Induced Moderate Hypothermia in Aortic Rupture With Retroperitoneal Bleeding: A Randomized Porcine Study.

IF 1.6 Q2 SURGERY
Artai Pirouzram, Maria Wikström, Thomas Larzon, Éva Tamás, Kristofer F Nilsson
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引用次数: 0

Abstract

Objective: Induced hypothermia improves outcome in aortic arch surgery, neonatal neurointensive care, and transplant surgery for example. In contrast, spontaneous hypothermia has been associated with worse outcomes in patients suffering from hemorrhagic shock, mostly explained by its adverse effects on the coagulation system. We investigated if induced hypothermia would impair short-term survival in experimental aortic rupture with retroperitoneal bleeding.

Methods: Anesthetized pigs were randomized into 2 groups: hypothermia by peritoneal lavage of ice-cold Ringer's acetate and external cooling (n = 10) and normothermia (n = 10). Aortic rupture with retroperitoneal bleeding was induced by endovascular means creating a 6 mm hole in the retroperitoneal portion of abdominal aorta. Survival (primary outcome), hemodynamics, and arterial blood gases including lactate were collected and analyzed up to 180 min after aortic rupture.

Results: The body temperature (mean ± standard deviation) in the hypothermic group was 31.5 ± 1.0 °C and 38.7 ± 0.4 °C in the normothermic group at the time for aortic rupture. Survival up to 180 min after the retroperitoneal bleeding was significantly higher in the hypothermic compared with the normothermic group (P = 0.023).

Conclusions: Induced hypothermia did not impair survival in this experimental retroperitoneal aortic bleeding model in anesthetized pigs. This finding may indicate a minor role for the coagulation system in this type of bleeding.

主动脉破裂伴腹膜后出血时的中度低温诱导:一项随机猪研究。
目的:诱导低体温可改善主动脉弓手术、新生儿神经重症监护和移植手术等的预后。与此相反,自发低体温与失血性休克患者的不良预后有关,这主要是由于低体温对凝血系统的不利影响。我们研究了诱导低体温是否会影响实验性主动脉破裂伴腹膜后出血患者的短期存活率:方法:将麻醉猪随机分为两组:通过腹腔灌洗冰冷的醋酸林格氏液和外部冷却进行低体温(n = 10)和正常体温(n = 10)。腹主动脉破裂伴腹膜后出血是通过血管内方法在腹主动脉腹膜后部分开一个 6 毫米的小孔诱发的。收集并分析了主动脉破裂后 180 分钟内的存活率(主要结果)、血液动力学和动脉血气(包括乳酸):结果:主动脉破裂时,低体温组的体温(平均值 ± 标准差)为 31.5 ± 1.0 °C,常温组为 38.7 ± 0.4 °C。与体温正常组相比,低体温组腹膜后出血后180分钟内的存活率明显更高(P = 0.023):结论:诱导低体温不会影响麻醉猪腹膜后主动脉出血模型的存活率。这一发现可能表明凝血系统在这类出血中的作用较小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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