ABSTRACT
OBJECTIVE: Deep hypothermic circulatory arrest may be associated with increased neural injury. We investigated whether short periods of deep hypothermic circulatory arrest are associated with altered neurophysiologic recovery or greater risk of injury. METHODS: Eighteen term infants with transposition of the great arteries undergoing the arterial switch operation were enrolled. Deep hypothermic circulatory arrest was used in 11, and bypass alone in 7. Near-infrared spectroscopy and amplitude-integrated electroencephalography were recorded with standard monitoring during and from 4 to 16 h after surgery. Fractional tissue oxygen extraction was determined from arterial oxygen saturation and venous weighted intracerebral oxygenation. Magnetic resonance imaging was performed before and 5 to 7 days after surgery. RESULTS: There were no significant differences between patients requiring deep hypothermic circulatory arrest (median, 5 min; range, 3-6 min) or cardiopulmonary bypass only at the beginning of surgery. At the end of surgery, amplitude-integrated electroencephalography minimum amplitude was significantly lower in the deep hypothermic circulatory arrest group (P < .05), and fractional tissue oxygen extraction tended to be lower (P = .068). After surgery, deep hypothermic circulatory arrest was associated with significantly higher tissue oxygenation index, lower fractional tissue oxygen extraction, and lower core temperature (P < .05). Magnetic resonance imaging-defined white matter injuries before and after surgery were similar between groups. CONCLUSIONS: In this prospective, observational study, brief deep hypothermic circulatory arrest during arterial switch was associated with reduced cerebral oxygen uptake during recovery, with transient electroencephalographic suppression but no increase in risk of white matter injury.
Subject(s)
Brain/blood supply , Cardiac Surgical Procedures/adverse effects , Cerebrovascular Circulation , Circulatory Arrest, Deep Hypothermia Induced/adverse effects , Oxygen Consumption , Transposition of Great Vessels/surgery , White Muscle Disease/etiology , Analysis of Variance , Animals , Body Temperature Regulation , Brain/metabolism , Brain/pathology , Cardiopulmonary Bypass/adverse effects , Diffusion Magnetic Resonance Imaging , Electroencephalography , Female , Humans , Infant, Newborn , Male , Monitoring, Intraoperative/methods , Predictive Value of Tests , Prospective Studies , Risk Factors , Spectroscopy, Near-Infrared , Time Factors , Transposition of Great Vessels/diagnosis , Transposition of Great Vessels/physiopathology , Treatment Outcome , White Muscle Disease/diagnosis , White Muscle Disease/metabolism , White Muscle Disease/physiopathologyABSTRACT
There have been many instances of livestock congenital defects in Trinidad and Tobago; however, this case is an interesting one because of the number of defects observed and systems involved in an individual animal. A 2-day-old male Anglo Nubian kid was presented to The University of the West Indies, Faculty of Medical Sciences, School of Veterinary Medicine. The kid was weak, unable to walk, unable to stand and had not suckled since birth, unlike its twin. After detailed physical examination the kid was euthanized and subsequent post mortem examination and histological analysis of tissues revealed atresia ani, numerous muscular defects, severe hepatic necrosis and ankylosis of the joints, strongly suggesting a possible complicated case of White Muscle Disease.
Subject(s)
Animals , Goats/abnormalities , White Muscle Disease/complications , White Muscle Disease/pathology , White Muscle Disease/physiopathology , Ankylosis/complications , Ankylosis/epidemiology , Trinidad and TobagoABSTRACT
Descreve-se um surto de distrofia muscular nutricional em ovinos no semi-árido Nordestino. Foram afetados animais de 3-4 meses de idade, da raça Dorper, pesando 30-40 kg. Os animais eram alimentados, à vontade, com leite, ração balanceada, capim Tifton e sal mineral. Dos 70 animais Dorper, 6 adoeceram e morreram em um período de 48 horas. Apresentaram temperatura, entre 40 e 41ºC, incoordenação com posterior paralisia e decúbito, depressão, prostração e diminuição dos reflexos pupilar e de ameaça, flacidez da língua e mandíbula, salivação, edema submandibular, dispnéia e aumento da freqüência cardíaca. A morte ocorreu após curso clínico de 6- 12 horas. Na necropsia de 3 animais, os músculos esqueléticos estavam de coloração pálida, o fígado estava aumentado de volume e de coloração amarelada, os gânglios parotídeos, submandibulares, retrofaríngeos, prescapulares e mediastínicos estavam aumentados de volume e avermelhados e os pulmões apresentavam áreas vermelhas. Na histologia havia necrose segmentar de todos os músculos examinados e congestão dos gânglios linfáticos e pulmão. Posteriormente mais três animais adoeceram, sendo tratado com oxitetraciclina e complexo vitamínico A,D e E. Desses 3 animais, 2 morreram e um sobreviveu. Na mesma fazenda havia e não adoeceram 20 ovinos da raça Santa Inês, da mesma idade que os animais afetados, que recebiam a mesma alimentação exceto o leite, e 900 ovinos de outras idades. A superalimentação em animais com rápido crescimento e o estresse causado pela restrição de água durantes 2 dias, para aumentar o consumo de leite, parecem ter sido fatores predisponentes para a ocorrência da doença. É possível, também, que algum dos minerais suplementados tenha antagonizado o Se presente na alimentação.
