Circulatory Arrest under Hypothermic Anesthesia Using Abdominal Cavity Cooling

Abstract

The purpose of this study was to investigate the potential for circulatory arrest during surgery under systemic hypothermie anesthesia, using the abdominal cavity cooling method. Eighteen beagles, each weighing 10.5 ± 2.3 kg, were cooled by filling the abdominal cavity with crushed ice. Just after the esophageal temperature reached 30°C, the heart was exposed, and a left-heart bypass from the left atrium to the aortic root was created. At 20-23°C. the heart was arrested by infusing cooled Young's solution into the aortic root. After a period of cardiac arrest, resuscitation and rewarming were initiated simultaneously. Throughout these procedures, an electrocardiogram (ECG) and the arterial blood pressure (ABP) were monitored continuously. Hematocrit (Ht), total protein (TP), and arterial blood pH and gases were measured every 30 min. The recoveries after surgery were divided into three types as follows, 1) recovery without any complications-11 dogs, 2) not extubated with spontaneous breaihing-4 dogs, 3) no reappearance of heart beat-3 dogs. PaO2 during resuscitation was significantly higher in dogs which recovered completely than in the rest of the dogs. These results suggest that hypothermia induced by the abdominal cavity cooling method could be useful for organ-protection during open-heart surgery, and that successful recovery may be attained through protection of the lung as well as the myocardium.