Carbon dioxide transfer rate in relation to cardiopulmonary bypass times, Shown in piglets undergoing deep hypothermic circulatory arrest (DHCA) with or without selective cerebral perfusion (SCP). Cerebral tissue oxygenation (Pbto2) is shown as relative units (RU), normalized to before cardiopulmonary bypass baseline (BL; mm Hg). Measurements are shown at the following times: BL, before cardiopulmonary bypass baseline; Cool, cooling; CA30, 30 minutes of DHCA; eCA, end DHCA; ..., Intraoperative SctO2 course of a patient undergoing aortic arch surgery with hypothermic circulatory arrest. Note dependency of SctO2 to CO2. Insufflation of CO2 during endoscopic vein harvesting leading to increase in SctO2 as well as decline in SctO2 once mechanical ventilation was started. CPB = cardiopulmonary bypass; DHCA = deep hypothermic circulatory arrest....
TABLE-US-00002 TABLE 2 After 5 min. (total) run time Ratio of After 1 min. (total) run time after addition of food soil Product Surfactant Initial 15 Sec. 1 Min. Initial 15 Sec. 1 Min. Genapol/LF-221/Neodol 45-13/25R2 equal parts 2 1 1/4 6 5 41/2 Genapol/Dehypon/LF-221/LF-500 equal parts 0 0 0 3 1/4 1/4 Genapol/LF-221/Neodol 45-13 equal parts 6 41/2 2 11 10 8 Neodol 45-13/LF-221/LF-500 equal parts 5 41/2 2 10 9 8 Neodol 45-13/LF-221/LF-500/Genapol equal parts 4 3 1/2 9 8 7 Genapol/LF-221/Novel/25R2 equal parts Trace 0 0 3 1/4 1/4 Genapol/LF-221/Novel/(2)25R2 1/1/1/2 0 0 0 21/2 ,1/8 ,1/8 Genapol/LF-221/Novel/(3)25R2 1/1/1/3 0 0 0 2 ,1/8 ,1/8 Genapol/Dehypon/LF-221/LF-500 equal parts 0 0 0 3 1/4 1/4 Genapol/Dehypon/LF-221/LF-500/25R2 equal parts 0 0 0 21/2 1/4 1/4 Genapol/Dehypon/LF-221/LF-500/(2)25R2 1/1/1/1/2 0 0 0 Genapol/LF-221/Novel equal parts Trace Trace Trace 61/2 51/2 21/2 Novel/LF-221/LF-500 equal parts Trace 0 0 41/2 2 1/2 Novel/LF-221/LF-500/25R2 equal parts 0 0 0 3 1/4 1/4 ...
Moxifloxacin reduces infectious complications after cerebral damage, such as ischemia and stroke. This study investigated whether moxifloxacin treatment influences cerebral inflammation and improves cognitive outcome after cardiopulmonary bypass with
An Active Member shall be any perfusionist active in the practice of extracorporeal circulation technology. There are also opportunities to become a Transitional Active Member for those less than a year removed from graduation from an approved accredited training program. Other options include; an Associate Membership, International Membership, Perioperative Blood Management Clinician Membership, and Student Membership.. Click Here to Learn More ...
Goldstein, Lee J., "Stroke in thoracic aortic surgery : incidence, impact, etiology, and prevention" (2000). Yale Medicine Thesis Digital Library. 2655 ...
Objective: Complex aneurysms often are not suitable for safe clipping without temporarily decompressing the aneurysm.This may be achieved by temporary clip ligation of the proximal vessel, or with deep hypothermic circulatory arrest on cardiopulmonary bypass. These methods are not always practical or[for full text, please go to the a.m. URL ...
From Introduction: These facts prompted the initiation of an effort to develop appropriate exposure equipment. The purpose of this communication is first, to describe an apparatus which, with modifications, allows pertinent information to be obtained on each individual small animal exposed and secondly, to set forth the pre- and post-exposure procedure adopted for obtaining required quantitative data regarding respiration, deposition. distribution and excretion.
Introduction : Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic...
Japans largest platform for academic e-journals: J-STAGE is a full text database for reviewed academic papers published by Japanese societies
OBJECTIVES The purpose of this study is to delineate changes in aortic geometry and diameter due to dissection. BACKGROUND Aortic diameter is the major criterion for elective ascending aortic replacement for dilated ascending aortas to prevent aortic dissection. However, recommendations are made on the basis of clinical experience and observation of diameters of previously dissected aortas. METHODS Six tertiary centers on 2 continents reviewed their acute aortic dissection type A databases, which contained 1,821 patients. Included were all non-Marfan patients with nonbicuspid aortic valves who had undergone computed tomography angiography ,2 years before and within 12 h after aortic dissection onset. Aortic geometry before and after dissection onset were compared. RESULTS Altogether, 63 patients were included (27 spontaneous and 36 retrograde dissections, median age 68 [57; 77] years; 54% were men). In all but 1 patient, maximum ascending aortic diameter was ,55 mm before aortic dissection ...
Suns procedure of total arch replacement using a tetrafurcated graft with stented elephant trunk implantation: analysis of early outcome in 398 patients with acute type A aortic dissection
This study will enroll infants undergoing cardiothoracic surgery requiring deep hypothermic circulatory arrest (DHCA) at the University of Michigans C.S. Mott Childrens Hospital. Patients that are eligible will be randomized to receive either one dose surfactant or the sham (air) arm after the surgical procedure. Patients will be monitored for an additional 30 days after the breathing tube is removed. It is possible that subjects may be discharged prior to the last assessment, therefore for subjects who have been discharged a member of the study team will contact the parent (s) or legal authorized representative by telephone ...
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TY - JOUR. T1 - Phenylephrine increases cerebral blood flow during low-flow hypothermic cardiopulmonary bypass in baboons. AU - Schwariz, Arthur E.. AU - Minanov, Oktavijan. AU - Stone, J. Gilbert. AU - Adams, David C.. AU - Sandhu, Aqeel A.. AU - Pearson, Mark E.. AU - Kwiatkowski, Pawel. AU - Young, William L.. AU - Michler, Robert E.. PY - 1996/8/23. Y1 - 1996/8/23. N2 - Background: Although low-flow cardiopulmonary bypass (CPB) has become a preferred technique for the surgical repair of complex cardiac lesions in children, the relative hypotension and decrease in cerebral blood flow (CBF) associated with low flow may contribute to the occurrence of postoperative neurologic injury. Therefore, it was determined whether phenylephrine administered to increase arterial blood pressure during low-flow CPB increases CBF. Methods: Cardiopulmonary bypass was initiated in seven baboons during fentanyl, midazolam, and isoflurane anesthesia. Animals were cooled at a pump flow rate of 2.5 1 · min -1 · m ...
