Cerebral ischemia: deep hypothermia

Clinical - Neurologic

Cerebral ischemia can occur hours after DHCA, because CBF and CVR are deranged for several hours after temperatures return to normal.

Deep Hypothermic Circulatory Arrest

  • 15-22 degrees Celsius (maintain for ~ 30 mins prior to stopping circulation
  • Verify isoelectric brain prior to stopping circulation
  • Rapid surgery is beneficial , nothing else has been shown to help
  • 45 to 60 minutes is upper limit of safe time period
  • Circulate cold blood 5-10 minutes prior to rewarming (wash out metabolites) and consider selective cerebral perfusion (may extend safety margin to 90 minutes)
  • Cerebral ischemia can occur several hours after DHCA

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Answered correctly

2009

Year asked