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Chapter 10 - Deep hypothermic circulatory arrest

Published online by Cambridge University Press:  15 December 2009

Sunit Ghosh ,
Florian Falter  and
David J. Cook
By
Joe Arrowsmith  and
Charles W. Hogue
Sunit Ghosh
Affiliation:
Papworth Hospital, Cambridge
Florian Falter
Affiliation:
Papworth Hospital, Cambridge
David J. Cook
Affiliation:
Mayo Clinic, Minnesota
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Summary

The majority of cardiac surgical procedures are accomplished using cardioplegia-induced cardiac arrest with cardiopulmonary bypass (CPB) to maintain perfusion to other organs. Preservation of organ function during the period of total circulatory arrest can be aided by reducing the core temperature of the body. The technique of core cooling combined with cessation of blood flow is termed deep hypothermic circulatory arrest (DHCA). The long duration of surgery with DHCA mandates careful attention to prevent pressure sores and inadvertent damage to the eyes, nerve plexuses, peripheral nerves and pressure points. The use of DHCA during surgery of the distal aorta via left thoractomy presents several problems. Reversing the direction of blood flow in the superior vena cava (SVC) has been advocated as a means of improving brain protection during DHCA and extending the period of safe DHCA.

Keywords

blood transfusioncardiopulmonary bypass circuitcolloidoxygen-carrying solutionshematocritcrystalloid
Type
Chapter
Information
Cardiopulmonary Bypass , pp. 125 - 139
Publisher: Cambridge University Press
Print publication year: 2009

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