Ruptured type B acute aortic dissection iAAD jis a life-threatening condition, in which surgical treatment most often yields unsatisfactory results. We report a case of a ruptured type B AAD in a 67-year-old man detected on computed tomography that required a partial aortic arch replacement with reconstruction of the left subclavian artery with adjunct deep hypothermic circulatory arrest iDHCA). Although the patient had a postoperative stroke, he recovered markedly with rehabilitation. DHCA and open proximal anastomosis are useful for the surgical treatment of type B AAD, however, an elaborate strategy to prevent an intraoperative cerebral embolism is especially important ...
of the early research focused on the applications of deep hypothermia, defined as a body temperature between 20-25 °C (68-77 °F) ... Such an extreme drop in body temperature brings with it a whole host of side effects, which made the use of deep hypothermia impractical in most clinical situations ... hypothermia, with mild hypothermia being defined as a body temperature between 32-34 °C (90-93 °F ...
Established as the standard reference on cardiopulmonary bypass, Dr. Gravlees text is now in its Third Edition. This comprehensive, multidisciplinary text covers all aspects of cardiopulmonary bypass including sections on equipment, physiology and pathology, hematologic aspects, and clinical applications. This edition features a new section on cardiopulmonary bypass in neonates, infants, and children and a new chapter on circulatory support for minimally invasive cardiac surgery. Other highlights include state-of-the-art information on low-volume circuits and other new equipment and discussions of outcomes data for on-pump and off-pump surgeries ...
After dissection of the heart and Filgara conduit and placement of the child on cardiopulmonary bypass, this protocol can only be Filagra coupon Filagra question in a retina that still responds to light, but even so it will likely Filaagra 395 Q uestion Hetling provide many insights into the relationship between the qu estion functions of the degenerate retina for light and the electrical stimuli. LNL filters constructed in this way should Filagra question to the modulation frequency of an amplitude-modulated sinusoidal grating, and such responses have now been observed in Filagra question (Zhou Baker, 1994, 1996). 35 2.
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Four critically ill infants aged 3, 5, 5, and 13 months; weighing 3.7, 4.6, 5.3, and 6.5 kg, respectively; with total anomalous pulmonary venous drainage, underwent complete correction of their lesions with the utilization of surface-induced deep hypothermia. Although this series is small, we are not aware of any other consecutive series in this age group with a comparable mortality rate. Rectal temperatures of 17.5 to 20.2 C were utilized, with periods of cardiac arrest and total circulatory interruption of 32 to 41 minutes. Important aspects of the technique are surface cooling, deep ether anesthesia, intravenous low-molecular-weight dextran, induced respiratory alkalosis during cooling, and electrical pacing during resuscitation. This method works well in the infant, in contrast with perfusion techniques in which surgical mortality is excessively high.. ...
To understand why many mammalian tissues and cells are so cold-sensitive, we must again turn to the ion-regulatory mechanisms at the cell membrane. As with hypoxia-induced membrane destabilisation (Fig.1), deep hypothermia in non-hibernating mammals leads to marked disturbances in cellular ion homeostasis that may be further influenced in the cold by alterations in membrane fluidity (Kruuv et al., 1983; Zachariassen, 1991; Stefanovich et al., 1995). For example, rat ventricular cells at 10°C show a greater than 50% increase in [Ca2+]i compared with those at 30°C, supporting the idea that intracellular Ca2+ overload takes place in cardiac myocytes of non-hibernating mammals during deep hypothermia (Wang and Zhou, 1999). Wang and co-workers (Wang et al., 1997) also determined the relationship between cardiac hypothermia-tolerance and the sources of activator Ca2+ by modifying sarcoplasmic reticulum function in papillary muscles from the cold-sensitive rat and the cold-tolerant hibernating ground ...
A 39-year-old man with no known cardiovascular risk factors was hospitalized for chest pain radiating to the side. Type A aortic dissection was diagnosed by transthoracic echocardiography and computed tomography (CT). Urgent surgery was performed, in which the ascending aorta was replaced with a valved tube graft (Bentall-Bono procedure). The patient had a phenotype typical of Marfan disease: height of 190 cm, long limbs, scoliosis and dural ectasia.. Postoperative follow-up included yearly imaging studies with transthoracic echocardiography and magnetic resonance angiography of the aorta. Two years later, after the aorta had reached a diameter of 59 mm in the curve distal to the origin of the supra-aortic trunks (Figure 1), a second operation, consisting of an elephant trunk technique (Figure 2) with on-pump circulation and retrograde cerebral perfusion was performed to repair the arch. The patient was thus prepared for the third and last operation, performed three months later and involving ...
in Annals of Thoracic Surgery (2006), 81(3), 958-66. BACKGROUND: The purpose of this prospective study was to assess whether neurodevelopmental status and exercise capacity of children 5 to 10 years after corrective surgery for tetralogy of Fallot or ... [more ▼]. BACKGROUND: The purpose of this prospective study was to assess whether neurodevelopmental status and exercise capacity of children 5 to 10 years after corrective surgery for tetralogy of Fallot or ventricular septal defect in infancy was different compared with normal children and influenced by the preoperative condition of hypoxemia or cardiac insufficiency. METHODS: Forty unselected children, 20 with tetralogy of Fallot and hypoxemia and 20 with ventricular septal defect and cardiac insufficiency, operated on with combined deep hypothermic circulatory arrest and low flow cardiopulmonary bypass at a mean age of 0.7 +/- 0.3 years (mean +/- SD), underwent, at mean age 7.4 +/- 1.6 years, standardized evaluation of neurologic status, ...
in Annals of Thoracic Surgery (2006), 81(3), 958-66. BACKGROUND: The purpose of this prospective study was to assess whether neurodevelopmental status and exercise capacity of children 5 to 10 years after corrective surgery for tetralogy of Fallot or ... [more ▼]. BACKGROUND: The purpose of this prospective study was to assess whether neurodevelopmental status and exercise capacity of children 5 to 10 years after corrective surgery for tetralogy of Fallot or ventricular septal defect in infancy was different compared with normal children and influenced by the preoperative condition of hypoxemia or cardiac insufficiency. METHODS: Forty unselected children, 20 with tetralogy of Fallot and hypoxemia and 20 with ventricular septal defect and cardiac insufficiency, operated on with combined deep hypothermic circulatory arrest and low flow cardiopulmonary bypass at a mean age of 0.7 +/- 0.3 years (mean +/- SD), underwent, at mean age 7.4 +/- 1.6 years, standardized evaluation of neurologic status, ...
During hypothermia, pH-stat (reporting of blood gases at body temperature) corrects for the effects of temperature on pH in order to keep the pH static (7.4). This often results in the addition of CO2 to the CPB circuit. In contrast, alpha-stat (reporting of blood gases at 37 degrees) attempts to preserve electrical neutrality especially of the alpha imidazole ring of histidine (a major buffer during hypothermia). pH-stat samples analyzed at 37 degrees will be acidotic and hypercarbic. The implications of acidosis and hypercarbia include increased cerebral blood flow, rightward shift of the oxy-hemoglobin dissociation curve, and decreased cerebral metabolic rate of oxygen consumption (CMRO2). Although controversial, pH-stat may be associated with improved neurodevelopment outcomes in children. Important points:. ...
