HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moat, N. E. Articles by Monro, J. L. Search for Related Content PubMed PubMed Citation Articles by Moat, N. E. Articles by Monro, J. L.

European Journal of Cardio-Thoracic Surgery, Vol 6, 579-584, Copyright © 1992 by European Association for Cardio-thoracic Surgery

ARTICLES

Induced hypothermia in the management of refractory low cardiac output states following cardiac surgery in infants and children

NE Moat, RK Lamb, JC Edwards, J Manners, BR Keeton and JL Monro
Wessex Cardiothoracic Centre, Southampton General Hospital, UK.

Post-operative low cardiac output states remain a major cause of mortality following cardiac surgery in infants and children. Since 1979 we have used moderate induced whole-body hypothermia in the management of low-output states refractory to conventional modes of therapy. This is based not only upon the relationship between body temperature and oxygen consumption, but also on experimental work showing a beneficial effect of cooling upon myocardial contractility, particularly when there is pre-existing impairment of ventricular function. Between July 1986 and June 1990, 20 children with refractory low-output states were cooled by means of a thermostatically controlled water blanket to a rectal temperature of 32-33 degrees C. The median age was 12 months (1 week-11 years) with a median weight of 6 kg (3.5-33 kg). Ten children survived to leave hospital while a further two made a haemodynamic recovery. There was a marked reduction in heart rate (P < 0.001). The mean arterial pressure rose (P = 0.037) while there was a fall in mean atrial pressure (P < 0.001). There was a significant improvement in the urine output (P = 0.002). A fall in the platelet count (P < 0.001) was not accompanied by any change in the white cell count (P = 0.15). Although it is impossible to say whether cooling influenced the outcome in any of these children, it was usually effective in stabilising their clinical condition. The technique is simple and has a sound theoretical basis.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				M. E. Lewis, A.-H. Al-Khalidi, J. N. Townend, J. Coote, and R. S. Bonser The effects of hypothermia on human left ventricular contractile function during cardiac surgery J. Am. Coll. Cardiol., January 2, 2002; 39(1): 102 - 108. [Abstract] [Full Text] [PDF]

				J. Li, I. Schulze-Neick, C. Lincoln, D. Shore, M. Scallan, A. Bush, A. N. Redington, and D. J. Penny OXYGEN CONSUMPTION AFTER CARDIOPULMONARY BYPASS SURGERY IN CHILDREN: DETERMINANTS AND IMPLICATIONS J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 525 - 533. [Abstract] [Full Text] [PDF]

				M. J.R. Dalrymple-Hay, C. D. Deakin, H. Knight, J. C. Edwards, B. Keeton, A. P. Salmon, and J. L. Monro Induced hypothermia as salvage treatment for refractory cardiac failure following paediatric cardiac surgery Eur. J. Cardiothorac. Surg., April 1, 1999; 15(4): 515 - 518. [Abstract] [Full Text] [PDF]