Book contents
- Cardiopulmonary Bypass
- Cardiopulmonary Bypass
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Human Factors and Teamwork in Cardiac Surgery
- Chapter 2 Equipment for Cardiopulmonary Bypass
- Chapter 3 Monitoring during Cardiopulmonary Bypass
- Chapter 4 Cardiopulmonary Bypass Circuit Setup and Safety Checks
- Chapter 5 Priming Solutions for Cardiopulmonary Bypass Circuits
- Chapter 6 Anticoagulation for Cardiopulmonary Bypass
- Chapter 7 Conduct of Cardiopulmonary Bypass
- Chapter 8 Minimal Invasive Extracorporeal Circulation
- Chapter 9 Considerations for Operations Involving Deep Hypothermic Circulatory Arrest
- Chapter 10 Metabolic Management during Cardiopulmonary Bypass
- Chapter 11 Myocardial Preservation during Cardiopulmonary Bypass
- Chapter 12 Weaning from Cardiopulmonary Bypass
- Chapter 13 Intraoperative Mechanical Circulatory Support and Other Uses of Cardiopulmonary Bypass
- Chapter 14 Mechanical Circulatory Support
- Chapter 15 Cardiopulmonary Bypass for Pediatric Cardiac Surgery
- Chapter 16 Coagulopathy and Hematological Disorders Associated with Cardiopulmonary Bypass
- Chapter 17 Inflammation and Organ Damage during Cardiopulmonary Bypass
- Chapter 18 Neuromonitoring and Cerebral Morbidity Associated with Cardiopulmonary Bypass
- Chapter 19 Renal Morbidity Associated with Cardiopulmonary Bypass
- Chapter 20 Common and Uncommon Disasters during Cardiopulmonary Bypass
- Index
- References
Chapter 9 - Considerations for Operations Involving Deep Hypothermic Circulatory Arrest
Published online by Cambridge University Press: 24 October 2022
Book contents
- Cardiopulmonary Bypass
- Cardiopulmonary Bypass
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Human Factors and Teamwork in Cardiac Surgery
- Chapter 2 Equipment for Cardiopulmonary Bypass
- Chapter 3 Monitoring during Cardiopulmonary Bypass
- Chapter 4 Cardiopulmonary Bypass Circuit Setup and Safety Checks
- Chapter 5 Priming Solutions for Cardiopulmonary Bypass Circuits
- Chapter 6 Anticoagulation for Cardiopulmonary Bypass
- Chapter 7 Conduct of Cardiopulmonary Bypass
- Chapter 8 Minimal Invasive Extracorporeal Circulation
- Chapter 9 Considerations for Operations Involving Deep Hypothermic Circulatory Arrest
- Chapter 10 Metabolic Management during Cardiopulmonary Bypass
- Chapter 11 Myocardial Preservation during Cardiopulmonary Bypass
- Chapter 12 Weaning from Cardiopulmonary Bypass
- Chapter 13 Intraoperative Mechanical Circulatory Support and Other Uses of Cardiopulmonary Bypass
- Chapter 14 Mechanical Circulatory Support
- Chapter 15 Cardiopulmonary Bypass for Pediatric Cardiac Surgery
- Chapter 16 Coagulopathy and Hematological Disorders Associated with Cardiopulmonary Bypass
- Chapter 17 Inflammation and Organ Damage during Cardiopulmonary Bypass
- Chapter 18 Neuromonitoring and Cerebral Morbidity Associated with Cardiopulmonary Bypass
- Chapter 19 Renal Morbidity Associated with Cardiopulmonary Bypass
- Chapter 20 Common and Uncommon Disasters during Cardiopulmonary Bypass
- Index
- References
Summary
Deep hypothermic circulatory arrest (DHCA), either alone or in combination with other perfusion strategies, has become the mainstay of vital organ protection for a variety of pathologies and surgical procedures that necessitate the complete cessation of blood flow. DHCA provides a near blood-less operating field, albeit of limited duration, while ameliorating the major adverse consequences of vital organ ischemia.Cooling of the brain – the organ at greatest ischemic risk – reduces cerebral metabolic rate, extending the period of "safe" ischemia from 3-4 minutes at normothermia to >20 minutes.
Keywords
- Type
- Chapter
- Information
- Cardiopulmonary Bypass , pp. 80 - 91Publisher: Cambridge University PressPrint publication year: 2022
References
Suggested Further Reading
Arrowsmith, JE, Ganugapenta, MSSR. Intraoperative brain monitoring in cardiac surgery. In Bonser, R, Pagano, D, Haverich, A (Eds.). Brain Protection in Cardiac Surgery. London: Springer-Verlag. 2011. pp.83–111.Google Scholar
Chan, MJ, Chung, T, Glassford, NJ et al. Near-Infrared spectroscopy in adult cardiac surgery patients: a systematic review and meta-analysis. J Cardiothorac Vasc Anesth. 2017; 31(4): 1155–1165.CrossRefGoogle ScholarPubMed
Ghadimi, K, Gutsche, JT, Setegne, SL et al. Severity and duration of metabolic acidosis after deep hypothermic circulatory arrest for thoracic aortic surgery. J Cardiothorac Vasc Anesth 2015; 29(6): 1432–1440.CrossRefGoogle ScholarPubMed
James, ML, Anderson, MD, Swaminathan, M et al. Predictors of electrocerebral inactivity with deep hypothermia. J Thorac Cardiovasc Surg 2014; 147(3): 1002–1007.CrossRefGoogle ScholarPubMed
Krüger, T, Hoffmann, I, Blettner, M et al. Intraoperative neuroprotective drugs without beneficial effects? Results of the German Registry for Acute Aortic Dissection Type A (GERAADA). Eur J Cardiothorac Surg 2013; 44(5): 939–946.CrossRefGoogle Scholar
Misfeld, M, Leontyev, S, Borger, MA et al. What is the best strategy for brain protection in patients undergoing aortic arch surgery? A single center experience of 636 patients. Ann Thorac Surg 2012; 93(5): 1502–1508.CrossRefGoogle ScholarPubMed
Scheeren, TWL, Kuizenga, MH, Maurer, H et al. Electroencephalography and brain oxygenation monitoring in the perioperative period. Anesth Analg 2019; 128(2): 265–277.CrossRefGoogle ScholarPubMed
Steppan, J, Hogue, CW Jr. Cerebral and tissue oximetry. Best Pract Res Clin Anaesthesiol 2014; 28(4): 429–439.CrossRefGoogle ScholarPubMed
Vuylsteke, A, Sharples, L, Charman, G et al. Circulatory arrest versus cerebral perfusion during pulmonary endarterectomy surgery (PEACOG): a randomized controlled trial. Lancet 2011; 378(9800): 1379–1387.CrossRefGoogle Scholar
Etz CD, , Weigang E, , Hartert M, et al.Contemporary spinal cord protection during thoracic and thoracoabdominal aortic surgery and endovascular aortic repair: a position paper of the vascular domain of the European Association for Cardio-Thoracic Surgery, European Journal of Cardio-Thoracic Surgery, 2015, 47(6): 943–957.Google Scholar