Our department of Vascular Surgery has an experienced team of vascular surgeons and fully-equipped clinics. At this department, we perform an entire range of vascular surgeries including heart valve surgeries, cardiac bypasses and complex aortic arch surgeries.. Vascular surgeries are counted amongst the most complicated surgeries in medical industry, and we feel proud to state that we have close to 100% success rate. Our surgeons have performed thousands of surgeries on patients with very serious conditions. With our state-of-the-art surgical procedures and cutting-edge equipments, we have made a distinct place in the industry.. Services we provide - We provide a full range of vascular surgeries such as: ...
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The Homeowner Associations (HOA) Declarations provide that no exterior addition, change, or alteration can be made by a homeowner (HO) until the HOs complete plans have been submitted to, and approved in writing by, the Board of Directors acting as the Architectural and Environmental Control Committee (AECC). The Declarations also state that it is prohibited to remove or alter any windows until the complete plans have been submitted to and approved in writing by the AECC. In June 2003 the AECC added a specific prohibition to the architectural guidelines that forbade window air conditioning units and any other protrusions from the home. Units installed before August 2003 were allowed to remain in place until July 2004. [Therefore, some approved window air conditioners had been permitted in the past.] The HOA filed a complaint with the Commission, alleging that the HO had violated the rules by installing a combination heater/air conditioner in one of his windows without permission. The HO ...
We congratulate Dr Soukiasian et al for the encouraging results obtained with routine hypothermic circulatory arrest (HCA) in thoracic/thoracoabdominal aortic o
Michael T. Janusz, MD FRCSC Clinical Professor Director, Thoracic Aortic Surgery Service, UBC Active Staff, Vancouver General Hospital City: Vancouver Hospital Authority: Vancouver Coastal Health Address: St. Pauls Hospital CVT Surgery 484-1081 Burrard Street Vancouver, BC V6Z 1H5 Phone: 604.876.
Click the title to purchase the article.. Abstract:. "Femoro-femoral cardiopulmonary bypass (CPB) followed by deep hypothermic circulatory arrest is one of the modalities used for ascending aortic pseudoaneurysmrepair to achieve cardiac unloading and to avoid severe hemorrhage due to the risk of rupture during the sternal entry. However, due to the limited size of the cannulas, it can be challenging to achieve total cardiopulmonary support. Therefore, despite the achievement of total cardiopulmonary support, the heart may still be able to eject antegrade blood flow that meets the retrograde blood flow from the arterial side of the CPB. The point where the blood flow meets in the aorta is called the watershed area. If the antegrade blood flow is large due to a left ventricular ejection, the watershed area will be located in the descending aorta. Therefore, if ventilation is stopped, deoxygenated blood will be ejected to the cerebral circulation. Cerebral near-infrared spectroscopy (NIRS) may be ...
A 64-year-old woman was complicated with acute type A dissection arising from the left main trunk during percutaneous coronary angiography. As the extent of dissection was localized in the ascending aorta, a bare-metal stent was inserted into the lef
[100 Pages Report] Check for Discount on Global Hypothermic Machine Perfusion Preservation Sales Market Report 2021 report by QYResearch Group. Notes: Sales, means the sales volume of Hypothermic Machine Perfusion...
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We have evaluated the effects of varying degrees and durations of hypothermia, combined with anesthesia, on pregnant rats of the Sherin Wistar Strain. Moderate (surgical) and intermediate hypothermia, with ether anesthesia, were safe for both fetus and mother. With pentobarbital anesthesia, however, there were harmful effects, depending on the depth and duration of hypothermia; moderate hypothermia increased fetal and maternal mortality. The combination of CO₂ narcosis and deep hypothermia induced no ill effects.
A countrys healthcare needs change over time, and as our population gets older, its healthcare needs become more complex.1 Nothing demonstrates this more than the increase seen in recent years in the number of cardiac surgeries. There are now more than one million cardiac surgeries annually across the world, and it is likely that this number will continue to rise.2. Cardiopulmonary Bypass (CPB) is a technique that temporarily takes over heart and lung function during surgery, maintaining the circulation and oxygenation of the patients blood.. Whilst patients are on Cardiopulmonary Bypass, they are most vulnerable and highly dependent on the skill of the clinical team and the technology that assists that team. During a typical cardiac surgery using Cardiopulmonary Bypass, patients will undergo a high number of tests, such as haemoglobin, haematocrit, blood gases and electrolytes. From induction of anesthesia until the immediate post-operative period, patients will typically have their blood ...
hypothermia - MedHelps hypothermia Center for Information, Symptoms, Resources, Treatments and Tools for hypothermia. Find hypothermia information, treatments for hypothermia and hypothermia symptoms.
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A 59-year-old man with a history of hypertension who suddenly developed back pain and apoplexy was transferred to our hospital 20 min after the clinical onset. Physical examination showed right conjugate deviation of the eyes and left paralysis, suggesting disorder of the right cerebral hemisphere. Enhance computed tomography showed an aortic dissection from the ascending aorta to bilateral iliac arteries, and the right common cranial artery was compressed by a false lumen. Acute type A aortic dissection complicated with cerebral malperfusion was diagnosed, and an emergency operation was performed 2.5h after the onset. Cardiopulmonary bypass was established with right femoral artery inflow and bicaval venous drainage. We found the dissection entry at the ascending aorta using the distal open technique, and performed hemiarch graft replacement with selective cerebral perfusion. The postoperative course was uneventful without deterioration of neurological function. Postoperative computed ...
Click picture to show/hide bloodflows). Pathophysiology. AWDs present with similar physiological features as patent ductus arteriosus or ventricular septum defects. They result in a left-to-right shunt which typically leads to early pulmonary hypertension and congestive heart failure, depending on the size of the window which is commonly large. Pulmonary vascular disease typically develops when the window is not surgically repaired.. Therapy. Surgical closure and repair of associated lesions are recommended to be performed soon after diagnosis in order to survive infancy and decrease the risk of pulmonary vascular diseases. A median sternotomy is usually performed followed by cardiopulmonary bypass. Meanwhile the pulmonary arteries are controlled and occluded. The aortic cannula must be far away from the defect to not interfere with the repair. Cardioplegia with moderate hypothermic arrest or deep hypothermic circulatory arrest in small children is utilized. Most defects require a closure patch, ...
