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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Filling the pericardial sac with ice and saline during open heart surgery protects the myocardium during periods of ischemic arrest. Bilateral diaphragmatic paralysis complicated intense local hypothermia in five patients undergoing coronary artery bypass surgery. All complained of severe orthopnea, exertional dyspnea, insomnia, and excessive daytime somnolence. All exhibited paradoxic inward movement of the abdominal wall with inspiration. The diagnosis of bilateral diaphragmatic paralysis was confirmed with upright and supine spirometry and, in one patient, with transdiaphragmatic pressure measurements. Although paralysis has resolved in four patients, all experienced months of disabling impairment. One patient required four months of mechanical ventilatory support prior to her recovery. Alternative methods of intraoperative myocardial preservation that avoid this complication should be developed.
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PMID:Bilateral diaphragmatic paralysis complicating local cardiac hypothermia during open heart surgery. 633 67

Topical cardiac hypothermia has been shown to be a safe and effective means of providing protection for the ischemic myocardium during aortic cross-clamping. We report herein two cases of postoperative bilateral diaphragmatic paralysis which we believe resulted from hypothermic injury to the phrenic nerves. After open-heart surgery, both patients experienced prolonged weaning from assisted ventilation and severe orthopnea. Return of normal diaphragmatic and phrenic nerve function was demonstrated in one patient ten months after surgery. Failure to correctly interpret the respiratory failure and orthopnea led to confusion and erroneous types of therapy. Awareness of this complication should lead to improved care and postoperative management of patients.
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PMID:Bilateral diaphragmatic paralysis following topical cardiac hypothermia. 660 35

We report on a rare case of a 65-year-old woman who was admitted with orthopnea (NYHA class IV) and a single syncopal episode. A transthoracic echocardiography examination showed a 7x6x6-cm mass located in the right atrium and perfusion lung scan showed embolization. Complete surgical removal of the right atrial myxoma and tumor embolectomy was successfully performed with deep hypothermia and circulatory arrest. Histologic investigations of the primary tumor as well as the emboly revealed benign myxoma. Six months clinical and echocardiographical follow-up showed a satisfactory exercise tolerance, a normal right atrium and a good ventricular function. Thirteen years later, the patient remains well and no recurrence could be observed.
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PMID:Successful surgical treatment of a right atrial myxoma complicated by pulmonary embolism. 1767 Jan 21