Colder is better during hypothermic circulatory arrest for acute type a aortic dissection. (April 2013)

• Record Type: Journal Article
• Authors: Legras, Antoine; Bruzzi, Matthieu; Nakashima, Kuniki; Hillion, Marie-Line; Loisance, Daniel; Kirsch, Matthias
• Is Part Of: Scandinavian cardiovascular journal. Volume 47:Number 2(2013:Apr.)
• Page Start: 121
• Page End: 128
• Publication Date: 2013-04
• Subjects: Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.3109/14017431.2012.743673
• Languages: English
• ISSNs: 1401-7431

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives</italic>. To evaluate the influence, on early postoperative outcomes, of temperature during hypothermic circulatory arrest in emergent surgery for acute type A aortic dissection. <italic>Design.</italic> Hypothermic circulatory arrest (HCA) with antegrade cerebral perfusion was performed in 63 patients who underwent emergent surgery for acute type A aortic dissection between 2000 and 2009. Patients were retrospectively separated in two groups: (<xref ref-type="bibr" rid="CIT0001">1</xref>) deep HCA, lowest nasopharyngeal temperature < 17°C (<italic>n = </italic>29; 46%) and (<xref ref-type="bibr" rid="CIT0002">2</xref>) moderate HCA, lowest nasopharyngeal temperature ≥ 17°C (<italic>n = </italic>34; 54%). <italic>Results</italic>. Hospital mortality reached 27%. The nasopharyngeal temperature did not influence postoperative mortality or neurological outcome. Patients with deep HCA had significantly lower rate of infection (33% <italic>vs</italic> 69%; p = 0.009) and shorter median intensive care unit length of stay (4 days (<xref ref-type="bibr" rid="CIT0017">17</xref>) <italic>vs</italic> 15.5 days (<xref ref-type="bibr" rid="CIT0026">26</xref>) p = 0.017). Multiple regression analysis revealed that the lowest nasopharyngeal temperature was the only significant variable associated with intensive care unit length of stay (p = 0.005). <italic>Conclusions</italic>. Patients suffering from acute type A aortic dissection might benefit from colder hypothermia during circulatory arrest.</p> </abstract>