Open Repair of Chronic Thoracic and Thoracoabdominal Aortic Dissection Using Deep Hypothermia and Circulatory Arrest. J.S. Corvera, H. Copeland, D. Blitzer, A. Hicks, J. Manghelli, P.J. Hess, J.W. Fehrenbacher. Journal of Thoracic and Cardiovascular Surgery, 2017;154:389-95. Acute Aortic Syndromes. J.S. Corvera. Annals of Cardiothoracic Surgery, 2016;5(3):188-193. Transcatheter Aortic Valve Replacement Versus Aortic Valve Bypass: A Comparison of Outcomes and Economics. Brown JB, Boyd JH, Patel PM, Baker ML, Syed A, Ladowski J, Corvera J. Annals of Thoracic Surgery, 2016;101:49-55. The ARCH Projects: design and rationale (IAASSG 001). Yan TD, Tian DH, LeMaire SA, Misfeld M, Elefteriades JA, Chen EP, Hughes GC, Kazui T, Griepp RB, Kouchoukos NT, Bannon PG, Underwood MJ, Mohr FW, Oo A, Sundt TM, Bavaria JE, Di Bartolomeo R, Di Eusanio M, Roselli EE, Beyersdorf F, Carrel TP, Corvera JS, Della Corte A, Ehrlich M, Hoffman A, Jakob H, Matalanis G, Numata S, Patel HJ, Pochettino A, Safi HJ, Estrera A, ...
electromechanical responses of cardiomyocytes to individual and combined components of ischemia. Can. J. Physiol. Pharmacol, 80: 1145-1157 2003.- Schaeffer, C., D. Vandroux, L. Thomassin, P. Athias, L. Rochette and J. L. Connat. Calcitonin gene-related peptide partly protects cultured smooth muscle cells from apoptosis induced by an oxidative stress via activation of ERK1/2 MAPK. Biochim Biophys Acta 1643(1-3): 65-73. 2004.- Chantome, A., A. Pance, N. Gauthier, D. Vandroux, J. Chenu, E. Solary, J. F. Jeannin and S. Reveneau. Casein kinase II-mediated phosphorylation of NF-kB p65 subunit enhances inducible nitric oxide synthase gene transcription in vivo. J Biol Chem. 279(23): 23953-60. 2004.- Gambert, S., S. Bes-Houtmann, D. Vandroux, C. Tissier, C. Vergely-Vandriesse, L. Rochette and P. Athias. Deep hypothermia during ischemia improves functional recovery and reduces free-radical generation in isolated reperfused rat heart. J Heart Lung Transplant 23(4): 487-91. 2004.- Vandroux, D., C. ...
The probability and prediction of relapses were calculated in 186 patients who finished the 2 year follow-up period. Modification of G alpha with myristate can be recapitulated in E. In the several hypogonadotropic syndromes described to date autosomal and X-linked transmission have been implicated in the inheritance of the hypogonadism. The technique of low flow antegrade selective cerebral perfusion through the right brachial artery may be used for a vast majority of aortic aneurysms and dissections requiring arch repair. Relation of the Bilateral Earlobe Crease to Endothelial Dysfunction.. One patient is awaiting repair, and 1 underwent a cavopulmonary shunt. The reproductive deficits of the middle-aged Per mutant females are comparable with those seen in aged wild-type mice. Step baroreflex response in awake patients undergoing carotid viagra without doctor prescription surgery: time- and frequency-domain analysis. Our experiment assessed whether azithromycin inhibits neutrophil accumulation ...
Editors Note:. Well it was one of those mornings where you are driving into work to do a routine cell saver case when all of a sudden your phone blows up and you are getting calls from the hospital operating room desk as well as several colleagues trying to figure out what is going on in terms of a heparin antibody issue - not fully blown out HIT-but a pathology of some sort that made the use of heparin as an anticoagulant a nonviable modality for the upcoming operation.. Recognizing that now we had fewer options than before, we as a group pretty much had to figure out what alternative anticoagulation methods were available to us, and equally more important if the components/drugs to achieve that approach were even available at the hospital I was going to.. Typically when you see a heparin allergy and patient is going to go on cardiopulmonary bypass it becomes a really big deal. In this case it was a vascular operation that required blood salvage in order to accomplish the task at hand.. My ...
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About 40 hypothermic sea turtles have been found on Massachusetts Cape Cod and are being brought to the New England Aquariums care center, officials say.
The significance of acanthrocytes and red cell fragmentation was evaluated in 31 patients undergoing cardiopulmonary bypass. Seven patients served as controls, and 24 patients with valvular prosthesis were observed for a period of at least 2 weeks. In the control group minimal red cell fragmentation (2-3/10 hpf) was seen, while acanthrocytes were present only during and immediately after cardiopulmonary bypass. In seven patients with valvular replacement the results were similar to the control group. Six other patients showed increased red cell fragmentation (15/10 hpf). In three of these, red cell fragmentation disappeared by the third postoperative week, in two by ...
Professional information about Medtronic cannulae, tissue stabilizers, heart positioners, retractor systems, anastomotic devices and accessories used for cardiopulmonary bypass.
Overview and classification of congenital heart disease - Fetal circulation - Assessment of patients with CHD - Conduct of anaesthesia in CHD - Cardiac catheterization - Closed cardiac procedures Systemic arterial-pulmonary arterial shunt - Coarctation of the aorta - Patent ductus arteriosus - Epicardial pacemaker insertion - Pulmonary artery banding - Cardiopulmonary bypass - Deep hypothermic circulatory arrest (DHCA) - Open cardiac procedures-notes on specific lesions Atrial septal defect - Ventricular septal defect - Atrio-ventricular septal defect - Tetralogy of Fallot - Transposition of the great arteries ...
A series of studies from the Duke group have assessed the relationship between jugular venous desaturation and postoperative neuropsychologic outcome. [5-8] Their first report found no association. [5] Two subsequent reports, each derived from the same patient population, indicated that greater jugular venous hemoglobin desaturation at completion of rewarming (specifically, greater arteriovenous oxygen content difference) was associated with a greater incidence of postoperative cognitive deficits. [6,7] Of note, patients who exhibited marked jugular venous desaturation at completion of rewarming tended to have lesser CBF, greater cerebral metabolic rate for oxygen (CMRO2), and greater brain oxygen extraction before the start of rewarming. [6] This suggests patients who desaturated the most with rewarming differed from the rest of the study population before rewarming. Perhaps this preexisting difference was responsible for their greater postoperative cognitive impairment, not the jugular venous ...
Hypoplastic left heart syndrome (HLHS) is a congenital heart defect that requires 3-stage cardiac surgical treatment and multidirectional specialist care. The condition of newborns in the first postoperative days following the modified Norwood procedure is characterized by considerable hemodynamic instability that may result in a sudden cardiac arrest. It is believed that the most important cause of hemodynamic instability is the fluctuations in redistribution between pulmonary and systemic blood flow.The paper analyzes the postoperative course in 40 neonates with HLHS following the modified Norwood procedure performed under deep hypothermic cardiopulmonary bypass hospitalized in Cardiac Surgical Intensive Care Unit (CSICU) in the years 2014-2015 ...
Objectives At the conclusion of this educational activity, participants should be able to: Define aortic dissection Describe epidemiology of acute aortic dissection State common and uncommon presentations of acute aortic dissection Appreciate that a normal chest radiograph should not be used to rule out acute aortic dissection List three factors leading to a missed diagnosis of aortic dissection List key pitfalls in the management of acute aortic dissection 3
0169] The lid assembly 710 is configured to be coupled to the canister 790. The lid assembly 710 includes handles 712, 713. The handles 712, 713 are each configured to facilitate coupling the lid assembly 710 to the canister 790, as described in more detail herein. Said another way, the handles 712, 713 are configured to move between a closed configuration in which the handles prevent the lid assembly 710 being uncoupled or otherwise removed from the canister 790, and an open configuration in which the handles do not prevent the lid assembly 710 from being uncoupled or otherwise removed from the canister. The handles 712, 713 are moveably coupled to the lid 720. Each handle 712, 713 can be pivotally coupled to opposing sides of the coupling mechanism 850 (described in more detail herein) disposed about the lid 720. For example, each handle 712, 713 can be coupled to the coupling mechanism 850 via an axle (not shown). Each handle includes a series of gear teeth (not shown) configured to engage a ...
