Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The increase in the number of cardiac operations has brought about an increase in aortic pathology that requires reoperation. The aim of the present study was to evaluate axillary artery cannulation in aortic reoperations. We operated on 23 patients diagnosed with acute type A aortic dissection (13 patients), chronic type A aortic dissection (7 patients), aortic pseudoaneursym (2 patients), and arcus aorta aneurysm (1 patient). The right axillary artery was cannulated directly or through a side graft which was anastomosed to the artery. Antegrade cerebral perfusion with moderate degree hypothermia was used for cerebral protection. Four patients were lost after the operation (17.4%) and no cerebral complications were encountered. Axillary artery cannulation provides safe reentry to the chest and provides good cerebral protection in aortic reoperations.
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PMID:Aortic reoperations: experience with 23 patients using axillary artery cannulation. 1639 5

The changes in gastric mucosal perfusion during distal aortic perfusion with femoro-femoral bypass (F-F bypass) were assessed by air-automated gastric tonometry. A prospective study was performed in six patients who underwent descending aortic surgery for aortic aneurysm under F-F bypass with mild hypothermia (34 degrees C). Gastric intramucosal pH (pHi) and PaCO2-PgCO2 gap (PCO2 gap) were measured. Data are presented as means and standard deviations and analyzed by using one-way analysis of variance followed by Scheffe test. Perioperative variables of hepatorenal functions are also evaluated. The PCO2 gap significantly increased during F-F bypass (3.0 +/- 2.1 mm Hg at control, 14.2 +/- 5.5 mm Hg during F-F bypass; p = 0.004), indicating abnormal gastric mucosal perfusion during F-F bypass. Significantly low pHi was found at weaning from F-F bypass (7.35 +/- 0.05 at control, 7.21 +/- 0.10 at weaning; p = 0.009), which might be related to progressing systemic metabolic acidosis. No impairment of hepatorenal functions was observed after the surgery. Distal perfusion with F-F bypass during descending aortic surgery could impair the gastric mucosal perfusion, but may have little effect on postoperative visceral dysfunction.
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PMID:Gastric intramucosal perfusion during descending aortic repair under femoro-femoral bypass. 1643 96

Surgical emergencies embrace the fields of general and visceral surgery (e.g. unclear/acute abdomen, blunt abdominal trauma, perianal venous thrombosis), vascular surgery (e.g.: venous and arterial bleeding, aortic aneurysm), accident, hand and plastic surgery (e.g. dislocations, fractures, amputation injuries, penetrating injuries, burns, hypothermia, complicated trauma, thoracic trauma). The prehospital treatment options discussed in the present article represent the current state of the art.
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PMID:[Prehospital care of surgical emergencies]. 1688 87

The present study reports the effects of systemic deep hypothermia (SDH) and subarachnoid block (SAB) on the longitudinally conducting evoked spinal cord potential (conducting ESCP) in man. Before induction of anesthesia, a pair of bipolar catheter electrodes was introduced to the epidural space: one at the level of the cervical enlargement and the other at the lumbosacral enlargement. The conducting ESCP was produced by electrical stimulation through the upper electrode and recorded through the lower electrode, and vice versa. SDH Study: Subjects were 6 patients who underwent replacement surgery of an aortic aneurysm with deep hypothermia anesthesia. The peak latency of the ESCP was gradually prolonged and the duration was widened with cooling via extracorporeal circulation. The amplitude of ESCP showed a biphasic change over the course of cooling with a turning point of around 30 degrees C in esophageal temperature. The ESCP was well observed until blood temperatures as low as near 10 degrees C. The result shows that ESCP is available as an intra-operative monitoring parameter of the spinal function even under SDH. SAB Study: Subjects were 7 patients, 6 of whom had SAB and the remaining 1 intravenous application of a local anesthetic. The conducting ESCP was markedly depressed or disappeared completely even after SAB with clinical doses of various local anesthetics, while it was hardly affected by the intravenous application. The result implies that SAB causes, at least partially, the conduction block within the spinal cord.
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PMID:Effects of systemic deep hypothermia and subarachnoid block on the longitudinally conducting evoked spinal cord potentials in man. 1704 91

Traumatic injuries to the thoracic aorta consequent on closed chest traumas present an extremely severe and unfavourable condition as regards natural history. One of the specific disease variants lies in the formation of false post-traumatic aortic aneurysm with an arteriovenous fistula. In the presence of post-traumatic aneurysm of the thoracic aorta with an arteriovenous fistula, the disease course may be complicated by the phenomena of circulatory decompensation. Taking into account certain features of the morphology and pathogenesis of the given disease, surgical interventions require strict adherence to a number of the rules which make it possible to avoid intraoperative aneurysmal rupture. The present paper describes a case of successful surgical treatment of acute false post-traumatic aneurysm of the aortic arch with an arteriovenous fistula under profound hypothermia and circulatory arrest. Presented herein is also a review of the literature concerned with the topic.
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PMID:[Surgical treatment of false post-traumatic aneurysm of the aortic arch with arteriovenous anastomosis]. 1705 74

