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KMID : 0356919770100020027
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Korean Journal of Anesthesiology
1977 Volume.10 No. 2 p.27 ~ p.40
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Clinical Study of Hypothermia Technique Undergoing Open Heart Surgery
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Abstract
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Total surgical corrections of complicated heart defects with the aid of moderate hypothermic and extracorporeal circulation in conjunction with light general anesthesia were undertaken since 1963 in Yonsei Medical Center.
In order to determine the better hypothermic technique, 39 cases were divided into 2 groups.
While in group 1 we performed the cardio-pulmonary by-pass with heat exchanger using only core cooling techniques, in group 2 we used combined surface and core cooling techniques.
The results obtained are summerized as follows;
1. Mean rectal temperatures just before by-pass in group 1 and 2 were 36.5 and 33.5℃ respectively and a moderate hypothermic state after by-pass was obtained about 15 minutes earlier in group 2 than in group 1.
2. Mean arterial pressures during by-pass in group 1 were higher than in group 2. Therefore chlorpromazine was required more often in group 1.
3. Arterial oxygen and carbon dioxide tensions (uncorrected) were maintained with about 100-300 and 32-40 mmHg during by-pass in both groups.
4. Arterial pH and base excess in group 1 during by-pass were lower than in group 2, therefore sodium bicarbonate injections were required more often in group 1.
5. The incidence of use of the electrical defibrillator at the end of the main surgical procedure was higher in group 1. There were 5 post-operative intrapericardial bleeding cases in group 1 and 2 cases in group 2. There was 1 post-operative mortality case in each group.
From the above results, it may be concluded that combined surface and core cooling in conjunction with light general anesthesia, proved to be the better method to provide optimal working conditions for the surgeon.
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