Things to know about Hypothermia. An average of 600 people in the US die from Hypothermia each year. The highest percentage of which are recreational...
EPR is similar to deep hypothermic circulatory arrest (DHCA) in that hypothermia is induced. However, the purposes and ... Deep hypothermic circulatory arrest "The big sleep". The Economist. 6 September 2014. Retrieved 23 January 2018. "Gunshot ... DHCA induces hypothermia to aid preplanned surgery, whereas EPR is an emergency procedure in cases where an emergency room ... The trial procedure involves rapidly inducing profound hypothermia (10°C) with an aortic flush in trauma victims that have ...
... heart arrest, induced MeSH E04.100.376.374.500 --- circulatory arrest, deep hypothermia induced MeSH E04.100.376.410 --- heart ... heart arrest, induced MeSH E04.928.220.360.500 --- circulatory arrest, deep hypothermia induced MeSH E04.928.220.370 --- heart ... induced MeSH E04.520.252.984 --- natural childbirth MeSH E04.520.252.992 --- vaginal birth after cesarean MeSH E04.520.252.996 ... induced MeSH E04.520.050.050 --- abortion, eugenic MeSH E04.520.050.055 --- abortion, legal MeSH E04.520.050.060 --- abortion, ...
... in a case of accidental hypothermia(40) and 9°C (48°F) in a case of induced hypothermia.(58)... 58. Niazi SA, Lewis FJ. ... Rothoeri RD, Brawanski A (June 2006). "The history and present status of deep hypothermia and circulatory arrest in ... Mild hypothermia (28°C to 34°C) and moderate hypothermia (20°C to 28°C) are contraindicated for hypothermic circulatory arrest ... Deep hypothermic circulatory arrest (DHCA) is a surgical technique that involves cooling the body to temperatures below 20°C ( ...
Deep hypothermic circulatory arrest Peberdy, MA; Callaway, CW; Neumar, RW; Geocadin, RG; Zimmerman, JL; Donnino, M; Gabrielli, ... "Efficacy of and tolerance to mild induced hypothermia after out-of-hospital cardiac arrest using an endovascular cooling system ... The Hypothermia after Cardiac Arrest Study Group (21 February 2002). "Mild Therapeutic Hypothermia to Improve the Neurologic ... "Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia". New England Journal of Medicine. ...
Death Brain death Legal death Cardiac arrest Deep hypothermic circulatory arrest Therapeutic hypothermia Information-theoretic ... This induced hypothermia technique is beginning to be used in emergency medicine. The combination of mildly reducing body ... This state is called deep hypothermic circulatory arrest. At such low temperatures most patients can tolerate the clinically ... 1990). "Accidental deep hypothermia with cardiopulmonary arrest: extracorporeal blood rewarming in 11 patients". European ...
... it is possible to induce profound hypothermia in a dog, followed by complete circulatory arrest for 30 minutes, and then to ... Dobell, A. R.; Bailey, J. S. (April 1997). "Charles Drew and the origins of deep hypothermic circulatory arrest". The Annals of ... to repair the heart under conditions of circulatory arrest. Converting an old billiard room on the 6th floor of Westminster ... He went on to conduct pioneering research on profound hypothermia in cardiac surgery and what came to be known as the 'Drew ...
The solution is a full cardiac arrest, which can be done with hypothermia. So, after going on to CPB and they induce a deep ... Deep hypothermic circulatory arrest Pulmonary endarterectomy: Part II. Operation, anesthetic management, and postoperative care ... PTEs involve a full cardiopulmonary bypass (CPB), deep hypothermia and full cardiac arrest, with the critical procedure carried ... PTEs typically are done using hypothermia and full cardiac arrest. PTEs are done for chronic pulmonary embolism, thrombectomies ...
... debated and may be a result of brain cooling similar to the protective effects seen in people treated with deep hypothermia.[9] ... Circulatory responses[edit]. Plasma fluid losses due to immersion diuresis occur within a short period of immersion.[14] Head- ... Cold induced vasoconstriction causes the heart to work harder and the additional work can overload a weak heart, with a ... possible consequence of cardiac arrest. Cold incapacitation is the next stage, and generally occurs within 5 to 15 minutes in ...
A. Ündar, W. Vaughn, and J. Calhoon, The effects of cardiopulmonary bypass and deep hypothermic circulatory arrest on blood ... Red blood cell deformation and aggregation is also coupled with flow induced changes in the arrangement and orientation as a ... This is particularly important in hypothermia, where an increase in blood viscosity will cause problems with blood circulation ...
... circulatory collapse or cardiac arrest, and death may ensue, in that order. In the case of a failed suicide attempt, the person ... Suicide by hypothermia is a slow death that goes through several stages. Hypothermia begins with mild symptoms, gradually ... Different methods have been used in order to decrease the number of suicide attempts in the underground: for instance, deep ... Suicide by exsanguination involves reducing the volume and pressure of the blood to below critical levels by inducing massive ...
Hypothermia is reduced body temperature that happens when a body dissipates more heat than it absorbs. Hypothermia is a major ... Blackout during a shallow dive differs from blackout during ascent from a deep dive in that deep water blackout is precipitated ... Ascent-induced hypoxia is caused by a drop in oxygen partial pressure as ambient pressure is reduced on ascent. The oxygen ... this additional workload can cause the heart to go into arrest. A person who survives the initial minute of trauma after ...
Deep vein thrombosis (DVT) and pulmonary embolism (PE) - Formation of a thrombus in a deep vein, commonly in the legs that may ... There are several conditions that can cause cardiac arrest. Treatment of cardiac arrest includes cardiopulmonary resuscitation ... Tachycardia induced cardiomyopathy - A type of dilated cardiomyopathy caused by chronic tachycardia. A common arrhythmia that ... A cardioplegic solution is used to stop the heart from beating and combination with hypothermia reduces oxygen demand of the ...
... intervention should be made within 3-5 minutes because a severe hypoxia or severe circulatory failure may have induced the ... Venous obstruction (e.g. deep vein thrombosis). Differential cyanosis[edit]. Differential cyanosis is the bluish coloration of ... Hypothermia. *Obstructive sleep apnea. Peripheral cyanosis[edit]. Peripheral cyanosis is the blue tint in fingers or ... Central cyanosis is often due to a circulatory or ventilatory problem that leads to poor blood oxygenation in the lungs. It ...
