YANG Jiuguang , LNG Cun , SUN Lizhong , et al .
  • 1. Department of Cardiopulmonary Bypass, Cardiovascular Institute and Fuwai IIospital, CAMS ＆ PUMC;;
  • 2. Department of Vascular Surgery, Cardiovascular Institute and Fuwai Hospital, CAMS ＆ PUMC, Beijing 100037, P. R. China ;;
  • 3. Department of Anesthesiology, Beijing Union IIospital , CAMS ＆. PUMC , Beijing 100730, P. R. China;
Cardiopulmonary bypass; Steady cooling ＆ rewarming; Cold reperfusion; Aortic arch replacement; Cerebral protection
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To compare the outcome of patients with the strategy of conventional and steady cooling ＆ rewarming and cold reperfusion , who suffered from DeBakey type Ⅰ aortic dissection or aortic arch aneurysm and underwent the total aortic arch replacement. Methods Thirty-two patients who underwent total arch replacement were randomly allocated to one of two strategies of temperature management in cardiopulmonary bypass （CPB）, conventional group （group C, 16 cases） and steady cooling ＆. rewarming and cold reperfusion group （group S, 16 cases）. The jugular bulb venous oxygenation saturation （SjvO2）, jugular bulb venous oxygen tension （PivO2） and jugular bulb venous blood temperature （JVBT） were tested or monitored during the operation. Preoperative and postoperative neurological examinations and brain computerized tomography scan were performed. Results All patients survived the operations and were discharged from hospital. No new brain infarction occurred. Transient neurologic dysfunction occurred in 2 patients of the group S and 3 patients of the groupC. The “cooling ＆ rewarming blanket-impress puple” occurred in 4 cases of the group C. The SjvO2, PjvO2, lowest nasopharyngeal temperature and the post operative nasopharyngeal temperature of the patients in group S were significantly higher than those of the patients in group C （SjvO2 0.85±0. 11 vs. 0. 74±0.23, PjvO2 36. 9± 15.6mmHg vs. 24.5±7.7mmHg, P（ 0.01 ）. While the highest brain temperature, wake time and ICU stay in group S were remarkably lower than those in group C （P 〈0. 01,0. 05）. Conclusion With less postbypass afterdrop and satisfactory clinical outcome, the strategy of steady cooling ＆ rewarming and cold reperfusion can effectively avoid brain hyperthermia and mismatch of cerebral blood flow metabolism in the surgery of total aortic arch replacement.

Citation： YANG Jiuguang,LNG Cun,SUN Lizhong,et al .. Management of Temperature in Total Aortic Arch Replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2005, 12(5): 312-315. doi: Copy