No postoperative paraplegia occurred in a patient whose leg myogenic motor evoked potentials (mMEPs) disappeared during thoracoabdominal aortic aneurysm repair. A 69-year-old man underwent resection and repair of a type III (Crawford classification) thoracoabdominal aneurysm. An epidural catheter was placed into the epidural space for epidural cooling, and a Swan-Ganz catheter was placed into the subarachnoid space for cerebrospinal fluid (CSF) drainage. Continuous CSF pressure and temperature measurement was carried out the day before surgery. The mMEPs gradually disappeared 10 min after proximal double aortic clamping and complete aortic transection. Selective perfusion of intercostal arteries was started about 20 min after the loss of the mMEPs, but the mMEPs were not restored. Possibly, spinal cord hyperemia, induced by selective perfusion of the intercostal vessels, narrowed the subarachnoid space so that CSF could not be satisfactorily drained during surgery. The spinal cord hyperemia may have decreased spinal function and suppressed the leg mMEPs. The persistence of the loss of mMEPs was undeniably due to the influence of the anesthetic agent or a perfusion disorder in the lower-extremity muscles. Of note, moderate spinal cord hypothermia and postoperative CSF drainage probably resulted in improved lower-limb motor function.
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PMID:Prolonged loss of leg myogenic motor evoked potentials during thoracoabdominal aortic aneurysm repair, without postoperative paraplegia. 1707 99

A 79-year-old man underwent aortic arch replacement for thoracic aortic aneurysm. He had a history of smoking, coronary stenting for ischemic heart disease and replacement with artificial blood vessel for abdominal aortic aneurysm. Anesthesia was induced and maintained with midazolam, fentanyl, sevoflurane, and vecuronium. A 20 gage catheter was placed in the right radial artery and a 22 gage catheter in the left posterior tibial artery. Total circulatory arrest under profound hypothermia and retrograde cerebral perfusion were performed using extracorporeal circulation. After finishing anastomosis with artificial blood vessel, he was weaned from extracorporeal circulation. The pressure in the left posterior tibial artery was maintained at 15 mmHg, although the blood pressure in the right radial artery increased gradually. Then, the pressure in the left femoral artery in the operative field was the same as the pressure in the right radial artery. Therefore, we suspected the arterial line occlusion of the left posterior tibial artery. After the operation, we found the left leg and foot pale and cold with no pulsation on the left popliteal, dorsal pedis, and posterior tibial arteries. Further, acute left popliteal arterial occlusion was assessed by means of Doppler and left lower extremity angiography. We immediately performed the balloon-catheter embolectomy. However, as he developed compartment syndrome on the left lower limb due to reperfusion injury postoperatively, fascitomy was performed. On the 58th postoperative day, he was discharged from our hospital. Measurement by Doppler is useful for the early diagnosis of the lower leg arterial occlusion.
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PMID:[Acute popliteal arterial occlusion during extracorporeal circulation]. 1713 97

Wiskott-Aldrich syndrome is a primary immunodeficiency characterized by infections, thrombocytopenia, and eczema. We present a 33-year-old man with this syndrome who underwent a one-stage ascending aorta, aortic arch and descending aortic aneurysm repair under moderate hypothermia and continuous visceral and cerebral perfusion. Histologic examination showed the presence of an aortitis with granulomatous inflammatory response and multinucleated cells.
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PMID:One-step surgical approach of a thoracic aortic aneurysm in Wiskott-Aldrich syndrome. 1738 80

We report a case in which a thoracoabdominal aneurysm was present in association with previously unknown critical spinal canal stenosis. In spite of using left heart bypass, systemic hypothermia, and controlled cerebrospinal fluid drainage for spinal cord protection, the patient developed paraplegia following aortic aneurysm repair. Computed tomography scan revealed critical stenosis of the spinal canal that was thought to be sufficient to produce spinal cord compression syndromes including paraplegia.
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PMID:Coincidence of spinal canal stenosis and thoracoabdominal aortic aneurysm. 1754 Oct 1

Prediction model for lethal outcome after operation for thoracoabdominal aortic aneurysm (TAAA) has been constructed based on assessment of preoperative risk factors. The main risk factors of lethal outcome at TAAA repair are: Crawford's operation (OR 12.25), deep hypothermia and circulatory arrest (OR 10.86), renal failure (OR 6.8), coronary heart disease (OR 2.49), chronic non-specific lung diseases (OR 2.29), age >50 years (OR 2.18), TAAA of II type by Crawford (OR 2.12). The prognostic system permits to access individual risk with high accuracy including at the patients with combination of different risk factors.
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PMID:[Prediction of surgical outcome for thoracoabdominal aortic aneurysm]. 1816 17


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