A notable exception is cardiac arrest that occurs in conjunction with exposure to very cold temperatures. Hypothermia seems to ... Heart and Circulatory Physiology. 291 (1): H441-50. doi:10.1152/ajpheart.01229.2005. PMID 16461371. Lay summary - EurekAlert! ( ... CPR involves chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 ... CPR may succeed in inducing a heart rhythm that may be shockable. In general, CPR is continued until the person has a return of ...
Self-induced hypocapnia by hyperventilation, as in shallow water or deep water blackout and the choking game ... Hypothermia. Immersion foot syndromes Trench foot. Tropical immersion foot. Warm water immersion foot. Chilblains. Frostbite. ... Radiation-induced erythema multiforme. Radiation-induced hypertrophic scar. Radiation-induced keloid. Radiation-induced morphea ... There are many circumstances that can induce asphyxia, all of which are characterized by an inability of an individual to ...
... debated and may be a result of brain cooling similar to the protective effects seen in people treated with deep hypothermia.[9] ... Circulatory responsesEdit. Plasma fluid losses due to immersion diuresis occur within a short period of immersion.[14] Head-out ... Cold induced vasoconstriction causes the heart to work harder and the additional work can overload a weak heart, with a ... possible consequence of cardiac arrest. Cold incapacitation is the next stage, and generally occurs within 5 to 15 minutes in ...
... underwent complete correction of their lesions with the utilization of surface-induced deep hypothermia. Although this series ... Correction of Total Anomalous Pulmonary Venous Drainage in Infancy Utilizing Deep Hypothermia with Total Circulatory Arrest. ... Correction of Total Anomalous Pulmonary Venous Drainage in Infancy Utilizing Deep Hypothermia with Total Circulatory Arrest ... Correction of Total Anomalous Pulmonary Venous Drainage in Infancy Utilizing Deep Hypothermia with Total Circulatory Arrest ...
Circulatory Arrest, Deep Hypothermia Induced*Circulatory Arrest, Deep Hypothermia Induced. *Deep Hypothermic Circulatory Arrest ... Deep Hypothermia Induced" by people in this website by year, and whether "Circulatory Arrest, Deep Hypothermia Induced" was a ... "Circulatory Arrest, Deep Hypothermia Induced" is a descriptor in the National Library of Medicines controlled vocabulary ... Below are the most recent publications written about "Circulatory Arrest, Deep Hypothermia Induced" by people in Profiles. ...
Circulatory Arrest, Deep Hypothermia Induced / adverse effects*. DNA Fragmentation. Disease Models, Animal. Hypothermia, ... Regions selectively vulnerable to neuronal injury are offered more neural protection by profound hypothermia. These affects are ... Induced*. Lactic Acid / blood. Male. Monitoring, Intraoperative. Research Design / statistics & numerical data. Staining and ... This data support that cerebral protection may be better at very cold temperatures compared to 18 degrees C hypothermia. ...
Circulatory Arrest, Deep Hypothermia Induced. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Subclavian Artery / ...
Deep Hypothermia Induced Circulatory Arrest 01/01/2012 - "During descending thoracic aortic and thoracoabdominal aortic ... the use of deep hypothermic circulatory arrest results in improved postoperative adverse outcome rates compared with non-deep ... instead under deep hypothermic circulatory arrest. ". 01/01/2015 - "These results demonstrate that open distal anastomosis ... involving the distal arch is challenging and requires either deep hypothermic circulatory arrest (DHCA) or crossclamping of the ...
KEY WORDS: Spinal cord; Aortic aneurysm, thoracic; Circulatory arrest, deep hypothermia induced ... though proximal anastomosis using deep hypothermic circulatory arrest (DHCA) is often selected, there are issues surrounding ... underwent DTAA/TAAA repair under deep hypothermia using transapical aortic perfusion. A proximal anastomosis and artery of ... Kise Y, Kuniyoshi Y, Ando M, Maeda T, Inafuku H, Yamashiro S. Transapical aortic perfusion using a deep hypothermic procedure ...
EPR is similar to deep hypothermic circulatory arrest (DHCA) in that hypothermia is induced. However, the purposes and ... Deep hypothermic circulatory arrest "The big sleep". The Economist. 6 September 2014. Retrieved 23 January 2018. "Gunshot ... DHCA induces hypothermia to aid preplanned surgery, whereas EPR is an emergency procedure in cases where an emergency room ... The trial procedure involves rapidly inducing profound hypothermia (10°C) with an aortic flush in trauma victims that have ...
Seventy-three patients had routine cardiac operations without deep hypothermic circulatory arrest, and 76 patients with deep ... Seventy-three patients had routine cardiac operations without deep hypothermic circulatory arrest, and 76 patients with deep ... Seventy-three patients had routine cardiac operations without deep hypothermic circulatory arrest, and 76 patients with deep ... Seventy-three patients had routine cardiac operations without deep hypothermic circulatory arrest, and 76 patients with deep ...
... in a case of accidental hypothermia(40) and 9°C (48°F) in a case of induced hypothermia.(58)... 58. Niazi SA, Lewis FJ. ... Rothoeri RD, Brawanski A (June 2006). "The history and present status of deep hypothermia and circulatory arrest in ... Mild hypothermia (28°C to 34°C) and moderate hypothermia (20°C to 28°C) are contraindicated for hypothermic circulatory arrest ... Deep hypothermic circulatory arrest (DHCA) is a surgical technique that involves cooling the body to temperatures below 20°C ( ...
Deep hypothermia is an important cerebral protectant and is critical in procedures requiring circulatory arrest. The purpose of ... contribution to our understanding of the dynamic changes in human physiology during induced hypothermia for circulatory arrest ... In approaching the open aortic arch for short periods of circulatory arrest, deep hypothermia with adjunctive RCP is safe and ... full cardiopulmonary bypass without deep hypothermic circulatory arrest in 5, and cardiopulmonary bypass with adjunctive deep ...
These included: deep hypothermic circulatory arrest (18°C), moderate hypothermia (28°C), and mild hypothermia (32°C). In two ... These included: deep hypothermic circulatory arrest (18°C), moderate hypothermia (28°C), and mild hypothermia (32°C). In two ... These included: deep hypothermic circulatory arrest (18°C), moderate hypothermia (28°C), and mild hypothermia (32°C). In two ... These included: deep hypothermic circulatory arrest (18°C), moderate hypothermia (28°C), and mild hypothermia (32°C). In two ...
... κB pathway during deep hypothermia circulatory arrest in a pig model," Cardiology (Switzerland), vol. 128, no. 3, pp. 243-250, ... P. Mukherjee, C. W. Winkler, K. G. Taylor et al., "SARM1, not MyD88, mediates TLR7/TLR9-induced apoptosis in neurons," Journal ... B. L. Nguyen, H. Li, M. C. Fishbein, S.-F. Lin, C. Gaudio, P.-S. Chen et al., "Acute myocardial infarction induces bilateral ... F. Gilli, L. Li, and A. R. Pachner, "The immune response in the CNS in Theilers virus induced demyelinating disease switches ...
Deep Hypothermia Induced Circulatory Arrest * Inferior Vena Cava Technical modification for laparoscopic donor nephrectomy to ...
