Application and comparison of moderate and deep hypothermic circulatory arrest during adult aortic arch surgery / 中华胸心血管外科杂志

ABSTRACT

Objective To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) during aortic arch surgery in the adult patients,to offer the evidence for the detection of which temperature provides best brain protection in the subjects who accept the great aortic surgery.Methods A total of 109 patients undergoing the surgery of aortic arch were divided into the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.We recorded the characters of the patients and their cardiopulmonary bypass time,aortic clamping time,cerebral perfusion time and postoperative recovery time,tracheal intubation time,time of intensive care unit (ICU) and postoperative cognitive dysfunction.Results Patients' characteristics were similar in two groups.All the patients were cured.There were no significant differences in aortic clamping time of each group [(111.4 ± 58.4) min vs.(115.9 ± 16.2) min];selective cerebral perfusion time [(27.4 ± 5.9) min vs.(23.5 ±6.1) min] of the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.There were significant differences in the cardiopulmonary bypass time[(207.4 ± 20.9) min vs.(263.8 ± 22.6) min],the postoperative recovery time [(19.0 ± 11.1) h vs.(36.8 ± 25.3) h],intubation time [(46.4 ± 15.1) h vs.(64.4 ± 6.0)h];length of ICU [(4.7 ± 1.7) d vs.(8.± 2.3) d],and postoperative cognitive dysfunction of the two groups.Conclusion Compared to the deep hypothermic circulatory arrest,the moderate hypothermic circulatory arrest can provide better brain protection and achieve good clinical results.