Value of mild hypothermia in patients who have severe circulatory insufficiency even after intra-aortic balloon pump

Journal of Clinical Anesthesia
N YahagiS Takamoto

Abstract

To evaluate the effectiveness of mild hypothermia in postcardiac surgical patients with severe heart failure in spite of conventional medical therapy and the use of intra-aortic balloon pumping (IABP). Prospective, clinical study. Teaching hospital. 10 postcardiac surgical patients with severe heart failure despite the use of IABP with massive doses of catecholamine. Patients underwent mild hypothermia produced by surface cooling (to approximately 34.5 degrees C). Hemodynamic criteria for the induction of hypothermia included a cardiac index (CI) of less than 2.2 L/min/m2 with a pulmonary capillary wedge pressure (PCWP) of up to 18 mmHg despite the use of IABP with massive doses of catecholamine. After control measurements had been taken at normal core body temperature (37 degrees C), patients were cooled to approximately 34.5 degrees C (using a cooling blanket and gastric lavage with cold water) to decrease tissue oxygen (O2) demand. Patients showed significant improvements in CI (1.9 +/- 0.3 to 2.2 +/- 0.3 L/min/m2), mixed venous O2 saturation, (SvO2; 55 +/- 7 to 64 +/- 6%), and urine output (2.1 +/- 1.1 to 3.4 +/- 2.2 ml/kg/hr). Patients were rewarmed while SvO2 was being monitored. The duration of the hypothermia was 38 +/-...Continue Reading

References

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Citations

Jan 5, 2002·Journal of the American College of Cardiology·Michael E LewisRobert S Bonser
Oct 1, 1973·British Journal of Urology·K JonssonL Ling
Mar 29, 2014·Therapeutic Hypothermia and Temperature Management·Cynthia Ocegueda-PachecoKees H Polderman
Apr 22, 2014·The Journal of Thoracic and Cardiovascular Surgery·Yu DuXue Feng
Jul 30, 2015·Therapeutic Hypothermia and Temperature Management·David J L ZughaftMatthias Götberg
Oct 5, 2010·Congestive Heart Failure·Mark A ThompsonHector Ventura
Jun 9, 2005·Critical Care Medicine·Michael HolzerFritz Sterz
Jul 9, 2003·Critical Care Medicine·Stephen A Bernard, Michael Buist
Jun 26, 2009·Critical Care Medicine·Kees H Polderman
May 19, 2000·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·E Diczfalusy
Mar 5, 2021·Frontiers in Cardiovascular Medicine·Kelly P YamadaKiyotake Ishikawa

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