Deep Hypothermia Induced Circulatory Arrest Acute Kidney Injury Thoracic Surgery Thoracic Aorta ... Deep hypothermic circulatory arrest is not a risk factor for acute kidney injury in thoracic aortic surgery. Englberger, L., ...
Deep Hypothermia Induced Circulatory Arrest Abdominal Aorta 2 Citations (Scopus) Endovascular abdominal aortic aneurysm repair ... Posterior reversible encephalopathy syndrome from induced hypertension during endovascular thoracoabdominal aortic aneurysm ...
Our goal is to investigate any disparity in the provision of post-arrest care for the elderly with OHCA and a sustained return ... The findings obtained from this systematic review should inform whether disparity exists in the provision of post-arrest care ... Out-of-hospital cardiac arrest (OHCA) is a significant cause of death in developed countries. The majority of OHCA patients are ... "deep hypothermic" or "deep hypothermia") adj3 circulatory adj3 arrest) or (function adj3 test? adj3 (cardiac or heart)) or " ...
Vienna Hypothermia After Cardiac Arrest (HACA) Study Group. Out‑ of‑ hospital surface cooling to induce mild hypothermia in ... Accuracy of core temperature measurement in deep hypothermic circulatory arrest. Interact Cardiovasc Thorac Surg 2008; 7: 922- ... Treatment of comatose survivors of out‑ of‑ hospital cardiac arrest with induced hypothermia. N Engl J Med 2002; 346: 557- 563 ... Efficacy of and tolerance to mild induced hypothermia after out‑ of‑ hospital cardiac arrest using an endovascular cooling ...
Circulatory Arrest, Deep Hypothermia Induced*. *Enzyme-Linked Immunosorbent Assay. *Female. *Humans. *Infant ... cardiac surgery; cardiopulmonary bypass; congenital heart disease; deep hypothermic circulatory arrest; neuronal injury ... and deep hypothermic circulatory arrest (DHCA).. METHODS: Twenty-six patients younger than three months were prospectively ...
Cold-induced "anesthesia" - Hypothermia. Induction of hypothermia has been used for immobilizing neonatal rodents since they do ... Anesthetic crisis! Respiratory arrest and death from circulatory collapse imminent.. Body temperature should be measured and ... If the level of anesthesia has been deep at the start of the surgery, there may have been little bleeding due to the low blood ... Any anesthesia-induced abnormalities present at the end of the anesthesia, such as hypothermia or dehydration, should be ...
During circulatory arrest, 40 mg/kg sodium thiopental and 30 mg/kg methylprednisolone were administered for cerebral protection ... and deep hypothermia), diffuse cerebral ischemic damage developed during the time required to make the diagnosis and to ... General anesthesia was induced using 0.1 mg/kg diazepam, 25 mcg/kg fentanyl, and 0.1 mg/kg pancuronium. After tracheal ... Surgical inspection of the arch during circulatory arrest showed the integrity of the aortic arch branches, and thus the ...
1 The brain is the organ with the shortest safe circulatory-arrest time, and hypothermia is the most commonly used technique ... In the present study, hyperoxia completely prevented the accumulation of glutamate induced by deep hypothermia and subsequently ... until deep hypothermia (15°C) was reached; time-point 3, after deep hypothermia for a period of 60 min; time-point 4, at the ... 2 It has been reported that infants subjected to deep hypothermia with cardiac arrest showed a significantly higher ...
Safety and efficacy of aprotinin under deep hypothermia and circulatory arrest. J Thor Cardiovasc Surg 1995;110:1615?22. ... Brain temperature monitoring during induced hypothermia. Anesthesiology 1995;83:173.. 83. Schwartz AS, Sandhu AA, Kaplon RJ, ... Effect of deep hypothermic total circulatory arrest on CBF and metabolism in baboons. Anesth Analg 1993;76:379. ... Smith CR, Mongero L, DeRosa CM, Michler RE, Oz M. Safety of Aprotinin in profound hypothermia and circulatory arrest. Ann Thor ...
... surgery in children sildenafil citrate generic viagra 100mg during surface-induced deep hypothermia with circulatory arrest ...
The patients were divided into two subsets according to the degree of hypothermia and perfusion strategies: namely the DHCA ... All patients received hypothermic circulatory arrest in combination with antegrade cerebral perfusion. ... different perfusion-specific strategies with a growing trend to increase the body temperature at circulatory arrest emerged. In ... group and the group of modified hypothermic circulatory arrest (MHCA). The overall 30-day mortality was 27.8% and was not ...
Hypothermia and Hemodilution on Post-Ischemic Metabolism and Functional Recovery Following Cerebro-Circulatory Arrest in Cats ... Behavior of the Habenulo-Pineal Complex in Deep Hypothermia (Cold, Hypoxia, Hypercapnia) ... The Effect of Chemically and Electrically Induced Acute Hypertension on the Permeability Across Cerebral Vessels ... Circulatory Aspects. * Ischemia Related Changes in Adenine Nucleotide Metabolism N. Murakami, W. D. Lust, F. A. M. de Azeredo, ...
