Hypermetabolic Response After Hypothermic Cardiopulmonary Bypass

Chiara, O; Giomarelli, P.; Biagioli, Bonizella; Rosi, R; Gattinoni, Luciano

doi:10.1097/00132586-198810000-00043

Cited by 17 publications

(25 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This rebound after rewarming might be due to a proposed hypermetabolic response after induced hypothermia, as it was described after cardiopulmonary bypass surgery. 34 The brain temperatures of all 25 patients were consistently higher than body-core temperatures, confirming previous data that showed a significant gradient between body-core and brain temperatures in neurotrauma patients. 35,36 This may be explained by the high metabolic activity of cerebral tissue with considerable production of heat.…”

Section: Discussionsupporting

confidence: 87%

Moderate Hypothermia in the Treatment of Patients With Severe Middle Cerebral Artery Infarction

Schwab

Schwarz

Spranger

et al. 1998

Stroke

599

351

View full text Add to dashboard Cite

Background and Purpose-Animal research and clinical studies in head trauma patients suggest that moderate hypothermia may improve outcome by attenuating the deleterious metabolic processes in neuronal injury. Clinical studies on moderate hypothermia in the treatment of acute ischemic stroke patients are still lacking. Methods-Moderate hypothermia was induced in 25 patients with severe ischemic stroke in the middle cerebral artery (MCA) territory for therapy of postischemic brain edema. Hypothermia was induced within 14Ϯ7 hours after stroke onset and achieved by external cooling with cooling blankets, cold infusions, and cold washing. Patients were kept at 33°C body-core temperature for 48 to 72 hours, and intracranial pressure (ICP), cerebral perfusion pressure, and brain temperature were monitored continuously. Outcome at 4 weeks and 3 months after the stroke was analyzed with the Scandinavian Stroke Scale (SSS) and Barthel index. The side effects of induced moderate hypothermia were analyzed. Results-Fourteen patients survived the hemispheric stroke (56%). Neurological outcome according to the SSS score was 29 (range, 25 to 37) 4 weeks after stroke and 38 (range 28 to 48) 3 months after stroke. During hypothermia, elevated ICP values could be significantly reduced. Herniation caused by a secondary rise in ICP after rewarming was the cause of death in all remaining patients. The most frequent complication of moderate hypothermia was pneumonia in 10 of the 25 patients (40%). Other severe side effects of hypothermia could not be detected. Conclusions-Moderate hypothermia in the treatment of severe cerebral ischemia is not associated with severe side effects.Moderate hypothermia can help to control critically elevated ICP values in severe space-occupying edema after MCA stroke and may improve clinical outcome in these patients. (Stroke. 1998;29:2461-2466.)

show abstract

Section: Discussionsupporting

confidence: 87%

Moderate Hypothermia in the Treatment of Patients With Severe Middle Cerebral Artery Infarction

Schwab

Schwarz

Spranger

et al. 1998

Stroke

599

351

View full text Add to dashboard Cite

show abstract

“…Ocorre aumento da água extravascular pulmonar 19 com preenchimento alveolar por células inflamatórias que levam à inativação do surfactante pulmonar e colabamento de algumas áreas, com modificação na relação ventilação/perfusão pulmonar, diminuição da complacência e aumento do trabalho respiratório. A produção de CO 2 depende do metabolismo do organismo que pode ser alterado pela anestesia e pela temperatura corporal, sendo que esta interfere também na solubilidade do gás no sangue 16,20 . Além disso, em pacientes submetidos à cirurgia cardíaca pode ocorrer barocompressão da microvasculatura 18 , além do possível embolismo por micropartículas que aumentam o espaço morto fisiológi-co 8 .…”

Section: Discussionunclassified

“…There is increase in extravascular pulmonary water 19 with alveolar filling by inflammatory cells which leads to pulmonary surfactant inactivation and collapsing of some areas, with changes in pulmonary ventilation/perfusion ratio, decreased patency and increased respiratory work. CO 2 production depends on body metabolism which may be changed by anesthesia and body temperature, this latter also interfering with blood gas solubility 16,20 . In addition, microvasculature barocompression may be observed in patients submitted to cardiac surgery 18 , as well as potential embolism by microparticles which increases physiological dead space 8 .…”

Section: Discussionmentioning

confidence: 99%

Avaliação da correlação entre o dióxido de carbono expirado e o débito cardíaco em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea

Miyaji

Buscati

Rodriguez

et al. 2004

Rev. Bras. Anestesiol.

View full text Add to dashboard Cite

RESUMO BACKGROUND AND OBJECTIVES: End-tidal carbon dioxide (P ET CO 2 ) not only reflects pulmonary ventilation but also carbon dioxide production (metabolism) and pulmonary blood supply (circulation). During constant metabolism and ventilation, P ET CO 2 reflects pulmonary blood perfusion, thus cardiac output (CO). This study aimed at evaluating the correlation between P E T C O 2 l e v e l s a n d C O d u r i n g c a r d i a c s u r g e r y wi t h cardiopulmonary bypass (CPB). METHODS: Participated in this study

show abstract

“…Increased O 2 consumption and CO 2 production caused by postoperative hypermetabolism are known to follow CABG ( 23, 24). In our study, the recovering respiratory function and increased alertness were probably increasing the metabolic demand.…”

Section: Discussionmentioning

confidence: 99%

The effect of sedation on weaning following coronary artery bypass grafting: propofol versus oxycodone‐thiopental

Leino

Nunes

Valta

et al. 2000

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Propofol infusion and oxycodone-thiopental bolus dosages, titrated to the same sedation end point, resulted in similar time from admission to extubation, although the weaning period was shorter in the propofol group. In terms of breathing pattern, gas exchange, blood gases and haemodynamics, the methods were similar. Propofol, despite its attractive pharmacological profile, may offer no clinical benefit in short-term sedation after a moderate dose fentanyl anaesthesia in cardiac surgery.

show abstract

Hypermetabolic Response After Hypothermic Cardiopulmonary Bypass

Cited by 17 publications

References 0 publications

Moderate Hypothermia in the Treatment of Patients With Severe Middle Cerebral Artery Infarction

Moderate Hypothermia in the Treatment of Patients With Severe Middle Cerebral Artery Infarction

Avaliação da correlação entre o dióxido de carbono expirado e o débito cardíaco em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea

The effect of sedation on weaning following coronary artery bypass grafting: propofol versus oxycodone‐thiopental

Contact Info

Product

Resources

About