Details

Autor(en) / Beteiligte

• Almond, Carl H.
• Jones, John C.
• Snyder, H. Martin
• Grant, Stanley M.
• Meyer, B.W.

Titel

COOLING GRADIENTS AND BRAIN DAMAGE WITH DEEP HYPOTHERMIA

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 1964-12, Vol.48 (6), p.890-897

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

1964

Quelle

MEDLINE

Beschreibungen/Notizen

• Mental changes have been reported by several investigators following operations with the use of cardiopulmonary bypass.1-6 The reasons for these changes have been numerous: emboli of calcium, muscle, air,7 fat,3,10 fibrin, silicon,9,11 denatured protein,8 and other factors, such as too rapid warming5 or cooling.4 Brain damage has been reported following cardiac operations utilizing surface cooling,2 cardiopulmonary bypass with moderate cooling and deep cooling, with or without an oxygenator, by Drew,4,5 Björk,1 Ehrenhaft,6 and Brierley.2 Examination of the brain following death in our own patients who had been cooled rapidly with the use of profound hypothermia demonstrate brain damage. Björk reported brain damage as the cause of death in 5 children undergoing cardiac operations in which deep hypothermia was used with various types of perfusion. Drew4,5 found mental changes in his first 3 patients who were operated upon after a change was made from a relatively inefficient heat exchanger to an efficient one. After first considering this as a problem of rewarming he found that the symptoms could be prevented by maintaining the cooling gradient (difference between the temperature of venous blood removed from the animal and arterial blood returned) between 10° and 15° C. This experiment is devised to determine whether the width of the cooling gradient during cardiopulmonary bypass has an effect upon brain damage in the dog.