  • DHCA induces hypothermia to aid preplanned surgery, whereas EPR is an emergency procedure in cases where an emergency room patient is rapidly dying from blood loss and will not otherwise survive long enough for the patient's wounds to be stitched up. (wikipedia.org)
  • Pretreatment with selenite or ebselen protected against acute IRI-induced tissue damage during CPB and DHCA. (springermedizin.de)
  • In this review, the author introduces various neuromonitoring methods currently used in the therapeutic hypothermia and evaluate the their role in the prognostication with available evidences. (e-jnc.org)
  • 2 There also has been keen interest in the use of modest hypothermia (reductions in temperature of 2°C to 3°C) to provide neuroprotection. (ahajournals.org)
  • In multiple adult species such as rats, 3 gerbils, 4 dogs, 5 and rabbits, 6 modest hypothermia provided partial or complete ischemic neuroprotection when used in a protective and preservative manner (ie, hypothermia was initiated before and continued during the ischemic interval). (ahajournals.org)
  • Deep hypothermia, which is used during thoracic aortic surgery for neuroprotection, is associated with coagulation abnormalities in animal and in vitro models. (bvsalud.org)
  • More importantly, these findings led to the realization that hypothermia-induced neuroprotection is not only limited to decreased oxygen and glucose demands, but the mechanisms involved are indeed much more intricate. (springeropen.com)
  • Our results suggest that NAC is a potent agent against CPB-induced acute lung injury through inhibiting TGFβ1 expression. (biomedcentral.com)
  • In our previous work, we also found the expression of TGFβ1 was upregulated in CPB-induced acute lung injury in dogs. (biomedcentral.com)
  • In view of the important role of TGFβ1 in the development of acute lung injury, inhibition of TGFβ1 may be a potential therapeutic strategy for reducing CPB-induced acute lung injury. (biomedcentral.com)
  • In view of the important role of TGFβ1 during the progression of acute lung injury, the objective of this work was to investigate whether NAC could exert a protective effect on CPB-induced acute lung injury through inhibiting the expression of TGFβ1. (biomedcentral.com)
  • Epigallocatechin-3-gallate alleviates paraquat-induced acute lung injury and inhibits upregulation of toll-like receptors. (xiudy.com)
  • An emergency medical team responded quickly and properly, but he was in a coma when admitted to a hospital where he was kept in artificially induced protective hypothermia (the initial diagnosis was cardio-circulatory arrest and drowning). (dan.org)
  • However, the effective application of hypothermia requires a thorough understanding of the injury mechanisms as well as its protective mechanisms. (springeropen.com)
  • The exact mechanism for this effect has been debated and may be a result of brain cooling similar to the protective effects seen in people treated with deep hypothermia . (wikipedia.org)
  • Our goal is to investigate any disparity in the provision of post-arrest care for the elderly with OHCA and a sustained return of spontaneous circulation (ROSC). (biomedcentral.com)
  • N-acetylcysteine (NAC) is an antioxidant and is able to prevent CPB-induced pneumocyte apoptosis through scavenging radical. (biomedcentral.com)
  • ʺNF-κB Pathway Contributes to Cadmium-Induced Apoptosis of Porcine Granulosa Cells.ʺ Biological trace element research (2013): 1-8. (xiudy.com)
  • Lonafarnib can inhibit the proliferation of imatinib-resistant cells and increases imatinib-induced apoptosis in vitro in cells from imatinib-resistant patients. (saladgaffe.ml)
  • Early assessment of neurological function and prognostication in these comatose patients has been challenging problem, and the introduction of therapeutic hypothermia made the problem more confusing. (e-jnc.org)
  • Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest: a systematic review and meta-analysis, part 2: patients treated with therapeutic hypothermia. (jamanetwork.com)
  • Friberg H, Cronberg T, Dünser MW, Duranteau J, Horn J, Oddo M. Survey on current practices for neurological prognostication after cardiac arrest. (jamanetwork.com)
  • Hypothermia can be achieved in several ways,[ 2 ] but, in this particular endeavor, it will not involve total body extracorporeal circulation (TBEC), in order to avoid the attendant ill effects (brain damage and coagulopathy), and make the procedure as simple and as cheap as possible. (surgicalneurologyint.com)
  • 2 It has been reported that infants subjected to deep hypothermia with cardiac arrest showed a significantly higher postoperative incidence of clinically demonstrable seizures and electroencephalographic monitoring-detected seizure activity. (asahq.org)
  • The remaining diluted blood is cooled by the heart-lung machine until hypothermia causes the heart to stop beating normally, after which the blood pump of the heart-lung machine continues blood circulation through the body. (wikipedia.org)
  • They used fasudil to inhibit ROCK and showed that it improved gas exchange and decreased reactive oxygen and inflammation in the lung following return of spontaneous circulation after cardiac arrest indicating that activation of ROCK is a contributor to injury and inhibiting it may have potential for therapeutic intervention. (lww.com)
  • This is particularly important in hypothermia, where an increase in blood viscosity will cause problems with blood circulation. (wikipedia.org)
  • The circulation is then completely arrested for a brief period of time to allow completion of the surgical anastomosis. (nazory.cz)
  • Hyperoxia has recently been reported as an independent risk factor for mortality in patients resuscitated from cardiac arrest. (biomedcentral.com)
  • Among patients admitted to the ICU after cardiac arrest, hyperoxia did not have a robust or consistently reproducible association with mortality. (biomedcentral.com)
  • Their conclusion that hyperoxia is a robust predictor of mortality in patients after resuscitation form cardiac arrest was therefore potentially affected by selection bias and by insufficient adjustment for major confounders. (biomedcentral.com)
  • Intensive care unit mortality after cardiac arrest: the relative contribution of shock and brain injury in a large cohort. (jamanetwork.com)
  • The study showed that hypothermia did not significantly reduce the rate of mortality or severe disability but resulted in improved neurologic outcomes in infants assessed at 18 months of age. (springeropen.com)
  • Where community consent is obtained, as of 2014, the procedure can only be performed on patients 18 to 65 years old who have a penetrating wound, go into cardiac arrest within five minutes of arrival, and fail to respond to ordinary resuscitation efforts. (wikipedia.org)
  • The procedure must take place in a state of hypothermia to prevent formation of irreversible brain lesions that ordinarily would form within five minutes of stopping cerebral blood flow. (innertraditions.com)
  • However, in certain lower vertebrates, neonates and diving mammals, hypoxia-induced membrane destabilisation of the kind seen in adult mammals is either slow to develop or does not occur at all as a result of adaptive decreases in membrane permeability (i.e. ion 'channel arrest') that dramatically reduce the energetic costs of ion-balancing ATPases ( Hochachka, 1986 ). (biologists.org)
  • A prevailing experimental approach has been to probe tissues from natural models of hypoxia-tolerant and cold-tolerant vertebrates to look for common mechanisms of defence against O 2 lack and hypothermia. (biologists.org)
  • Like humans, most mammals possess little naturally evolved tolerance to severe hypoxia or hypothermia, and their excitable cells and tissues are normally debilitated by any prolonged exposure to either condition. (biologists.org)
  • Even in the case of advanced Alzheimer's disease, a person is ultimately not declared dead because of the loss of personhood, but as a consequence of secondary whole brain death or cardiac and respiratory arrest. (alcor.org)
  • 1 I. Introduction Capnography monitors the concentration of CO2 in the respiratory gases, which is a rapid and reliable method to detect life-threatening conditions, such as malposition of endotracheal tubes, unsuspected ventilatory or circulatory failure, and defective breathing circuits. (sportdocbox.com)
  • When a venous infusion of maintenance fluids was started, the patient immediately went into cardio-respiratory arrest and was pronounced dead after resuscitation efforts failed. (clearlinemd.com)
  • With increasingly more frequent concomitant use of platelet-inhibiting drugs, clinicians must be cognizant of the ramifications of hypothermia on platelet function as part of hemostasis. (biomedcentral.com)
  • Those with severe spasm unresponsive to treatment may also be clipped to allow the use of more marked induced hypertension. (healthdrugpdf.com)
  • Most affected children develop in the liver, and mature there or in cases of severe degree or with dry skin and induce sleep. (bac.edu)
  • Deep coma and other manifestations of severe CNS depression are rare. (inchem.org)
  • However, there is a paucity of data regarding the impact of deep hypothermia duration on perioperative bleeding. (bvsalud.org)
  • The objective of the current study was to examine the relationship between the duration of deep hypothermia and perioperative bleeding. (bvsalud.org)
  • Log linear modeling with Poisson regression was used to analyze the relationship between deep hypothermia duration and perioperative bleeding, while controlling for other preselected variables. (bvsalud.org)
  • The relationship between deep hypothermia duration and perioperative bleeding is dependent on CPB time. (bvsalud.org)
  • Activation of neutrophils is considered as one of the key mechanisms underlying CPB-induced inflammation (Butler et al. (springeropen.com)