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Chapter 24 - Temperature Management and Deep Hypothermic Arrest

from Section 5 - Cardiopulmonary Bypass

Published online by Cambridge University Press:  12 May 2020

By
Charles W. Hogue  and
Joseph E. Arrowsmith
Edited by
Joseph Arrowsmith ,
Andrew Roscoe  and
Jonathan Mackay
Joseph Arrowsmith
Affiliation:
Royal Papworth Hospital, Cambridge
Andrew Roscoe
Affiliation:
Singapore General Hospital
Jonathan Mackay
Affiliation:
Royal Papworth Hospital, Cambridge
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Summary

In animals that maintain body temperature within a tight range (homeotherms), thermoregulation represents the balance between heat production (thermogenesis) and heat loss. Thermogenesis occurs as a result of metabolic activity, particularly in skeletal muscle, the kidneys, the brain, the liver and (in infants) adipose tissue. Body heat is lost by conduction, convection, radiation and evaporation (Table 24.1). Cold-induced hypothalamic stimulation activates autonomic, extra-pyramidal, endocrine and behavioural mechanisms to maintain the core temperature.

Type
Chapter
Information
Core Topics in Cardiac Anaesthesia , pp. 191 - 198
Publisher: Cambridge University Press
Print publication year: 2020

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References

Further Reading

Arrowsmith, JE, Hogue, CW. Deep hypothermic circulatory arrest. In Ghosh, S, Falter, F, Perrino, AC (eds), Cardiopulmonary Bypass, 2nd edn. Cambridge: Cambridge University Press; 2015, pp. 152–67.Google Scholar
Dorotta, I, Kimball-Jones, P, Applegate, R 2nd. Deep hypothermia and circulatory arrest in adults. Semin Cardiothorac Vasc Anesth 2007; 11: 66–76.CrossRefGoogle ScholarPubMed
Ginsberg, S, Solina, A, Papp, D, et al. A prospective comparison of three heat preservation methods for patients undergoing hypothermic cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2000; 14: 501–5.CrossRefGoogle ScholarPubMed
Grigore, AM, Murray, CF, Ramakrishna, H, Djaiani, G. A core review of temperature regimens and neuroprotection during cardiopulmonary bypass: does rewarming rate matter? Anesth Analg 2009; 109: 1741–51.CrossRefGoogle ScholarPubMed
Hogue, CW Jr, Palin, CA, Arrowsmith, JE. Cardiopulmonary bypass management and neurologic outcomes: an evidence-based appraisal of current practices. Anesth Analg 2006; 103: 21–37.CrossRefGoogle ScholarPubMed
Khaladj, N, Shrestha, M, Meck, S, et al. Hypothermic circulatory arrest with selective antegrade cerebral perfusion in ascending aortic and aortic arch surgery: a risk factor analysis for adverse outcome in 501 patients. J Thorac Cardiovasc Surg 2008; 135: 908–14.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Clinical Guidance 65. Perioperative hypothermia (inadvertent). April 2008. www.nice.org.uk/guidance/CG65 (accessed December 2018).Google Scholar
National Institute for Health and Care Excellence. Intervention Practice Guideline 386. Therapeutic hypothermia following cardiac arrest. March 2011. www.nice.org.uk/guidance/ipg386 (accessed December 2018).Google Scholar
Nielsen, N, Wetterslev, J, Cronberg, T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med 2013; 369: 2197–206.CrossRefGoogle Scholar
Polderman, KH, Varon, J. How low should we go? Hypothermia or strict normothermia after cardiac arrest? Circulation 2015; 131: 669–75.CrossRefGoogle Scholar

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